Inspection on 02/08/06 for George Leonard Rest Home

This inspection was carried out on 2nd August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

George Leonard Rest Home 16/03/10

George Leonard Rest Home 05/03/09

George Leonard Rest Home 28/11/05

George Leonard Rest Home 11/04/05

George Leonard Rest Home 04/10/04

George Leonard Rest Home 27/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE George Leonard Rest Home 237 - 239 Oldbury Road Rowley Regis West Midlands B65 0PP Lead Inspector Mrs Cathy Moore Unannounced Inspection 2nd August 2006 07:10 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service George Leonard Rest Home Address 237 - 239 Oldbury Road Rowley Regis West Midlands B65 0PP Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0121 561 4984 0121 561 1783 Mr S B Odedra Mr R S Odedra Miss Christine Stanton Care Home 23 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (23) of places George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 23 OP and up to 3 DE(E) at any one time not exceeding the total number registered for. 28/11/05 Date of last inspection Brief Description of the Service: George Leonard Care Home is located on a main road between Blackheath and Whiteheath . A number of local shops and other facilities are available within easy reach of the home including a main bus route. The home originally comprised of two semi-detached police houses that have been linked together, converted and extended to provide the 23 bedded care home, as it now consists. The home has a small garden and a car parking space for approximately five cars to the front of the property and a good sized garden to the rear. The home comprises of two storeys . The ground floor houses the office, lounge, dining room, conservatory, kitchen, one of the assisted bathrooms and toilets. The first floor houses bedrooms, toilets and the second assisted bathroom. The home provides 19 single and 2 double bedrooms. 10 single and both double bedrooms are provided with en-suite facilities. George Leonard is registered with the Commission for Social Care Inspection to provide care to a maximum of 23 residents who have needs that fall within the category of old age, 3 of these places at any one time can be allocated to older people who have a diagnosis of dementia. Weekly fees for this home range from £335-£370. Additional charges include; hairdressing, private chiropody, newspapers, toiletries, transport and some hobbies. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one inspector over one day between 07.10 and 18.10 hours. Prior to the inspection a pre-inspection questionnaire was sent to the home for completion and a number of resident questionnaires. The completed preinspection questionnaire together with 21 resident questionnaires were returned to aid inspection preparation and focus. Nine residents’, two relatives and four staff were spoken to during the inspection. The manager was involved in the whole of the inspection. Three residents’ were ‘case tracked’ this process involves looking at their experiences and records/care delivery in detail. Three staff files were examined to focus on supervision, recruitment and training. Medication and safety were assessed together with records concerning quality assurance, health and safety and maintenance. The premises were randomly assessed to include the communal areas, garden, five bedrooms, two bathrooms, the laundry and kitchen. Breakfast and lunch times were briefly observed as were general interactions between staff and residents’. What the service does well: This home continues to improve across all areas. It is extremely positive that so much work has been carried out by the staff and manager to achieve these improvements. The atmosphere in the home is friendly and welcoming. The home actively encourages residents to maintain contact with family and friends. Visitors confirmed that they are made to feel welcome and comfortable. It is extremely positive that 21 of the 21 completed resident questionnaires received confirmed that ‘ Staff listen and act on what they say’. All staff have received accredited medication training. The manager is competent experienced and knowledgeable. She has a positive attitude and is keen to ensure that the residents in her care receive a good quality service. The manager offers staff guidance and support. The staff are motivated, confident and professional, yet kind, caring and approachable. Staff /resident interactions observed during the inspection were positive. With staff being polite and courteous to residents and giving them choices where possible. Residents’ showing that they were confident to approach staff and make requests. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 6 Care planning and health and personal care delivery are good. As is record keeping and the management of systems. The inspection day was very positive with positive comments from staff, residents and relatives examples being; “ The staff look after me”. “ The staff are lovely”. What has improved since the last inspection? What they could do better: George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 7 Very few requirements have been made following this inspection . Fees applicable in terms and condition documents must be accurate and up to date. One main area for improvement is the premises. Although work has been carried out the premises still appear dull and dreary. Re-decoration work is needed and new carpets are needed in corridors, on landings and in some bedrooms. Activity provision needs further exploration. A realistic activity budget must be allocated to the home. Dedicated activity hours ( an activities co-ordinator) must be provided no less than 20 hours per week. Meal provision also needs further exploration to ensure that food offered is satisfactory to each resident. A cleaner must be provided 7 days per week. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4. The overall outcome for this group of standards is judged to be good. Resident contract/terms and conditions require some ‘fine tuning’. No resident moves into the home without having their needs assessed and being assured that these will be met. EVIDENCE: 16 of the 21 completed questionnaires received confirmed that they had been given enough information before they were admitted to the home to enable them to make the decision that the home would be suitable for them, 5 stated that they had not but offered some explanation for this; “ My granddaughter made the choice for me”. “ Social Services placed me here due to my old home closing”. Positive comments were received as follows; “ I heard it was very good and I was right to think so”. “ A member of staff spent time with me and my family (at the home) to explain how it is run”. It is positive that 21 of the 21 completed resident questionnaires received confirmed that they had all been issued with a contract. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 10 A contract was seen in place on each resident file examined. Documents provided however should be a contract for residents who are self funding and terms and conditions for those who are being funded by a local authority. A separate document /contract should also be available where a third party charge has been agreed. The fee detailed on the terms and conditions and contract should be current and up to date. A discussion was held with the manager about the amended Care Home Regulations concerning fees and terms and conditions coming in to affect September 2006. The home has a good assessment of need process and documentation in place. A copy of this documentation was on files viewed. Information from funding authorities was also on file as was a letter to each resident confirming that the home can meet their needs. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. The overall outcome for this group of standards is judged to be good. Generally, residents needs are set out in an individual plan and their personal and health care needs are being met. Medication systems are robust and safe. Residents’ feel that they are treated with respect. EVIDENCE: A care plan was seen for each resident who was case tracked. Care plans have a set format and were seen to be of a good standard. However, it was identified that the signs and symptoms of urinary retention were not recorded for one resident who is prone to this condition. It was positive that written evidence was available to demonstrate that residents’ have been involved with the production of their care plan. One relative was very complimentary about the home. Her relative had been in another home for a short stay but had to move as a bed was no longer available. She said, “I was very annoyed about the move and when I came to look here I did not like it . It appeared very cramped. However, when I came George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 12 two days later I couldn’t believe it. My.. was more talkative, mixing with other residents’ and sociable than I have ever seen in my life. .. was happy. Catheter care is better than it has ever been. You can see that staff are encouraging fluids by the colour of urine. In the other home .. had to go to hospital twice because of catheter blockage. The hospital was not pleased”. 17 of the 21 completed resident questionnaires confirmed that they always received the care and support needed, 4 usually. 20 of the 21 confirmed that they always receive the medical support they need, 1 usually. There was documentary evidence available to demonstrate risk assessments for nutrition, tissue viability and falls. Evidence of professional visits from the chiropodist, optician, doctors and district nurses. There was however, very limited records of dental assessments. A visiting district nurse confirmed, “there is adequate communication between the home and ourselves. They always follow the instructions that we give”. New documentation to record personal care delivery was implemented on August 1 2006, which is working well. However, negotiation and encouragement or advice needs to be given and secured for one resident who has incontinence problems which are causing a body odour. It is extremely positive that certificates were available to demonstrate that all staff who have responsibility for medications have received accredited medication training. The manager or one of the secured consultants undertake regular medication audits to ensure compliance with medication processes and safety. The homes pharmacy provider also carries out as part of the contract between them and the home at least half yearly medication audits. Medication systems were seen to be robust and safe. Medications counted when received into the home and recorded if being returned to the chemist. No initial gaps were identified on medication records. The home has a controlled drug register for the recording of controlled drugs. A risk assessment was seen for the one resident who self medicates their inhaler. The preferred name for each resident is determined on admission, recorded and used. It is positive that each resident has been asked if they object to their care being delivered by a staff member of opposite gender. The district nurse confirmed that nursing assessments and treatments are always carried out in the residents’ bedroom. This observed during the inspection. One area that needs further consideration is the hairdressing provision. As there is no hairdressing room in the home hairs are dried in the conservatory. Residents’ should be asked individually if this is acceptable or not. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. The overall outcome for this group of standards is judged to be good. Generally, the lifestyle experienced in the home meets resident requirements although activity provision needs further improvement. Residents are very much encouraged to maintain contact with family and friends They are helped to exercise choice and control over their lives. Further development is needed in respect of meals provided. EVIDENCE: On arrival at the home at 07.15 hours ten residents were already up, washed and dressed in the lounge areas. Four of the residents’ were asked if they minded getting up at this time. Their answers were positive and included; “ No I like getting up early. Oh no, I don’t like staying bed.” “ I like to get up at about 7 o’clock, always have”. It is positive that rising and retiring times and general preferences concerning daily routines have been explored and determine individually with residents ‘ the findings recorded on their files. Activity provision whilst it has been improved needs further improvement. There was no evidence of a set activity budget and no dedicated hours set aside per week for activity provision. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 14 One resident commented, “ I would like to go out to the shop or somewhere. Sometimes all I do is sit here”. She did however, also say, “ I love doing painting”. She proudly showed some pictures on cards that she had painted or coloured in. The manager was able to demonstrate that activity provision takes place using records and photographic evidence of events such as the Christmas party for relatives and residents’. Two representatives from different churches visit the home regularly to give communion and services. The hairdresser comes to the home for a full day every Wednesday. An activity schedule was available for the week of the inspection however, activity participation records did not mirror activities offered. General feedback from the staff team suggested that activity provision could be improved upon to include community trips and outings. 7 of the 21 completed resident questionnaires received confirmed that the home always arranged activities that they could take part in, 7 usually and 6 sometimes. Comments received included the following; “ I enjoy doing bingo and exercises”. “ Would be nice if there were more”. The home has open visiting arrangements but discourages visits at meal times. Visiting times are displayed in the front entrance hall. Residents spoken to confirmed that they receive visitors. Visitors confirmed that they were made to feel welcome by the staff as follows; “When I visit they always offer me a drink”. “ staff make me feel welcome”. Written materials concerning external advocacy services were available within the home. Residents bedrooms viewed held a range of personal belongings ranging from pictures and ornaments to televisions and furniture. The home has a set menu. This offers 4 meals per day breakfast, lunch, tea and supper. Daily menus are available in the home. Staff were heard asking residents what they would like for their breakfast and after breakfast asking what they would like for their lunch from two choices. Food eaten by residents’ is recorded daily. The breakfast and main meal were observed. Breakfast offered consisted of a range of cereals, toast and scrambled egg. Lunch toad in the hole or cottage pie, carrots, broccoli and potatoes followed by apple strudel and custard. The food looked well cooked, smelt nice and was nicely presented. One resident did comment that; “ Some meals I do not like, they do not agree with me. I do like cabbage, lettuce and tomatoes which they give me”. Another resident after their lunch said; “ That was nice”. 7 of the 21 completed resident questionnaires received confirmed that they always liked the meals at the home, 10 usually and 3 sometimes. It was positive that fresh fruit was seen in lounge areas. Staff were on hand during meals to give assistance to those who needed it. Meals are discussed in resident meetings this area however, does need further exploration. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. The overall outcome for this group of standards is judged to be good. Residents and relatives are confident that their complaints will be listened to and acted upon. Generally systems are in place to prevent abuse. EVIDENCE: No complaints have been received by the home or the CSCI for some time. The home has a written complaints procedure which is available within the home. 17 of the 21 completed resident questionnaires received confirmed that they always know who to speak to if they are not happy and 4 usually. 16 of the completed resident questionnaires received confirmed that they always know how to make a complaint, 3 usually and 1 sometimes. Comments received included the following;” I would go to the office and speak to staff or the manager”. “Unsure how to make a complaint- I would tell the staff”. There have been no allegations or incidents of abuse for over a year at the home. Policies and procedures are in place including Sandwell Council’s Multi-agency policies and procedures. It is positive that all staff are to attend Sandwell Councils’ abuse awareness training. The manager has attended their higher abuse management training, the deputy due to attend this in the autumn. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. The overall outcome for this group of standards is judged to be adequate. The general internal appearance and environment is letting the home down. Some work is needed in terms of infection control. EVIDENCE: Although the premises are safe and to some extent comfortable, the overall impression is ‘dingy’. This confirmed by one visitor who said; “When first seeing the home my impression was cramped and poor”. Another person visiting the home said that the home appeared;” Dark and dreary”. It has possibly been some time since the living areas were redecorated, wall paper is ripped in places, woodwork past its best. New chairs have been provided in the lounges and one bedroom has had new carpets. The dining room furniture is past its best, with odd chairs and tables that move. Carpets in corridors and landings have seen better days. Toilets George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 17 and bathrooms generally are in need of redecoration with the exception of the one on the first floor which is of a good standard. The home has a good size garden at the rear however, due to incline much of the grass area is not usable. There is a patio area outside the lounge doors with garden furniture for resident and visitor use. One bedroom highlighted during the inspection had a very strong malodour. It was identified that there is only one sink in the laundry instead of the required two. 20 of the 21 completed resident questionnaires received confirmed that ‘the home is always fresh and clean’. One comment received was as follows; “ The home could be cleaned better in bedrooms”. At the present time there is not always a cleaner provided every day which is in the process of being resolved. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. The overall outcome for this group of standards is judged to be good. Residents’ needs are met by the skill mix and numbers of staff. The home has not to day met the required 50 attainment of staff achieving NVQ level 2 or above in care. Residents are supported and protected by the homes recruitment practices. Staff are generally trained and competent to do their jobs. EVIDENCE: Staffing is provided as follows; AM one senior and three carers. PM one senior and two carers. Night either one senior and one carer or two seniors. The manager is on site 5 days per week at least between the hours of 9-5. There was no suggestion from any source that the home was short staffed. In fact for the first time in many years it is fully staffed with regard to care staff. 16 of the 21 completed resident questionnaires received confirmed that ‘staff are always available when they are needed’, 4 usually. One comment received was as follows; “ Sometimes they are busy and we have to wait for a little while”. The manager is in the process of appointing some bank carers to cover holidays and sickness. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 19 It is extremely positive that 21 of the 21 completed resident questionnaires received confirmed that ‘ Staff listen and act on what they say’. Positive comments were received about the staff and included; ”The staff look after me”. “The staff are lovely”. Staff seen during the inspection looked confident and professional. They were kind and caring and responded to the residents’ positively. The manager has made arrangements for a number of staff to commence onto an NVQ programme to address the present shortfall of only 25 of the care staff having NVQ. The manager stated that she was having difficulty finding funding for seniors to commence on a NVQ level 3 course. Generally, recruitment processes and practices are being complied with. A staff file containing evidence of CRB/POVA list check was available for the hairdresser but not the chiropodist. There was evidence of induction for new staff. The new Skills for Care induction standards were seen on site. The manager was able to provide an up-to-date training matrix. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38. The overall outcome for this group of standards is judged to be good. The manager has been approved as a fit person to be in charge of the home. She is extremely competent and knowledgeable and demonstrates excellent leadership skills. The home is run in the best interests of the residents. Residents financial interests are safeguarded. Staff are appropriately supervised. Generally the home promotes health and safety practices which only need some ‘fine tuning’. EVIDENCE: The manager was employed by the home in September 2005. Since that time the home has improved considerably across all areas. She has a positive attitude and is keen to improve and maintain high standards in the home to benefit the residents in her care. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 21 The manager has achieved NVQ level 4 in both care and management and also has achieved her Registered Managers Award. Staff and relatives commented positively about the manager as follows; “ Things have improved since the new manager came. We have support and guidance and more training opportunities”. “ The manager has helped me resolve a problem with my relatives placement she took the pressure of me for that I am very thankful”. Quality assurance systems have progressed considerably since the last inspection. A cycle if action and review is in operation together with a monitoring system. Questionnaires are used on a regular basis to gain the views of staff, relatives, residents and other stakeholders. The registered providers authorise appropriate persons to carryout monthly visits to the home to audit service delivery. The home holds money for a number of residents. The money for 3 residents was checked. Balances were correct and the total money available was correct against balances. Receipts were available to confirm expenditure. In general evidence was available to confirm that all staff are receiving one to one supervision. This proven further by verbal confirmation by staff. Health and safety, maintenance and mandatory training was checked and examined. Service certificates were available for equipment and fire fighting appliances. Risk assessments and processes were seen to be in place an example being; the checking of hot water temperatures and the fire alarm system. In general mandatory training either has been received or has been arranged. It is concerning that one night staff member does not have the required training as it is difficult to attend. This situation is unacceptable and must be resolved. The home has had a new kitchen with stainless steel appliances/units which has improved the kitchen considerably. It was noted that the fridge needs a good clean and water temperatures were not high enough. Both of these issues must be addressed. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 2 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 3 x 3 3 x 2 George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP2 Regulation 5(1)(b) Requirement Timescale for action 10/09/06 2 OP7 15(1)(a) 3 OP8 13(1)(b) The registered persons must ensure that; Social services funded residents are issued with a terms and conditions document not contract. Private payers are issued with a contract. A separate document is produced and put into operation concerning third party payments. Fee rates detailed are current. The registered persons must 15/08/06 ensure that the signs and symptoms of urinary retention are detailed in the care plan of any resident who is prone or at risk from urinary retention. The registered persons must be 01/10/06 able to demonstrate that dental assessments are offered to every resident at least annually. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 24 4 OP8 12(1)(a) 12(1)(b) 5 OP10 12(4)(a) 6 OP12 16(2)(n) (m) The registered persons must manage the situation where incontinence or refusal of personal hygiene is causing an offensive body odour. This may mean asking the continence advisor to assess. And that accurate records to prove this are made. The registered persons must be able to demonstrate that each resident has been asked their views about hair drying by the hairdresser being carried out in the conservatory. The registered persons must; Provide evidence to the CSCI of the amount of activity budget allocated to the home in years 2005/2006 and 2006/2007. Provide a dedicated activity coordinator no less that 20 hours per week. Ensure that any resident who wants to has the opportunity to be taken out at least in the local community or to the shops. Explore activity provision further to make sure that activity, recreational and stimulation needs are met. The registered persons must explore meal provision further to ensure that it meets with the needs and wishes of the residents. The registered persons must explore ways to make the home brighter and more attractive. Feedback from this exercise must be provided to the CSCI. 15/08/06 01/09/06 01/10/06 7 OP15 16(2)(i) 10/09/06 8 OP19 23(2)(b) 01/10/06 George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 25 9 OP19 23(2)(d) The registered persons must; Purchase all new dining room tables and chairs. Replace carpets in corridors and landings. Redecorate the lounges and dining room. Redecorate toilets and bathrooms. 01/12/06 10 OP26 13(3) 11 OP26 16(2)(k) 12 OP26 18(1)(a) The registered persons must install a second sink in the laundry for ‘ hand washing’ purposes. The registered persons must manage and eradicate the strong odour present in the bedroom identified during the inspection to the manager. The registered providers and manager must ensure dedicated domestic hours are increased on a daily basis and must cover seven days. (Timescale of 01/05/05 not fully met). 01/11/06 01/09/06 10/09/06 13 OP28 18(1)(a) The registered persons must ensure that at all times at least 50 of the care staff have NVQ level 2 or above. 01/02/07 George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 26 14 OP29 13(6) 19(2) 15 OP38 18(1)(a) 23(4)(d) The registered persons must ensure that the chiropodist has all of the required checks carried out to include an application for an enhanced CRB/ POVA list check. In the interim risk minimising control measures must be implemented. The registered providers and manager must ensure that ALL STAFF have or receive the following : First aid, moving and handling/ hoist training. (Timescales of 12.12.04,01/06/05 and 01/02/06 not fully met). Appropriate actions must be taken where staff refuse to receive training. 01/09/06 01/10/06 16 OP38 13(4)(d) 17 OP38 13(3) 18 19 OP38 OP38 13(3) 13(3) The registered persons must ensure and be able to evidence that the homes trainer is competent to train staff for example in fire safety. The registered persons must ensure that hot water to the required temperature is available in the kitchen at all times. The registered persons must ensure that the fridge is adequately cleaned at all times. The registered persons must purchase new chopping boards for the kitchen. 01/09/06 10/08/06 10/08/06 12/08/06 George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP26 Good Practice Recommendations The registered providers and manager should consider employing dedicated laundry staff. George Leonard Rest Home DS0000004797.V305892.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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