Inspection on 02/11/05 for Georgian House Nursing Home

This inspection was carried out on 2nd November 2005.

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

Georgian House Nursing Home 07/09/06

Georgian House Nursing Home 19/07/05

Georgian House Nursing Home 20/01/05

Georgian House Nursing Home 19/07/04

Georgian House Nursing Home 23/12/03

Georgian House Nursing Home 03/06/03

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

CARE HOMES FOR OLDER PEOPLE Georgian House Nursing Home 20 Lyncroft Gardens Ealing London W13 9PU Lead Inspector Ms Jean Bovell Unannounced Inspection 2nd November 2005 11:30 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 Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 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. Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Georgian House Nursing Home Address 20 Lyncroft Gardens Ealing London W13 9PU 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) 020 8567 6232 020 8567 1955 Mr and Mrs Hopley Mrs Margaret Hopley Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability over 65 years of age (0), of places Terminally ill (0) Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 28 medical beds for the elderly of which 4 patients may be received for palliative care. 19th July 2005 Date of last inspection Brief Description of the Service: Georgian House Nursing home is registered with the CSCI as a care home with nursing for 28 older people, four of whom may receive palliative care. The building comprises two semi-detached houses combined into one detached property, with parking at the front and a large landscaped garden and patio to the rear. There are twelve single and eight double bedrooms. Communal facilities include a large lounge and a separate dining room. The property is on a quiet residential street, not very far from central Ealing. Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out between 11.30 am and 4.30 pm on 2nd November 2005. The Sister in Charge, two Registered Mental Nurses, five care support workers and 25 service users were present. The Inspector was advised that the Registered Manager was not expected at the home that day. Discussions were held with two Registered Mental Nurses, one care support worker, ten service users and one visiting relative. A tour of the building was undertaken, records and policies were examined and observations were made. The Standards that were not covered at the last inspection and the requirements made, were examined at this inspection. The Sister in Charge was co-operative and provided appropriate assistance throughout the inspection. What the service does well: The home has maintained a qualified and experienced staff group of many years. This has benefited the service users by providing continuity of good working relationships. Members of the care support staff group who spoke to the Inspector expressed satisfaction with the support they received from the Registered Manager and also from within the staff team. They were observed to respond competently to the needs of the service users. The service users appeared well cared for, appropriately dressed and comfortable within their environment. They reported being happy with the standard of care provided at the home, a view similarly expressed by a relative who visited the home during the inspection. The home’s policies and procedures were satisfactory and indicated that the best interests of the service users were being safeguarded. The home was found to be clean, hygienic and well maintained throughout. The environment was safe, calm and homely. Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: 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. Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 7 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 Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 8 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, 5 and 6. Requirements made under Standards 2 and 3 at the last inspection had been met. Prospective service users and their relatives are invited to the home and are able to participate in the initial assessment process. However, a letter confirming that the home will meet the assessed needs of individual service users is not sent to prospective service users and/or their relatives. This practice does not meet with the regulatory requirement. EVIDENCE: The home’s service users guide was satisfactory but a letter detailing how the home would meet the needs of individual service users could not be evidenced at the time of the inspection. The Inspector was informed that prospective service users and their relatives were invited to the home prior to admission, and that they were able to participate in assessing the home’s suitability and capacity to meet the specific needs of prospective service users. Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 9 A sample of signed and dated assessments and contracts/statements of terms was seen during the inspection. This complied with requirements that were made at the last inspection. The home does not provide intermediate care. Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 10 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 and 11 The requirements that were made under the above Standards at the last inspection were fully or partially met. EVIDENCE: The social care needs of the service users were identified within some care plans viewed and action plans had been put into place. The Sister in Charge reported that social care assessments would be undertaken in relation to all the service users at the home in due course. This requirement was made at the last inspection and was partially met. The home had commenced the process of ensuring that the signatures of service users or their relatives were obtained in relation to all drawn up care plans. This requirement was made at the last inspection and work was ongoing to ensure full compliance. It was reflected on records seen that service users received access to specialist services such as reflexology and physiotherapy. This was made at the last inspection and work was ongoing to ensure full compliance. Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 11 Members of the care support staff team said that personal care tasks were undertaken in privacy within bedrooms or bathrooms. They were observed to relate to service users in a respectful manner and knock on bedroom doors. Service users who spoke to the Inspector confirmed that their privacy and dignity were respected at the home. This complied with a requirement made at the last inspection. The home’s policy and procedures relating the death and dying were in place. This complied with a requirement made at the last inspection. Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 12 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 and 14. The requirement made under Standard 12 at the last inspection had been met. Service users are given choice and are encouraged to be independent in their daily living routines. EVIDENCE: The Sister in Charge confirmed that service users received choice regarding activities, meals, what to wear and when they got up in the mornings or retired at night. Service users were observed being involved in separate activities in their bedrooms, others sat in the lounge, a quiet area or chose to have a cigarette in the garden. The Inspector was advised one service user was able to visit the local community independently. Several service users were escorted to church services on a Sunday and that a Catholic priest visited the home and gave Holy Communion each week. This requirement was made at the last inspection and had been complied with. Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 13 The visitors’ book reflected signatures of visitors entering and leaving the home. Separate activities and meals taken had been recorded. This requirement was made at the last inspection and had been complied with. Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 14 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): 17 and 18. The requirement made under Standard 18 at the last inspection was met. The legal rights of the service users are being protected at the home. EVIDENCE: It was evidenced on records seen that training on the Protection of Vulnerable Adults had been delivered to the members care support staff team. This met with the requirement made at the last inspection. The Sister in Charge reported that social workers were responsible for ensuring that where appropriate advocates or representatives acted on behalf of service users. The Inspector was informed that service users maintained their right to vote or seek legal advice whilst being at the home. Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 15 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 and 25. The environment within the home is safe, comfortable and well maintained. EVIDENCE: A tour of the building was undertaken at the time of the inspection. Overall, the home was found to be clean, hygienic and well maintained. The environment was safe and comfortable and suitable for meeting the needs of the service users. Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 16 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): 28 and 30. The service users safety and welfare are safeguarded by an appropriate number of experienced and qualified care staff. The requirement made under Standard 30 at the last inspection had been met. EVIDENCE: It was indicated on the rota that a maximum of five care support staff members and two registered nurses were on duty during waking hours and two care support workers and one registered nurse covered duty at night. Members of the care support staff team who were on duty at the time of the inspection were observed being sensitive and attentive in meeting the needs of the service users. It was reflected on records viewed that training on the Protection of Vulnerable Adults had been delivered to the care support staff team. This complied with the requirement made at the last inspection. Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 17 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): 33, 35, 36, 37 and 38. . The best interests of the service users are being protected by satisfactory policies and procedures but the home does not handle the financial affairs of the service users. Staff supervision records were not accessible at the time of the inspection. The requirement made under Standard 38 at the last inspection had not been met. EVIDENCE: The Inspector was advised that the ethos of the home was ensuring that the needs of the service users were being met within a warm, caring and homely environment. Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 18 It was evidenced on records viewed that risk assessments had been undertaken in relation to specific activities identified within service users’ care plans. Regular fire safety checks and fire drills had also been carried out. The homes policies and procedures were in place and indicated that the service users safety and welfare were being protected. The Sister in Charge confirmed that relatives, representatives or local authorities held responsibility for the financial affairs of the service users. Regular staff supervision was not evidenced during the inspection. The Sister in Charge explained that supervision records could not be accessed as the Registered Manager who was not present during the inspection, held the key to the cabinet in which supervision records were being kept. The requirement made under Standard 38 which related to environmental risk assessments, had not been complied with. Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 19 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 3 X 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 3 3 X X X X X 3 X STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 2 3 2 Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 20 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 OP4 Regulation 14(1)(d) Requirement The Registered Person must confirm in writing that the home will meet service users assessed needs. The Registered Person must ensure that supervision records are available for inspection. The Registered Manager must ensure that risk assessments are carried out for safe working practice topics and for all areas of the property. This requirement is restated from the last inspection. (Timescale of 01/10/05 not met) Timescale for action 30/12/05 2 3 OP36 OP38 17(3)(b) 12(1)(a) 30/03/06 30/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection West London Area Office 58 Uxbridge Road Ealing London W5 2ST 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. Extracts may not be used or reproduced without the express permission of CSCI Georgian House Nursing Home DS0000010947.V251843.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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