Inspection on 19/03/07 for Georgina House

This inspection was carried out on 19th March 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Georgina House 29/11/05

Georgina House 28/06/05

Georgina House 09/03/05

Georgina House 04/01/05

Georgina House 17/03/04

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

CARE HOME ADULTS 18-65 Georgina House 20 Malzeard Road Luton LU3 1BD Lead Inspector Katrina Derbyshire Unannounced Inspection 19 & 22nd March 2007 12:55 th Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 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 Georgina House DS0000015011.V329868.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 Adults 18-65. 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. Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Georgina House Address 20 Malzeard Road Luton LU3 1BD 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) 01582 456574 F/P 01582 456574 info@craegmoor.co.uk Parkcare Homes Limited Miss Kellie Marie Ryan Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: Georgina House is a semi-detached house situated in a residential area of Luton, close to Luton town centre and is owned by Craegmoor Healthcare. There are local shops and a park close to the home and a bus service available to the town centre. The home is registered for three people with learning disabilities. Each person has a good sized single bedroom, two on the first floor and one on the ground floor. The bathroom and toilet are located upstairs, along with the office/staff room. There is a lounge/diner and kitchen on the ground floor. The home has a large enclosed rear garden and a paved area at the front of the building with parking for two cars. The fees for this home £657.51 per week. Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this visit was to undertake a key inspection. This unannounced visit took place on 19th and 22nd March 2007. The Manager was present throughout the inspection. During the inspection communal areas and private rooms in the home were visited. The care of two residents’ was examined by looking at their records and interviewing the residents’ and staff who look after them. The views of residents and their feedback has been used alongside information from the home through a pre inspection questionnaire to assess the outcomes within each standard. Evidence used and judgements made within the main body of the report include information from this visit alongside their views. Observations of care practice and communication between the residents’ and staff was also made at the inspection. The focus of this inspection was to look at the key standards and to follow up on previous requirements. What the service does well: What has improved since the last inspection? When we last visited we made a requirement for the home to tidy the garden, fix a wall and carryout redecoration of several areas in the home. This work has now been carried out. The garden is now tidier and the wall that had been falling down was repaired. The areas of redecoration that had been carried out means that the people living there have a better environment, in which to live. Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessment systems are to a standard that ensures the home know if they will be able to meet the prospective persons needs. EVIDENCE: The home continues to have in place a guide to the home and contracts for residents which are written in a way that is easy to read. On examination of the assessment documentation of a person admitted to the home since its last inspection, the process of assessing the needs of prospective residents had improved. Staff and documents confirmed that the person had been involved in the planning of their move to the home. When it had been possible for them to influence the assessment process, this had been undertaken. The person had been given the opportunity to visit prior to making a decision on whether to move in. Documents seen made clear how the person should be supported and the personal preferences to meet their physical, emotional and social needs. There was also evidence of family involvement, they had been given the opportunity to contribute to the assessment process. Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems in place for the management of risk are good and protect the residents whilst maintaining their independence. EVIDENCE: Written records were seen within resident files that evidenced that the home had approached the management of risk in a systematic way. Areas of the residents’ life had been reviewed and any risk identified with that activity had been explored with the resident and safety measures put in place to protect the resident. Those safety measures put in place were noted not to restrict the residents rights so ensuring the resident could remain as independent as possible. Within the files of the individual residents documents that supplemented the plan of care was in place for example a ‘pen picture’ of the resident. Care plans Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 10 made clear the level of support to be provided by staff to the resident’s for the care needs that had been included, and staff review plans. Daily entries are made to describe the progress and care of residents, and changes to residents needs are recorded. Written records and observation at this visit indicated that personal care is carried out appropriately. Observation of the interaction between residents and staff showed staff speaking to residents in a supportive and encouraging manner. Observations made during the inspection showed several instances when residents were offered choices and the carers respected the resident’s decisions for example at the evening meal. Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Support offered to the residents in maintaining important relationships in their lives are good so resident’s benefit from the emotional and psychological gain associated with close relationships. EVIDENCE: Records examined showed the home had a system in place to ensure the birthdays of those close to residents were kept within their individual care notes. In addition records showed that the home had on an ongoing basis supported residents in maintaining relationships with their friends and family, through supported visits, telephone calls and social activities. Residents confirmed that their friends and families often visited them in the home and they too spent time away visiting them. Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 12 Staff through discussion described the rights of the people living at the home and were very clear in their knowledge of how staff should treat them and if they were unhappy what they could do about it, for example contacting the family or advocate. Observation of the interaction between staff and residents showed that staff when appropriate would point out residents own individual responsibilities as they lived together in the home and how their behaviour can affect other residents. The response from residents indicated that they all knew the expectations of the home. On several occasions it was observed that all residents had opportunities to be independent in their use of communication, social and living skills. Entries within the care records described the social and leisure activities the residents’ had received. Records viewed on the day of inspection indicated that activities that had been provided for example were shopping trips, walks and going out to Milton Keynes. The care records seen identified very different individual interests of the residents and they were specific in the identification of their preferred leisure interests, regular contact with family members and visits to their homes were also included. One resident was enjoying watching a music and dance video in the sitting area of the home. Observation of the evening meal showed that all residents received an ample amount of food. Fresh vegetables were provided and all residents received two helpings. All residents reported that the food at the home was “good”. Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of medication ordering, storage and administration is good so residents receive prescribed medication in a timely manner by trained staff using current guidance in best practice. EVIDENCE: The systems for the ordering of medication showed that the home maintained clear records to ensure that the medicines ordered were received from the pharmacist. Medication administration sheets contained the balance of stock and contained staff signatures to show when medication had been given. The amount of stock kept at the home was at acceptable levels. Management advised that the home undertakes regular audits and records of these are maintained. Observations of the personal support to residents by staff were noted to be sensitive and respectful, the guidance to one resident during the evening meal was noted to be both sensitive and supportive to the resident. Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 14 Through observation and confirmation by the residents it was confirmed that clothes and hairstyle for example reflected their individual personalities. Guidance and support regarding personal hygiene was offered and the level offered by staff was reflected in the care plans examined on this inspection. All residents were registered with a General Practitioner and any needed referral to access other healthcare services would be made through the General Practitioner. This would be following their assessment and subsequent referral. Documentation of this was seen within the care records of residents. Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes complaints policy is clear so residents know how to complain and to who. EVIDENCE: Staff records examined indicated that staff had received training in the recognition and prevention of abuse, to help them avoid and deal with challenging behaviour and to understand specific conditions such as autism. The training records showed that all staff had now received training in the management of challenging behaviour. The manager had attended a workshop about Autism and cascaded the information to the staff team to increase their knowledge and awareness. All of the staff team attended training in identifying and preventing potential abuse. Continued strategies are being used to divert one resident from self-harming behaviour with success. As assessed previously the home continued to have a very clear complaints procedure, which detailed how a resident could complain, to whom and how long they would wait before they received a response. Staff when questioned were able to accurately describe the actions that they should take when receiving a complaint as detailed within the homes own policy. Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of décor and furnishings in this home are sufficient to provide a pleasant place for the residents to live in. EVIDENCE: Accommodation to residents was seen to be provided within a domestic style 3-bedded property. The décor, furniture and fittings were of a satisfactory standard. The home now shares the support provided by a maintenance person employed by the company, this person has responsibility for the repair and upkeep of the environment. However it was noted that the freezer that had been stored in an empty bedroom had now been moved into the sitting room, as the bedroom had since been occupied. This is not appropriate and a requirement has now been made to move this. Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 17 All areas seen within the home were clean and tidy and free of odours. Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff training is sufficient to provide staff with the knowledge of the needs of the people who live at the home. EVIDENCE: Staff training records showed staff had undertaken mandatory and specialist training courses, including LDAF (Learning Disability Award Framework) induction training, medication training, and NVQ’s. Staff also confirmed that training was always available and that this had been the case throughout their employment with the home. Equal opportunities training workshops had been attended by all staff. A check of staff files was undertaken to look at recruitment practices. It was noted that the files of staff most recently employed contained proof of identity, references and that Criminal Records Bureau clearance had been obtained prior to commencement of employment. However one staff member had been appointed using a CRB check from another employer, this did not meet the Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 19 regulation in this area. The manager confirmed that she would instigate a check following this inspection. Records examined showed that supervision was not being undertaken in accordance with the National Minimum Standards. Staff through discussion confirmed this. Staff must receive supervision at least six times yearly, a requirement has been made. Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does not have a quality assurance system so that residents’ views do not underpin the way it is run. EVIDENCE: Staff through discussion stated that they found the manager to be supportive and felt that she had the resident’s needs as her priority when planning at the home. One resident said “she is nice”. The manager demonstrated that she was enthusiastic and conscientious in her work, through the planning and systems that were in place in the home. The manager advised that the home still had not carried out a resident survey. There was little evidence that residents’ views underpin the running of the Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 21 home or that the views of relatives or other stakeholders are sought, other than through the reviewing process. The manager continues to use pictures and symbols so that one resident, who cannot express his choices and views by language, can communicate more easily with staff. Therefore a previous requirement remains outstanding with an extended timescale given for compliance. Georgina House DS0000015011.V329868.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 Adults 18-65 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 23 YES Are there any outstanding requirements from the last inspection? 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 YA24 Regulation 23(2)(b) Requirement The freezer must be moved from the sitting room of the home as this is not appropriate storage in the home of the residents.. Staff must receive at least 6 supervision sessions each year to review individual practice and plan for improved standards. The home must establish and maintain a system for reviewing and improving the quality of care provided, including consultation with residents and relatives, and produce an annual report. 9previous requirement timescale of 30/06/07 not met). Timescale for action 15/06/07 2. YA36 18 30/06/07 3. YA39 24 31/07/07 Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 24 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 Georgina House DS0000015011.V329868.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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