Inspection on 29/11/05 for Georgina House

This inspection was carried out on 29th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Georgina House 19/03/07

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 Linda Cappello Unannounced Inspection 29th November 2005 16:00 Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 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.V264195.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 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.V264195.R01.S.doc Version 5.0 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 01582 456574 Parkcare Homes (No. 2) Limited Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28/06/05 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 residents with learning disabilities but there is currently one vacancy. Each resident 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. Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the afternoon and evening on 29th November 2005. The manager and one member of staff were on duty and both residents returned to the home during the inspection. The purpose of the inspection was to assess those key standards which were not assessed during the inspection on 28th June 2005 and to review whether the requirements issued at that time had been met. During this inspection, all areas in the home were visited, relevant records were examined and both staff and residents were spoken with. The inspector is grateful for the help given by the staff and residents during this inspection. For a more comprehensive assessment of the care provided in this home, this report should be read in conjunction with the report of 28th June 2005. What the service does well: What has improved since the last inspection? What they could do better: There is now a guide to the home for residents and contracts which are written in a way that is easy to read but they must now be given to each resident and discussed with them or their relatives. The home’s kitchen is quite small and the home needs to make a separate area where the washing machine can go and also the freezer, which is in a Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 Page 6 spare bedroom at the moment. The home must also make sure that if things are broken or damaged, they are repaired as soon as possible. There needs to be a way of asking residents and their relatives, at least once each year, whether they are happy with the care they receive and the home must write a report saying whether they need to make any changes to improve things for the residents. 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. Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 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.V264195.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 The home has developed a guide and contract so that residents will have all relevant information when it is shared with them. The home uses an outcome based evaluation tool so that the needs of prospective residents’ needs can be assessed. EVIDENCE: The home has now developed a guide to the home and contracts for residents which are written in a way that is easy to read, but they must now be given to each resident and discussed with them or their relatives. The home has not admitted any new residents for some time so that it was not possible to examine whether the process of assessing the needs of prospective residents had improved. However, the new manager had undertaken a reassessment of the needs of one resident using an outcome-based evaluation. By using this process, the manager had identified that the home was not able to meet all of this resident’s needs and, at a recent review, discussions had taken place about potential alternative placements. Prospective residents would also be assessed using this process and it is, therefore, likely to identify their needs and aspirations in a comprehensive manner. Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were assessed during the last inspection. EVIDENCE: Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were assessed during the last inspection. EVIDENCE: Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were assessed during the last inspection. EVIDENCE: Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Staff at the home have attended relevant training so that residents are better protected from potential harm. EVIDENCE: Following the last inspection, the home was required to ensure 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 for the staff team were examined and it was noted that all but one member of staff had now received training in the management of challenging behaviour. A further course had been arranged for the remaining member of staff. One member of staff said that this was the first time she had received such training during the five years she had worked for the provider. The manager had attended a workshop about Autism and was cascading 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. New strategies are being used to divert one resident from self-harming behaviour with some success. Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 30 There is no clear process or budget identified so that residents do not benefit from minor repairs being carried out promptly. EVIDENCE: During the inspection various issues with the environment of the home were noted. It became evident that there was no clear process for the home to get minor repairs undertaken promptly and an examination of the budgets for the home also showed that there was no budget identified for general repairs. It was noted in the garden that a retaining wall was broken with loose brickwork falling onto the patio area and that a trailer, which was of no benefit or relevance to the residents, was parked on the patio. In the hallway of the home, there was an area where the wallpaper had been removed leaving bare plaster and, at the top of the stairs, there was a hole in the wall awaiting repair. The curtain track in one resident’s bedroom has been pulled off the wall and is awaiting repair. The home’s chest freezer if stored in the downstairs bedroom which is currently vacant. This must be removed before a new resident moves in and must not be placed back in the lounge/dining room, which is where it was previously stored. The presence of the washing machine in the kitchen where all meals are prepared has been raised on previous occasions. The staff are instructed not to process soiled washing while food is Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 Page 14 being prepared but it would be preferable to place the equipment elsewhere to prevent cross contamination. Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35 Residents are benefiting from the increased knowledge and awareness of staff, gained through attending relevant training courses. EVIDENCE: As discussed above, the training records of the staff team were examined and it was evident that staff had attended a number of relevant training courses which had increased their awareness, knowledge and skills. As well as attending courses in relation to challenging behaviour and abuse, since the last inspection they had been attending mandatory training such as First Aid and COSHH (dealing with dangerous substances). One member of staff who was interviewed during the inspection had completed NVQ Level 2 in care. The home had an identified training budget and there appeared to be no barrier to staff receiving the necessary training. Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, The residents benefit from the home having its own manager although further support is needed. The home does not have a quality assurance system so that residents’ views do not underpin the way it is run. EVIDENCE: A new manager has been appointed so that the residents and staff benefit from having a manager who solely has responsibility for this home. This has resulted in a number of improvements, however, the manager could not provide any evidence of having received any induction training or of having been given the basic knowledge and information such as a copy of the National Minimum Standards. The manager has not managed a residential care home previously and therefore needs additional support and direction. However, it was evident that she is bringing initiative and enthusiasm which are benefiting the residents. The home does not have a system for measuring quality although the provider company is planning to introduce a system in the next few months. There was little evidence that service users’ views underpin the running of the home or Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 Page 17 that the views of relatives or other stakeholders are sought, other than through the reviewing process. The manager is introducing a greater use of pictures and symbols so that one resident, who cannot express his choices and views by language, can communicate more easily with staff. Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 2 X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 X X X X 2 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score x 3 x x 3 x CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Georgina House Score X X X x Standard No 37 38 39 40 41 42 43 Score 2 X 1 X X X x DS0000015011.V264195.R01.S.doc Version 5.0 Page 19 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 YA1 Regulation 5 Requirement Each resident must be provided with a service user guide and contract which is in a suitable format Original dates November 2003, August 2004, February 2005, April 2005 and July 2005 not met. N.B. the guide and contract must now be supplied to and discussed with each resident Robust arrangements must be in place to ensure that repairs and maintenance to the building and grounds are carried out promptly. The manager must receive the necessary training and support. 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. Timescale for action 31/01/06 2 YA24 23(2)(b) 31/01/06 3 4 YA37 YA39 10 24 28/02/06 30/06/06 Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 Page 20 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 2 Refer to Standard YA25 YA30 Good Practice Recommendations The freezer which is stored in the downstairs bedroom should be removed to a more suitable place. The laundry equipment should be removed from the kitchen where food is prepared. Georgina House DS0000015011.V264195.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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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