Inspection on 12/01/06 for Gerald House

This inspection was carried out on 12th January 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Gerald House 18/06/07

Gerald House 12/06/06

Gerald House 11/08/05

Gerald House 10/03/05

Gerald House 21/06/04

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

CARE HOMES FOR OLDER PEOPLE Gerald House 4 Gerald Road Oxton Birkenhead Wirral CH43 2JX Lead Inspector Les Hill Announced Inspection 20th January 2006 09:30 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 Gerald House DS0000018888.V272620.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. Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gerald House Address 4 Gerald Road Oxton Birkenhead Wirral CH43 2JX 0151 652 1606 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) Mr George Alan Shone Mrs Kamini Shone Mrs Kamini Shone Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One Named Adult with Learning Disabilities under 65 years of age in an overall total of 18 Two Named Adults under 65 years of age in an overall total of 18 Date of last inspection 11th August 2005 Brief Description of the Service: Gerald House is a detached property situated in Oxton, near Birkenhead, Wirral. The home is registered to provide personal care to 18 older people, though variations to the registration have been agreed to enable three residents below the age of 65 years to live at the home. Accommodation is provided on two floors. Downstairs there are lounge and dining rooms and some bedrooms. Most of the homes bedrooms are situated on the first floor that is accessible by stairs or passenger lift. Outside there are car parking spaces to the front and a reasonably sized, enclosed garden to the rear. Gerald House is located in a residential area but some local shops are within walking distance and bus routes to Birkenhead pass close to the home. Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on Friday 20th January 2006 over a period of 3.5 hours. It involved the examination of some records, a tour of the building, meeting with the manager and three residents. Completed CSCI questionnaires were received from six residents and one relative. The inspection was part of the Commission’s responsibility to visit and report on each registered care home on two occasions each year. What the service does well: What has improved since the last inspection? What they could do better: Recommendations have been made to continue and improve on the developments in care planning and the maintenance of staff records. An additional recommendation has been made to develop staff supervision. Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 6 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. Gerald House DS0000018888.V272620.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 Gerald House DS0000018888.V272620.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): 1, 2, 3, 4, 5 and 6 Prospective residents are provided with information about the home. Assessments have been improved. EVIDENCE: The home’s statement of purpose and service user guide were examined and found to contain all matters identified in National Minimum Standards. Records of resident’s financial affairs are kept separate to the care records in the home. Each of the residents funded by the local authority has a care contract in place that includes the responsibilities of the placement agency, the care home and the resident. The home has its own contract/terms and conditions of residency that is provided to any resident who is self-funding, although the same document is given to funded residents as well. Examination of three resident’s care files showed that the home undertakes a pre-admission assessment, including the resident’s mental health status, and that the information is used to support the care planning processes. The Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 9 documents used have been further updated and contain more detailed assessment information. The present owners have supported residents in Gerald House for approximately 16 years and have experience of running two other homes in the past. Residents who completed the CSCI questionnaires and those who spoke with the inspector were complimentary about the services and support they receive. Prospective residents and their families are encouraged to visit the home and to spend some time there before making a commitment to stay. Gerald House is not contracted to provide Intermediate Care. Gerald House DS0000018888.V272620.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 and 10 Further work had been undertaken to develop care planning and this needs to be consolidated. The health care needs of residents are identified and appropriate support is provided. Residents are treated with dignity and respect and their right to privacy is respected. EVIDENCE: An examination of three resident’s care files confirmed that care plans are in place and are being reviewed on a monthly basis. The care plans are kept in a folder that is accessible to all staff and are used to assist them in working with individual residents. Improvements have been made to the care plans to include more detailed directions for staff and the progress should be developed to consolidate and improve the records of work with individual residents. Resident’s health needs are recorded and access to health care professionals is sought when necessary. The home has links with three GP surgeries and has good support from district nurses when they are required. Residents also have visits from the optician and the dentist. The continence adviser will carry out assessments when requested to do so, but the process can take seven or eight Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 11 weeks during which time the home is expected to fund the costs of any equipment needed. The new pharmacy arrangements are working well and the home is benefiting from the support provided by the pharmacist. Medicines are provided in “blister” packs. A check of the arrangements for administering medicines in the home was carried out and found to be satisfactory. All prescriptions are ordered and checked by the home before being dispensed by the pharmacist. The home’s policies and procedures expect that residents will be treated with respect. During a tour of the building the homeowner knocked on each bedroom door and waited for a reply before entering. Residents told the inspector that staff are very kind and supportive and always treat them with respect. Residents can meet with visitors in one of the communal areas or in the privacy of their own room. Gerald House DS0000018888.V272620.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, 13, 14 and 15 Residents are helped to exercise choice in their lives. EVIDENCE: Staff at the home provide a range of activities that residents can choose to join in. Some of the residents are able to go out alone, whilst others are taken out for a walk or for a ride in the manager’s car. Activities provided include music and TV, exercise groups, Bingo, videos and films, quizzes, reminiscence and card games and individual one-to-one activity. Not all of the residents wish to join in group activities and they can spend their time on their own, observing or following an individual interest. Visitors to the home are welcome at any time. The local priest attends to provide communion for those who wish to maintain their faith. The home will support residents of other faiths who wish to attend church and will contact the appropriate clergy if a request to do so is made. Residents told the inspector that they are able to make choices about their everyday lives; they can choose when to get up and when to go to bed. They can choose to spend time on their own room or in the lounge. Residents who gout into the community alone or with family/friends are expected to let the Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 13 staff know where they are going and when they are likely to return for the purposes of personal safety. A four-week menu is in place and residents have a choice of food at each mealtime. The menu has been created around the likes and dislikes of residents and is reviewed with them form time to time. Residents who spoke about the food served in the home were positive about the quality and range of meals provided. Gerald House DS0000018888.V272620.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): 16, 17 and 18 Residents are protected from abuse. EVIDENCE: The home has a complaints procedure in place that is known to residents and their visitors. Residents who replied with the CSCI questionnaire said they would know who to speak to if they were unhappy about the care they were being provided with. The home had recorded two minor complaints both of which had been dealt with appropriately and within the time scales identified. No complaints about the home have been made to CSCI. All of the residents are included on the Electoral Register and have the opportunity to vote in local and national elections. The home has policies and procedures in place to protect residents from abuse, including Wirral Borough Council’s own procedures around adult protection. The procedures are available to staff. Advice and information for staff on adult protection matters has been given during NVQ training. Gerald House DS0000018888.V272620.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, 20, 21, 22, 23, 24, 25 and 26 Residents live in a safe and well-maintained environment. EVIDENCE: Gerald House is situated in a residential area of Oxton, Wiral. It is conveniently Located for local shops and bus routes to Birkenhead. The home is well decorated and is furnished in a domestic style. It is clear that on-going maintenance is given appropriate priority. Lighting around the home is also domestic in character. Contract gardeners maintain the grounds. The home’s laundry is located in a wooden building at the back of the home. A lockable store cupboard had been provided since the last inspection to store bleach and other cleaning materials. Lounges are bright and comfortably furnished. The home’s separate dining room has domestic style furniture and tables are laid with cloths and individual place settings. Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 16 Most of the bedrooms have an en-suite WC and wash hand-basin. The other three rooms have almost exclusive use of a WC located by the door of their room and the owners are considering arrangements to designate all rooms as en-suite. Resident’s bedrooms had been personalised with items of furniture, pictures and ornaments brought in from their own home. Two of the home’s three bathrooms have adapted bathing facilities; the third bathroom is fitted with a shower. Aids and equipment to support residents with a disability are provided throughout the home. Ramped access is provided at the front door. A passenger-lift and staff call systems are installed. Hot water delivered to resident’s bathrooms and showers is thermostatically controlled. Hot water delivered to wash hand-basins in bedrooms is not controlled, however, a notice identifies that the water may be hot. The inspector was assured that all current residents are able to manage the temperature of hot water in their own bedrooms. Where concerns may arise a risk assessment would be completed and any appropriate actions taken. On the day of this inspection the home was clean and tidy and there were no offensive odours present anywhere in the home. Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 17 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 and 30 Staffing levels are appropriate for the current group of residents. EVIDENCE: Rotas confirmed that from Mondays to Fridays, the home is staffed (during the daytime hours) by the manager and two carers. At all other times two care staff are on duty. At night there is one wakeful carer and one member of staff sleeping in. Separate cooking and domestic staff are also employed. The home does not employ anyone below the age of 18 years and does not use agency staff. Nine of the home’s thirteen care staff have an NVQ award at level 2 or above. The home has therefore exceeded the standard of 50 of care staff with this award. Three staff files were examined during the inspection and each contained the appropriate information. This was in contrast to the previous inspection when some documents were missing or checks not made. To maintain the improvements the homeowner should ensure that all of the staff records identified in Schedule 4 of the National Minimum Standards, Care Homes for Older People are kept on file. The home takes advantage of free training in food hygiene, moving and handling, fire awareness and first aid, and has ensured all staff are trained in the management of medicines. Copies of certificates gained are kept on the Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 18 staff files. The pre-inspection questionnaire completed by the homeowner did not identify any other training for staff. Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 19 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, 32, 33, 34, 35, 36, 37 and 38. The home is run in the best interests of residents. EVIDENCE: The home’s joint owner/manager has successfully completed an NVQ level 4 in management. she is also an NVQ assessor. The manager works in the home and is directly involved in providing personal care alongside the care staff. She organises activities and is accessible at all times to residents, their visitors and staff. Observations during the inspection and comments from residents confirmed that there is an open and inclusive atmosphere in the home that permits discussion and the resolution of minor conflicts. One of the residents told the inspector that it is “home from home”. The main focus of discussions with the homeowners was the needs of the residents and the inspector was confident that the home was run with their best interests at the centre of all decisions. Residents were complimentary Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 20 about the home, the staff and particularly the management and felt able to raise any concerns. The inspector was not made aware of any financial matters that would affect the continued running of the home. Apart from small amounts to pay for hairdressing etc, the home does not manage any personal money on behalf of residents. The home owner/manager has begun the process of staff supervision through observations of them carrying out particular tasks. The process should be developed to engage staff in one-to-one meetings with managers when their performance and training needs can be discussed. The meetings should be held six times each year. A record of the meeting should be made and the supervisor and supervisee should sign to confirm it is a correct record. The record should be kept securely in the home. The homeowners were undergoing an assessment for the Investors in People Award. They undertake annual quality assurance surveys amongst residents and their visitors requesting their opinion about the care and support provided at Gerald House. The home has purchased a good set of policies and procedures that have been scrutinised to ensure they are appropriate for the work in Gerald House. The importance of maintaining full and detailed records was discussed during the inspection. The owner/manager promotes a safe environment for residents and staff. This is achieved through regular checks on equipment, risk assessments and staff training in moving and handling. The fire alarm system is checked weekly and the emergency blighting system is checked monthly. Six-monthly fire drills are held in the home. The homeowner provided information to confirm that contracts are in place for all of the electrical and gas appliances and installations and for moving and handling equipment. A new staff call system was installed in November 2005. Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 21 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 2 3 3 Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 3 Refer to Standard OP7 OP29 OP36 Good Practice Recommendations Improvements to the written care plans should be built on and maintained Improvements to the records kept on staff files should be built on and improved. The programme of staff supervision should be developed to include one-to-one meetings the outcomes from which are recorded and kept on file. Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Gerald House DS0000018888.V272620.R01.S.doc Version 5.0 Page 24 - 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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