Inspection on 26/07/06 for Gerald Street House

This inspection was carried out on 26th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Gerald Street House 19/09/05

Gerald Street House 28/04/05

Gerald Street House 11/10/04

Gerald Street House 21/04/04

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

CARE HOMES FOR OLDER PEOPLE Gerald Street House Gerald Street Whiteleas Estate South Shields Tyne and Wear NE34 8RG Lead Inspector Sheila Head Key Unannounced Inspection 26th July 2006 10:00 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 Street House DS0000037965.V302935.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gerald Street House Address Gerald Street Whiteleas Estate South Shields Tyne and Wear NE34 8RG 0191 536 9479 0191 536 9744 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) South Tyneside MBC Lorraine Gallagher Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35), Physical disability over 65 years of age (4) of places Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service may from time to time admit persons between the ages of 60 and 65 years of age. 19th September 2005 Date of last inspection Brief Description of the Service: Gerald Street is a Local Authority owned residential care home, which provides permanent accommodation for up to thirty-five older people with personal care needs including a residential short break (respite care) service for up to three people. The Home does not provide nursing care. A day resource centre for older people is also operated on the same site. All accommodation is at ground floor level and is divided between four units, each with its own self-contained facilities including lounges, toilets and bathrooms and access to a central dining area. The property is situated on a housing estate in the Whiteleas area of South Shields and is within walking distance of a range of local amenities, including a small selection of shops and a Church. The area is well served by public transport therefore easily accessible. There is ample care parking to the front of the building. Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place over six hours and was carried out as part of the annual inspection programme. The Registered Manager was present throughout the inspection. A selection of documentation was examined including three resident care plans, three staff files, training records, maintenance records, medication records and duty rotas. The inspector also toured the building looking at bedrooms, communal areas and service areas. Residents, visitors and staff were spoken with throughout the day. A lunchtime meal was taken with the residents. The Manager had completed a questionnaire and sent it to the Commission before the inspection. This gave the inspector up to date information about the home. This information is included in the report. Fees for this home are £408.79 per week. What the service does well: What has improved since the last inspection? Staff have had the opportunity to access training in dementia so that they will have extra skills to be able to care for residents in an appropriate way. The first aid box is now situated in the main office so that it is available for use and staff all know where it is kept in case of emergency. An activities organiser has been appointed and is due to start work shortly. Although shared between homes, this person will be based in Gerald Street and it is anticipated that they will be encouraged to promote one to one social stimulus for residents. Gerald Street House DS0000037965.V302935.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. Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 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 Street House DS0000037965.V302935.R01.S.doc Version 5.2 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): 3 A local care manager, prior to admission, assesses each prospective resident however the home does not always receive the information needed to ensure an appropriate placement so that the residents needs can be met. The home does not provide intermediate care so this standard was not assessed. Quality in this outcome is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The system has remained unchanged since the last report. Care assessments are available in the residents care plans, however the information lacks consistency. Some are detailed such as ‘can only walk with the help of one person or walking aids’ others say ‘mobility restricted’. The home depends on this information to make their decision that the home can meet the person’s needs effectively. Home staff will possibly see the prospective resident before admission, depending on the information they receive, but this does not always Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 Page 9 happen. It is necessary for home staff to see potential residents to make sure that the home is right for them and to give residents and families the opportunity of expressing any concerns. Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 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 Care plans are not sufficiently developed to give clear instruction to staff on how to fully meet residents’ needs. The home operates a medicine policy that is safe for residents. Residents are treated with respect and staff ensure their privacy is protected. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Three residents were case tracked throughout the inspection and their care files were examined. As indicated in the last report a new system of care planning was to be introduced but this has not yet taken place. All three care plans raised the same concerns. Problems are identified but recorded together so that it is difficult to separate individual plans of care. For example, one care plan showed ‘independence’ and ‘mobility’ together as one problem, then showed one complex care plan that did contain some important information, however it was not clear how staff should care for that person. Problems need to be identified and a ‘one problem, one plan’ approach should be considered so that staff have clear instructions on how to care for the residents. Risk assessments are not part of the care plan as these are kept in a separate file to accommodate quality monitoring. Although commendable, risk assessments Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 Page 11 are generated by the care plans so should be part of the care planning documentation. This is so that staff are able to easily and clearly identify how to manage individual risk and protect residents. The professional intervention recording was good as was the social activity sheet as these reflected care given to residents. However attention must be paid to completion of documentation, signatures and dates as these were often missing. Staff from the home were involved and contributed to the new care planning system that has been developed. Implementing the new system has been put on hold due to budget implications concerning training needed and cost of documentation. Management in the home recognise the need to change the system and are to investigate ways of using the new documentation that would meet all the requirements made by the Commission. Management were advised that the new system must be a priority, as this requirement has not been met from the last two inspections. The home has a safe and effective policy in place for administration of medicines. The recording and storage of medicines was satisfactory and audit trails confirmed that all was correct. The storage area was clean and tidy, as was the medicine trolley. Care staff that have responsibility for giving out the medicines have all completed a ‘safe handling of medicines’ course. The home operates the ‘nomad’ system for giving out the medication. Each resident has an individual cassette that has been filled by the chemist. The cassette contains their medication for a month in compartments that show the date and time medicines are to be given. This system minimises risk so that the residents can be sure they receive the correct medication at the right time. Care is given in a discreet manner. ‘You can’t fault the staff’ and ‘the staff are lovely and kind’ were comments received from residents. Staff are knowledgeable about residents’ preferences and needs. Staff were observed being kind and polite with cheerful banter taking place throughout the day. Staff spoke to residents always explaining what was about to happen and what they were going to do so that residents knew what to expect when being helped to move around the home. All residents have individual rooms that they can use if they need to discuss issues with family, friends or staff so that their privacy is safeguarded. Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 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 There is a range of activities available to residents and visitors are made welcome at any time. Residents are supported by staff to make choices about the way they live and the home provides a balanced, wholesome and nutritious choice of meals. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and after the visit to this service EVIDENCE: Talking to residents confirmed that they were content and pleased with the staff and the home. ‘Christmas was wonderful’ and ‘They always make an occasion out of your birthday, everyone gets a piece of cake’ were comments. The hairdresser visits every Monday and ‘the fella that does our toe nails’ comes to the home every month. Residents could order a newspaper and one resident said ‘You can really do as you like which is nice’. There have been recent trips to the beach for an ice cream and the residents confirmed that this month they would be having entertainment by a singer with a piano. An activities co-ordinator has been appointed to work throughout services in the area and will be based in Gerald Street. This person is due to start this job shortly. This should take some pressure from the carers who organise the social activities for the home at the moment. Visitors were observed coming and going throughout the day. All were made welcome and appeared to have a good relationship with the staff. Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 Page 13 Lunch was shared with the residents. The dining room offers a light, airy and spacious space for the residents to take their meals. Comments from residents included ‘The food is always good’ and ‘You always have enough to eat, if you don’t like it they will make you something else’. Tables were set to promote independence with tablecloths, condiments, napkins, milk, sugar and a teapot for residents to help themselves. The menu consisted of vegetable soup, a roast chicken lunch followed by angel whirl or tapioca. The chicken lunch was pre plated and delivered to the table. To promote independence and choice, serving dishes or tureens could be used so that residents could help themselves to whatever and how much they wanted. Alternate choices are available such as salad or jacket potatoes. Residents make their choice of meal the day before and talking to residents confirmed they thought this was good practice. The residents are also offered a flexible breakfast menu and are able to have a cooked breakfast if they wish, high tea that comprises of a choice of a hot or cold meal such as toasted ham sandwiches or beans on toast, and then sandwiches are available for supper. Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 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 and 18 Residents and families can be confident that their complaints are dealt with efficiently and resolved quickly Residents are protected by robust policies that ensure they are safeguarded from abuse. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The home has a rigorous complaints policy and procedure in place. Around the home there are advice booklets and invitations to advise staff if they have any concerns. There has been one complaint since the last inspection that was dealt with speedily and resolved quickly. Recording was accurate and clear. Staff training records demonstrate that all staff have received Protection of Vulnerable Adults training and that this training is updated when necessary. The policies and procedures are available in the home to guide staff if necessary. Staff have the skills to recognise potential abuse and know what to do if an abusive situation were to arise. The residents can feel confident that a knowledgeable staff group protects them from potential harm. Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 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 26 The home is a clean and warm place to live and offers residents a homely and safe environment in which to live. Quality in this outcome is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: ‘The place is spotlessly clean’ said one resident. This was confirmed as the inspector toured the home. All the areas are very clean and there was no evidence of odours. The home is designed in ‘wings’ that enable small groups of people to sit in separate lounges. This also means that residents do not have too far to go to their bedrooms if they are tired or have mobility problems. The home has a small well- decorated sitting room for residents to use if they want a quiet space or if they wish to hold a family party. The home is decorated and furnished to a high standard and offers a pleasing homely environment to the residents. Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 Page 16 The service area is very clean and tidy, particularly the laundry. Attention must be paid to keeping doors locked when the area is unattended so that safety of staff and residents in maintained. Sluice areas, where there is not a lock on the door, must remain clear of toilet cleaning materials, as these could be harmful to residents and staff if inappropriately used. Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 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 remain at the minimum required. Staff are well trained to meet the assessed needs of the residents safely. The recruitment procedure in the home ensures that residents are safeguarded from potential abusive situations. Quality in this outcome is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Staffing rotas reflected the staff on duty on the day of inspection. The service has recruited an activities co- coordinator that will take up post shortly. The post is yet to be developed but it is anticipated that the post will be shared by other local authority homes. Input may be limited but this is an improvement in the service given to residents. The system for staff files is being developed so that the home can hold copies of staff information such as Criminal Records Bureau checks, references, application forms and interview records. The files are not yet consistent. Three files were randomly selected and all held copies of Criminal Records Enhanced Disclosures so that residents can be assured that their safety is being protected. However one file contained an application form and references whilst another did not. The manager must ensure that files are arranged in an easy to access manner and that they contain the necessary information. Some files have different contents because staff have been transferred from other establishments. The local authority head office has previously held files. All files contained a personal development plan that is used to identify training needs. The home supports staff training and all staff receive training in Protection of Vulnerable Adults, fire safety, moving and assisting. Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 The manager is appropriately qualified to competently manage the home and systems are in place to determine the quality of the service provided to the residents. Systems are in place that safeguard residents’ personal allowances and staff follow safe working practices that promote a safe environment for residents, visitors and staff. Quality in the outcome is good. This judgement has been made using the available evidence gathered both during and before the visit to this service. EVIDENCE: The Registered Manager has the appropriate qualifications and experience to successfully manage the home. The manager contributes towards the general feeling of well being in the home with staff following that ethos. ‘I enjoy working here’ and ‘I feel included in decisions’ were comments from staff. Supervision is offered to the staff so that they have an opportunity of one to one discussion with management. Some staff have signed a declaration to Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 Page 19 decline the offer of supervision but the manager ensures that group supervision is available. The manager is responsible for both implementation of safe working practices such as testing water temperatures and fire safety but also for auditing all systems and procedures through the home to ensure safety of residents, visitors and staff. All monitoring records were complete and up to date. Equipment checks and service records were examined and found to be up to date and correct. The manager completes a full audit and checking procedure that also includes medication and care plans. The home has recently been internally audited and has achieved the highest rate of compliance in local authority services. The Manager and their team need to be congratulated on their achievement given the minimum staffing levels and the need for the manager to be also part of the care team. Residents and visitors are asked their views on the service provided and there are questionnaires available through the home. The accident recording in the home is robust. Case tracking showed that entries in the accident book were reflected in the daily record within individual care files. Accidents are monitored and analysed so that risks can be identified. Safety is promoted for residents by using these systems effectively and by having a staff group that is trained in fire safety, moving and assisting, infection control and food hygiene. The senior management team in the home are responsible for safeguarding residents’ personal monies, as the home does not employ an administrator. Each resident has an individual balance showing a running total of monies kept in the home. Each resident also has an individual wallet containing his or her money locked securely in the safe. Balances reflected the actual amounts held and recording was found to be correct. Transactions are signed and dated by two members of staff and are audited weekly by the manager. Residents can access their money at any time. Residents can be confident that their personal monies are handled safely and appropriately. Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 Page 20 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 X 2 X X X 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 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP2 Regulation 14 Requirement Timescale for action 31/10/06 2. OP7 15 Pre-admission assessment information for residents must be available in sufficient detail to enable a decision about the suitability of placement and for a care plan to be developed. (Previous timescale of 31/10/05 not met) Improvements to the residents 30/11/06 care plan system must continue with staff receiving training when the new system is implemented. (Previous timescales of 30/09/05 and 31/12/05 not met) Doors marked ‘keep locked’ must 26/07/06 be kept locked at all times when the areas are unattended. 3. OP38 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 Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 Page 22 1. OP27 The Registered Provider should give strong consideration to ensuring the manager is supernumerary to the staffing rota so that standards can be maintained and requirements met. Gerald Street House DS0000037965.V302935.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Street House DS0000037965.V302935.R01.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!