Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Germaina House 4 - 5 St Vincent Terrace Redcar TS10 1QL The quality rating for this care home is: The rating was made on: one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Stephen Ellis Date: 1 2 1 2 2 0 0 8 Information about the care home
Name of care home: Address: Germaina House 4 - 5 St Vincent Terrace Redcar TS10 1QL 01642475740 01642296039 annpalmer4@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Ann Palmer care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category 0 Over 65 18 Conditions of registration: The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP, maximum number of places: 18 The maximum number of service users who can be accommodated is: 18 Date of last inspection Brief description of the care home Germaina House is a large, Victorian, converted, mid terraced house, situated in a residential area of Redcar. The home is close to all local amenities. To the front of the house there is a small lawned area. The rear patio area has been designed to provide a low maintenance planting area and a raised decking area with tables and chairs. Accommodation is provided for eighteen residents in twelve single bedrooms and three double bedrooms. Some bedrooms have en-suite facilities, which comprise of a toilet and hand washbasin. There are two lounge areas and one dining area. The kitchen and laundry whilst domestic in style are not available for use by residents. The home Care Homes for Older People
Page 2 of 12 provides two stair lifts, to enable residents with poor mobility to access their bedrooms. The cost of care at the time of the inspection visit was #414 per week. Care Homes for Older People Page 3 of 12 What we found:
Germaina House was visited on 12th December 2008 by Stephen Ellis, link inspector for the service and Janet Long, pharmacist inspector, between 08:30 and 12:45. We spoke with the manager and one of the staff responsible for medication at the home. We also looked at the medicine storage arrangements and medicine records, plus some other records that the home is required to keep. We shadowed a member of staff who was administering medication, to observe the practice. We found that the home was redispensing medicines from their original containers (supplied by the Pharmacist and in which the medicines were originally dispensed) into named pots (the names of people who use the service were printed clearly on labels attached to the side of the pots) before the medicines were subsequently administered. This was the case at each medicine round (about 5 or 6 each day) and, at the breakfast medication round, the person who put up the medicines into the named pots was not the same person as the one who subsequently administered the medicines. Also, Lactulose was observed to be administered from a bottle with the name of another person who uses the service printed on its label. The correct dose and strength was given. The Medicines Administration Record (MAR) sheets for each person who uses the service were not signed by the person administering the medicines until after the medicines round had been completed. We observed that there were several instances on recent MAR sheets of discrepancies between the number of tablets supplied and the number administered. The most likely explanation for the discrpancies is that the MAR sheet was not signed immediately after the medicines were given, but at the end of the round when all people who required medicines had received their medicines. There were some medicines listed on some MAR sheets with the directions for their administration as as directed (mainly for pain relief and creams). The entry on the MAR sheet should state the directions as printed on the prescription and on the label on the container supplied by the Pharmacist, to avoid any ambiguity. New storage and administration arrangements were discussed with the manager and staff at length. The home plans to refurbish its medicines storage room and cupboards in the near future. Some items (such as eyedrops that had been opened and begun) were being wrongly stored in the fridge and this was pointed out to the manager and staff, who were advised to seek clarification from the dispensing Pharmacist about the correct storage arrangements for such medicines. Staffing levels were found to be appropriate for the needs of the people currently using the service. Portable Appliance electrical testing (PAT) was found to have been carried out appropraitely by a suitably qualified person. The minibus available to the home is not owned by the home and it is rarely used, with other forms of transport being preferred by people who use the service and staff (such as cars, taxis and public transport). There are 2 stair lifts connecting the ground and first floors and these are satisfactorily maintained and serviced. Any breakdown is usually responded to the same day and there is no history of both lifts being out of action together. Food quality was acceptable and people who use the service were pleased with the menus and meals taken. What the care home does well:
The people who use the service expressed contentment and satisfaction with its quality. There is a homely, friendly atmosphere and people who use the service were observed to get on very well with the staff. Peoples health care needs are being addressed and the Community Nursing Service visits frequently to assist anyone who Care Homes for Older People
Page 4 of 12 requires nursing support (such as bandaging of limbs or the administration of insulin). The service tries to promote individual choice and dignity, recognising that people have different needs, wishes and preferences, and accommodating those differences wherever possible. A high proportion of care staff are trained and qualified to National Vocational Qualifications (NVQ) in Care at level 2 and above, which is commendable. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 12 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 7 15 All of people?s personal care 30/06/2008 needs must be recorded in Care Plans. People must be involved with reviews of their Care Plans. Risk Assessments must be completed for all areas where it has been identified a person is at risk. Care Plan information must be updated to reflect people?s current care needs. All this information would show people?s care needs and how those needs are met. The manager must plan and 30/06/2008 provide suitable activities for people who live at the home, to ensure stimulation is provided. Previous timescale for action 01/11/07 not met. The home must keep a record of all food served at the home, so that we can determine whether people have a satisfactory diet. 30/06/2008 2 12 16 3 15 17 4 18 13 Staff must complete 30/06/2008 safeguarding training, for the protection of vulnerable adults. Care Homes for Older People Page 6 of 12 5 19 23 The manager must refurbish, 30/06/2008 replace or repair: Outside Paint the woodwork that had peeling paint Inside Repair one of the two stairs lifts that had a chair that did not fold away. Dining room Replace the worn carpet Previous timescale for action 01/08/07 not met Fit a lamp shade that was missing from a lamp Renew the cabinet that had a badly scratched surface Room 2 Replace the stained carpet Replace the glass of the double glazed window that was misted up Decorate where the wallpaper was peeling and stained Room 3 Replace the bed headboard that was ripped Room 9 Repair and decorate the ceiling that had a large crack Room 10 Secure the curtain rail that was hanging down Room 12 En-suite: replace the missing floor tile and the toilet seat that had paint worn off. Paint the woodwork of the boxed in piping that had not been painted. Remove the home?s equipment that was stored on the top of the wardrobes Room 13 Replace the en-suite toilet frame that was badly rusted Toilet near Room 15 Care Homes for Older People Page 7 of 12 Decorate the ceiling that was stained Room 15 Replace the carpet that was stained Re-varnish the chair arms where the varnish had worn off. All of the above is to improve the home environment. 6 26 23 The home must replace the 30/06/2008 carpet of Room 15 that was stained and had an offensive odour. Induction training, of new staff, must be recorded. 30/06/2008 7 30 17 8 31 18 The manager must achieve a 31/12/2008 National Vocational Qualification at Level 4, or equivalent, in care. Previous timescale for action of 30/12/06 not met. The manager must complete 30/06/2008 all of the requirements as stated in the last Inspection Report. The manager must complete the Annual Quality Assurance Assessment on time, to show there has been an annual audit of the service. The manager must meet with 31/07/2008 staff, to gain their views about the conduct of the care home. Meetings must be recorded. The manager must ensure 30/09/2008 care staff receive one to one supervision at least six times yearly. Supervision must be 9 33 24 10 33 21 11 36 18 Care Homes for Older People Page 8 of 12 recorded. 12 38 17 The manager must make 31/07/2008 sure policies and procedures are reviewed and updated. The home must have Risk Assessments, for the Control Of Substances Hazardous to Health. Care Homes for Older People Page 9 of 12 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action 1 9 13 The home must stop the secondary dispensing of medicines and make sure that the MAR sheets are signed immediately the medication has been administered. Only administer medicines that have been prescribed and dispensed for a named individual whose details are correctly recorded on the label on the container into which the Pharmacist dispensed the medication. Secondary dispensing is inherently unsafe and MAR sheets must be a contemporaneous record of administration in the interest of safe practice. People should not be given other peoples medication so that proper audit trails can be maintained of who had what and when. 17/12/2008 2 9 13 The medication details 17/12/2008 handwritten onto MAR sheets must contain the full information and directions as listed on the label on the original container into which the Pharmacist dispensed the medication. Medicines must be stored and administered in accordance with the directions issued by the pharmacist and prescribing medical practitioner. Care Homes for Older People Page 10 of 12 This is to ensure safe practice with no confusion and to follow the directions of the people responsible for prescribing and dispensing the medication. Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 9 13 Complete refurbishment of 16/02/2009 medicines room, including the provision of a metal cabinet in which to store any Controlled Drugs. To ensure the safe storage of medicines in accordance with regulations. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 9 Seek the advice and help of your dispensing Pharmacist about any issue you are not sure of concerning the safe handling of medicines. Carry out periodic competency assessments of staff and arrange refresher training in the safe handling of medicines for them as required. Carry out regular audits of medicines, including storage, administration and disposal, to monitor the practice of staff to ensure that good standards are achieved and maintained. 2 9 Care Homes for Older People Page 11 of 12 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 12 of 12 - 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!
