Inspection on 22/11/05 for Germaina House

This inspection was carried out on 22nd 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 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

Germaina House 12/12/08

Germaina House 22/04/08

Germaina House 01/05/07

Germaina House 05/05/06

Germaina House 11/04/05

Germaina House 19/01/05

Germaina House 27/05/04

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

CARE HOMES FOR OLDER PEOPLE Germaina House 4 - 5 St Vincent Terrace Redcar TS10 1QL Lead Inspector Katherine Acheson Unannounced Inspection 22nd November 2005 09:55 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 Germaina House DS0000000103.V260378.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. Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Germaina House Address 4 - 5 St Vincent Terrace Redcar TS10 1QL 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) 01642 475740 01642 473481 annpalmer4@yahoo.co.uk Mrs Anne Palmer Mrs Anne Palmer Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th April 2005 Brief Description of the Service: Germaina House is a large, Victorian, converted, mid terraced facility, 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 well-maintained lawned area. The rear patio area has been designed to provide a low maintenance planting area and a raised decking area with table’s chairs and umbrellas. Accommodation is provided for eighteen residents in twelve single bedrooms and three double bedrooms. All bedrooms meet the spacial requirements of national minimum standards. Some bedrooms have ensuite facilities, which comprise of a toilet and hand washbasin. There are two lounge areas and one dining area all of which are comfortably furnished. The kitchen and laundry whilst domestic in style, are not available for use by residents. The home provides a stair lift to enable residents with poor mobility to access their bedrooms. Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection started at 9:55am and lasted for just over five and half hours. Four residents and the Manager were spoken to during the inspection. Staff were spoken to informally. Numerous records including care plans, medication, policies/procedures, and staff recruitment and training records were examined. Requirements highlighted at the last inspection in April 2005 were re-visited. Due to the poor management of the home and high number of requirements identified at the last inspection a number of additional visits were made to the home from April 2005 until August 2005 to offer support and check progress. What the service does well: What has improved since the last inspection? It is evident following this inspection that major improvements that have taken place. The Manager has begun to develop and update policies and procedures. Care plans have improved vastly as has the standard of record keeping. Staff have received moving and handling and medication training. A great deal of effort has been given by the Manager and staff to address the majority of requirements highlighted at the last inspection in April 2005. Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 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. Germaina House DS0000000103.V260378.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 Germaina House DS0000000103.V260378.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): The above standards were not inspected in full, however, a requirement highlighted at the last inspection in April 2005 in respect of contracts was revisited and observed to have been addressed. EVIDENCE: Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 9 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 The home provides a good standard of care. Care plans reflect current care needs of residents, which ensures that health, personal, and social care needs of residents are met. EVIDENCE: Three plans of care were examined at random during this inspection. Since last inspection the Manager and staff have worked extremely hard to develop the care planning system in the home. Care plans examined were well presented, informative, and stated capabilities, limitations and assistance required by the resident. Care plans had been evaluated on a monthly basis, and contained a signature of the resident/relative to confirm that they had been involved in drawing up the plan of care. Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 10 Four residents were spoken to during the inspection all of who confirmed that their care needs were met. One resident said, “I think that this is the best place in the world, staff can’t do enough for you”, another said, “Everyone is good, I get a laugh in here, if I was at home I would be staring out of my window”. One resident did point out that the television reception in her bedroom was poor; the Manager said that she would take immediate action to address the problem. Standard 9 medication, was not inspected in full during this inspection, however, requirements highlighted at the last inspection in April 2005 was revisited. Since last inspection the home has developed a policy/procedure in respect of medication systems that are in place at the home. The majority of care staff at the home have now received medication training. A staff member spoken to during the inspection was able to give a clear account of procedures to follow in respect of administration of controlled medication. Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 11 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): The above standards were not inspected in full, however, requirements highlighted at the last inspection were re-visited. EVIDENCE: The Manager said that since last inspection, staff at the home have developed a plan of activities to carry out with residents. Activities included, cards, dominoes, sing a longs and gentle exercises. Motivational classes are carried out with residents on a monthly basis, and a number of residents have been shopping with staff into the town centre. One resident spoken to during the inspection said, “I went out shopping on Wednesday with staff, we went all round the shops and then round the market. We had a cup of coffee and I thoroughly enjoyed it”. Three out four residents spoken to during the inspection said that they felt that there were sufficient activities, one did not. The home is busy planning for Christmas, a party has been arranged and entertainment booked. Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 12 The Manager had recently carried out a quality assurance exercise involving residents and relatives. Three questionnaires received from relatives stated that they did not feel that there were sufficient activities occurring in the home, and had given some ideas for activities. The Manager said that she was taking the ideas on board. It was highlighted at the last inspection that suitable storage must be found for potatoes and vegetable, this had been addressed. Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 13 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 The home has an effective complaints procedure, which enables residents to make any complaints they feel necessary. EVIDENCE: The home has a complaints procedure, details of which are also available in the statement of purpose and service user guide. Residents interviewed during the inspection said that the Manager and staff at the home are approachable and if they felt the need to complain then they would do so. Standard 18 was not inspected in full, however requirements highlighted at the last inspection were re-visited. Since last inspection the Manager has developed a policy/procedure for staff to follow if abuse is suspected. The Manager has attended adult protection training and intends to cascade to staff, however informed the Inspector that as yet has not had time to do so. Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 14 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): The above standards were not inspected, however requirements highlighted at the last inspection in April 2004 were re-visited and were observed to have been addressed. EVIDENCE: Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 15 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): 28 EVIDENCE: The Manager said that 78 of care staff are trained to NVQ level 2 in care or equivalent. Standard 27 was not inspected in full, however requirements identified at the last inspection were re-visited. Since last inspection the Manager has reviewed staffing levels in the home. At the last inspection it was noted that there were two care staff on duty between the hours of 3pm until 9pm, one of which helped with tea preparation. The Manager said that there is now an additional staff member working each day to prepare tea. The Manager informed the Inspector that she has carried out a risk assessment and review of residents and feels that one night staff on duty is sufficient with the Manager, who lives on the premises on call. The Manager said that the home has now employed a cook, who is currently undergoing induction. Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 16 Standards 29, recruitment was not inspected in full, however requirements identified at the last inspection were re-visited. Records were available to confirm that the Manager now ensures that all newly appointed staff receive a POVA FIRST/Criminal Record Bureau Check. Staff records examined during the inspection were observed to have a photograph on file and other records required. Records were examined to confirm that staff working at the home have received recent training in moving and handling. The Manager informed the inspector that she has not had time to review and update the home’s recruitment policy/procedure due to heavy work load and the number of requirements identified at the last inspection that required attention, however will now take action to do so. Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 17 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, 38 Not all servicing in the home environment has been carried out as required, a rolling programme of servicing machinery and equipment must be implemented to ensure safety of residents, staff and visitors. The home ensures that the financial wellbeing of residents is safeguarded and protected. EVIDENCE: The Manager, Ann Palmer, has worked in the social care environment for many years, and has achieved an NVQ level 4 in Management. Due to work commitments and personal reasons the Manager has been unable to complete her NVQ level 4 in care, however has re-registered and is to commence the course in the next couple of weeks. Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 18 It is evident following this inspection that the Manager and staff have worked extremely hard to develop working systems and improve the standard of record keeping in the home. Records examined at random confirmed that the homes fire extinguishers and fire alarm and are serviced on a regular basis. The Manager said that the home’s gas boilers and central heating had been serviced, however, was unable to find the certificate of inspection/service at the time of the inspection. The servicing of the emergency lighting was observed to be out of date. Portable electrical appliances are service on a yearly basis, however the home does not have a system in place for any equipment brought into the home in the interim. Certificates were available to confirm that the home’s mobile hoist had been serviced. The Manager said that temperatures of baths, sinks and showers are taken on a regular basis to check that they within normal limits, however, that this is not recorded. Records were available to confirm that staff had received recent fire training and that a weekly check of the fire alarm system is carried out. Records were available of staff taking part in fire drills, however the home is not carrying out an evacuation that involves both residents and staff. The Manager said that she would consult with the Fire authority and take action to address this. The Manager said that all windows on the first floor of the home are restricted to ensure safety of residents. Mandatory training has recently been provided to staff working at the home, certificates were available to confirm that this is the case. The home operates an effective system in which they look after the personal allowance of a number of residents. Accurate records of transactions and receipts were available for examination Since last inspection the Manager has carried out a quality assurance exercise, which has involved sending questionnaires to residents and their representatives. A discussion took place with the Manager regarding publishing the results of the survey and making them available to residents and relatives. It was requested at the last inspection that a statement of the homes financial viability be forwarded to the Commission for Social Care Inspection, this as yet has not been carried out. The Manager informed the Inspector that she has recently appointed a new Accountant and that budgets will be available in the next couple of weeks. Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 19 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 3 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 3 3 3 3 X STAFFING Standard No Score 27 3 28 3 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 2 3 X X 2 Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 20 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 OP12 Regulation 16 Requirement The Manager must consult with residents and relatives to develop further the home’s activity program All staff must received adult protection training (Previous timescale for action of 31/03/2005 not met) The homes recruitment policy/procedure must be updated (Previous timescale for action of 28/02/2005 not met) The Manager must achieve an NVQ level 4 in care by December 2006 A statement of financial viability must be forwarded to the Commission for Social Care inspection (Previous timescale for action of 30/07/2005 not met) Gas boilers must be serviced on a yearly basis. Certificates must be available in the home as proof of servicing DS0000000103.V260378.R01.S.doc Timescale for action 30/12/05 2 OP18 13 30/12/05 3 OP29 13, 17 30/01/06 4 5 OP31 OP34 18 25 30/12/06 30/01/06 6 OP38 13 22/11/05 Germaina House Version 5.0 Page 21 7 8 OP38 OP38 13 13 9 10 OP38 OP38 13 23 Emergency lighting must be serviced on a yearly basis The home must develop a system in which to ensure that all portable appliance equipment brought into the home which is not in line with the annual servicing of the home is serviced Temperatures of baths, sinks and showers must be taken and recorded on a regular basis The Manager must consult with the Fire Authority and carry out a fire drill/evacuation that involves both residents and staff 22/11/05 22/11/05 22/11/05 30/12/05 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 Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Germaina House DS0000000103.V260378.R01.S.doc Version 5.0 Page 23 - 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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