Inspection on 05/05/06 for Germaina House

This inspection was carried out on 5th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Germaina House 12/12/08

Germaina House 22/04/08

Germaina House 01/05/07

Germaina House 22/11/05

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 Derek Stow Key Unannounced Inspection 5th May 2006 11:00 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 Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 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.V292598.R01.S.doc Version 5.1 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 296039 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.V292598.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd November 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 tables 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 wash basin. 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.V292598.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took ten and a half hours spread over three days with the inspector examining a number of records; speaking to five residents, the manager, the administrator, three members of the Care staff and the cook. A tour of the building was carried out and requirements identified at the last inspection were re-visited. This inspection looked at only those standards, which the Commission for Social Care Inspection regard as Key standards. The details of any issues identified as requiring action are to be found at the back of this report. What the service does well: What has improved since the last inspection? Germaina house continues to provide a homely caring service for up to eighteen residents and is building up its management systems to support the standards required. In addition the Manager has undertaken Adult protection training and has passed this training down to the majority of the staff. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 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.V292598.R01.S.doc Version 5.1 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.V292598.R01.S.doc Version 5.1 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 Appropriate information about the service at Germaina House is available to help people in making a choice of where to live. Contracts are issued to residents / relatives. An assessment of needs is carried out on people moving into the home in order to ensure that the home can meet their needs. The Inspector felt that the standards for this area of the service should be judged as “adequate”. EVIDENCE: The Service user guide and contract for residents were developed following inspections during 2005-2006 and were satisfactory. The manager stated that no changes had been made since the last inspections and stated that the new contracts are issued to residents. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 Page 9 The files were examined for the last to two people to be admitted to Germaina House and these showed evidence of appropriate pre-admission assessment information. The home does not provide intermediate care. The Service User guide must be updated to inform residents/relatives of their right to complain to the Social Services Complaints officer where the service has been contracted by the Local Authority. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 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 & 10 Health and personal care needs are well documented and met however recorded evidence regarding social, emotional, leisure and religious issues should be strengthened. Residents are protected by appropriate policies and procedures relating to the giving and storage of medicines. Residents are treated with dignity and respect. The Inspector felt that the standards for this area of the service should be judged as “adequate”. EVIDENCE: The two files examined had evidence of health and personal care needs in the care plans and were well presented and easy to follow and read. However, staff need brief but clear information, which tells them what to do in order to try to maintain or stimulate social, leisure or religious needs. This area of care planning must be strengthened. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 Page 11 There was clear evidence of appropriate contact with G.P’s, District Nurses, Opticians and Chiropody services.’ Medication policies and procedures were developed and improved following inspections during 2005-2006 and were found to be satisfactory. The manager said that no changes had been made since that time. Training records show that eleven staff have been trained in the administration of medication and observation of the giving of medicines at lunchtime was satisfactory. The manager must ensure that all staff giving medication use the correct codes on the medication records as on examination not all entries were correct. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 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 & 15 Residents find that the lifestyle at Germaina House meets their expectations and feel that they have control over their lives however the programme of activities must be maintained. Contact with family and friends is encouraged and religious needs are catered for. Residents receive a wholesome, balanced and varied diet. The Inspector felt that the standards for this area of the service should be judged as “adequate”. EVIDENCE: It was apparent from observation and conversation with staff and residents that there was a relaxed and friendly atmosphere in the home. Residents said that they could come and go as they please and spend as much time in their own rooms as they wished. Records show that residents are offered a key to their rooms on admission. Residents said that they are offered activities such as cards, dominoes, bingo and a sing-along but a programme of activities, which had been developed resulting from inspection in 2005-06, was not evident on the day. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 Page 13 The Manager is committed to ensuring that stimulating and enjoyable activities are carried out and two staff are booked on to a course run by the National Association of Providers of Activities on 26thmay 06. It is important however that a formal programme of activities within the home together with trips outside the home should be maintained to help inform and motivate both staff and residents. These programmes should support the social and leisure needs and wishes identified in the care plan. The residents spoken with confirmed that they have access to Church activities either outside or brought in to the home. The home does not hold any monies on behalf of any residents as residents either manage their own money independently or relatives manage it. Four residents were consulted about the food and all said that the food was of a very good quality and they were satisfied with the choice and variety. A good supply of fresh fruit and vegetables was seen in the kitchen and the cook confirmed that mainly fresh vegetables are used rather than frozen. The lunchtime meal on the day of inspection was fish/chips and mushy peas and this appeared in good portions and was well presented. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 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 & 18 Residents feel safe at Germaina House and appropriate policies and procedures are in place in relation to the protection of vulnerable adults. The complaints information needs updating. The Inspector felt that the standards for this area of the service should be judged as “good.” EVIDENCE: The Complaints record was examined and this showed that no complaints had been made since the last inspection. The manager said that she has attended Adult Protection training and this has been cascaded down to all staff. One staff file examined at random supported this and staff spoken with confirmed this. The complaints information given to residents and relatives must be updated to inform residents/relatives of their right to complain to the Social Services Complaints officer where the service has been contracted by the Local Authority. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 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 & 26 The home was observed to be generally clean, comfortable, well furnished, well decorated and maintained although there were areas of stained carpet, which need attention. Documentary evidence was not available to support some aspects of safety. The Inspector felt that the standards for this area of the service should be judged as “adequate” as the shortfalls were being addressed by the manager/proprietor. EVIDENCE: A tour of the building showed the home was clean and tidy throughout and in good state of repair. Each bedroom was pleasantly decorated, comfortably furnished and personalised with small items of furniture, photographs and ornaments. This created a warm and homely setting. Within the three double rooms there were screens suspended from the ceiling, which gave privacy for the residents. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 Page 16 The five residents spoken with all said that they were happy with their bedrooms. The bathrooms and toilets were clean and pleasant and all had bacterial hand wash available. There were some small areas of stained carpeting which the Manager agreed needed cleaning/re-placing. An Immediate Requirement Notice was issued relating to a broken patio door lock to a bedroom, which opened on to a rear patio area. This was made safe at the time and on a follow up visit the lock was observed to have been replaced. The last inspection report of the Fire officer’s visit on 2nd December 2005 had recommended that smoke detectors be fitted and this work was observed to have been carried out. The last Environmental Health officer’s visit to inspect the kitchen, food storage and hygiene was on the 20th September 2005 and the findings were satisfactory. A gas safety certificate was not available at the time of inspection and the manager is required to have this in place. The electrical wiring certificate is recorded as been carried out in November 2000 which is outside of the 5 year recommended timescale. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 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, & 30 Germaina House is staffed by a stable and well-trained team of care staff who are positively recruited with the safety and protection of residents in mind. There are however times when there are not sufficient staff on duty. The Inspector felt that the standards for this area of the service should be judged as “adequate”. EVIDENCE: It is clear that training is given priority at Germaina House with 92 (12 of the 13 care staff) trained to NVQ level 2 and on the first day of the inspection 10 staff were attending up—dating of 1st Aid training. The three staff files examined all showed evidence of criminal record bureau checks, two written references as well as training and supervision. One file did not hold a staff photograph or copy of birth certificate/passport. At the time of the inspection the home had been without their own cook for a few weeks and were being assisted by a visiting cook and on one afternoon of the inspection there were only two care staff on duty without management support, without a cook and the two care staff were occupied preparing the tea meal. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 Page 18 The manager must review the staff required to meet the care needs of the residents between 3-5pm and ensure there are sufficient staff on duty. Any additional staff brought in to the home to assist during periods of shortages of cooks or care staff must be recorded on the rota. The Manager has undertaken Adult protection training and is training staff internally. All staff including ancillary staff must receive training /instruction in Adult Protection. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 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): 31,33,35 & 38 There was clear evidence that the manager and staff work hard to ensure that the residents receive consistent quality care in the way they wish to receive it. However, although management systems, polices, procedures and records have improved progress must continue to be made particularly regarding health and safety and quality assurance. The Inspector felt that the standards for this area of the service should be judged as “adequate”. EVIDENCE: The Manager, Ann Palmer, has worked in the social care environment for many years, and has achieved an NVQ level 4 in Management and has given a written undertaking to complete the final elements required to qualify to NVQ level 4 in Care. The home does not hold money on behalf of any resident. Residents either look after their own money or relatives look it after. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 Page 20 Formal management systems are still gradually being worked on and are improving. A sample number of management and health and safety records were examined. A statement of accounts was made available and a letter was sent to Commission for Social Care Inspection from the home’s accountant confirming that the service was financially viable. Hot water temperature checks were recorded weekly and during the inspection bath water was recorded as 45 degrees. The last fire training within the home was recorded as 18th October 2005 with the next training being booked in the diary for 23rd June 2006 at which the manager said that evacuation drill will be covered. A maintenance /inspection of equipment such as hoists/bath and stair lift were recorded as having taken place on 19th April 2006. It has been mentioned in a previous section that a gas safety certificate and a electrical wiring certificate were not available at the time of inspection. A more robust system of audit and health and safety checks would help to ensure compliance. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 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 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 x x x x x x 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 x x 2 Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 Page 22 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 OP18 Regulation 13 Requirement All staff must received adult protection training (Previous timescale for action of 31/12/2005 not met) The Manager must achieve an NVQ level 4 in care by December 2006 Timescale for action 31/07/06 2. OP31 18 30/12/06 3. OP38 13 Gas boilers must be serviced on 30/06/06 a yearly basis. Certificates must be available in the home as proof of servicing.( Previous timescale 22/11/05 not met) The Service User guide must be updated to inform residents / relatives of their right to complain to the Social Services Complaints officer where the service has been contracted by the Local Authority. The manager must ensure that all staff giving medication use the correct codes on the medication records as on examination not all entries were correct. DS0000000103.V292598.R01.S.doc 4. OP1 5 30/09/06 5. OP9 13 30/06/06 Germaina House Version 5.1 Page 23 6. OP16 22 The complaints information given 30/09/06 to residents and relatives must be updated to inform residents / relatives of their right to complain to the Social Services Complaints officer where the service has been contracted by the Local Authority. The small areas of stained carpeting identified with the Manager need cleaning / replacing. The manager must address the staff shortages in respect of employing a cook. Interim arrangements in preparing the tea meal must be reviewed to ensure that sufficient care staff are on duty to meet the care needs of the residents. The staff rota must record accurately the staff brought in to the home including interim arrangements. 30/09/06 7. OP26 23 8. OP27 13,18 25/05/06 9. OP29 13 All staff including ancillary staff 30/09/06 must receive training /instruction in Adult protection. The manager must achieve an 30/12/06 NVQ level 4 in Care by December 2006 10 OP31. 18 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 Page 24 No. 1 Refer to Standard OP38 Good Practice Recommendations The electrical wiring should be checked at least every five years. Germaina House DS0000000103.V292598.R01.S.doc Version 5.1 Page 25 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. 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