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Inspection on 07/02/06 for Ghyll Grove Residential and Nursing Home

Also see our care home review for Ghyll Grove Residential and Nursing Home for more information

This inspection was carried out on 7th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Both relatives who responded to the survey questionnaire commented that they were satisfied overall with the care provided by Thames House. Staff working on Thames House ensure that only people for whom the home can meet their needs are offered a place at the home. There is detailed information recorded about each person`s care and treatment including details of any risks to health and safety such as risk of injury from the use of equipment or in the pursuit of daily activities. Where it is deemed that there are risks, staff implement plans so as to minimise these risks. Staff act so as to ensure that all people living on Thames House receive medicines as prescribed for them.Residents are consulted about how they wish to spend their days including leisure time and the daily routines are flexible so as to meet the wishes of the people living in the house.

What has improved since the last inspection?

Not applicable at the time of this inspection.

What the care home could do better:

While not all of the standards were assessed during this inspection there was evidence that staff worked so as to ensure a good quality of life for the people who live in Thames House. Some care plans would benefit from a little more detail, particularly in relation to residents preferences for how care and treatment is delivered and how they wish to spend their days including preferences for leisure activities.

CARE HOMES FOR OLDER PEOPLE Ghyll Grove Residential and Nursing Home Ghyllgrove Basildon Essex SS14 2LA Lead Inspector Carolyn Delaney Unannounced Inspection 07:00 7 & 8 February 2006 th th 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 Ghyll Grove Residential and Nursing Home DS0000015535.V260837.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. Ghyll Grove Residential and Nursing Home DS0000015535.V260837.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ghyll Grove Residential and Nursing Home Address Ghyllgrove Basildon Essex SS14 2LA 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) 01268 273173 01268 288289 BUPA Care Homes Limited Mrs Christine Ann Walton Care Home 150 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (150), of places Terminally ill (4) Ghyll Grove Residential and Nursing Home DS0000015535.V260837.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Nursing and Personal Care to be provided for up to a maximum of one hundred and fifty (150) Older People. Nursing and Personal Care to be provided for up to a maximum of four (4) people who have a diagnosed Terminal Illness. Nursing and Personal Care to be provided for up to a maximum of thirty (30) Older People who have a diagnosis of Dementia and who require nursing care Accommodation and Personal Care to be provided for up to a maximum of thirty (30) Older People who do not require nursing care and have a diagnosis of Dementia. Nursing Care for people who have a diagnosis of Dementia to be provided on Kennett House only. Accommodation and Personal Care for people who do not require nursing care and who have a diagnosis of Dementia to be provided on Thames House only. 8th June 2005 5. 6. Date of last inspection Brief Description of the Service: Thames House is one of the five houses which make up BUPA Ghyllgrove. Thames House provides personal care and accommodation for up to thirty people who have a diagnosis of Dementia but who do not require nursing care. Care staff with appropriate skills and knowledge were employed at the home to meet the needs the people who live there. Thames House has recently opened after a period during which the house was redecorated in bright colours with and comfortable furnishings so as to improve recognition of key areas and provide a homely environment for residnets to live in. The house provides each resident with their own bedroom and access to clean and well maintained communal areas including a combined lounge and dining area and garden space.Ghyllgrove is situated in a residnetial area of Basildon close to the town centre, local shops and amenities and bus and train links to Southend and London. Ghyll Grove Residential and Nursing Home DS0000015535.V260837.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection carried out on 7th & 8th March 2006 between the hours of 07.00 and 17.00. Carolyn Delaney, Lead Inspector for the home, carried out the inspection. Records including care plans and assessments in respect of residents’ needs and risks to health, safety and welfare were examined. Four residents were spoken with during the course of the inspection. The relatives of five residents at the home were contacted by post so as to offer them the opportunity to make comments about the services provided by the home. Two relatives responded and a summary of the comments made has been included in the report. Six members of staff were spoken with during the course of this inspection so as to determine their awareness of the needs and wishes of the people living at the home and the homes policies and procedures. Key standards as identified in the intended outcomes sections of this report are inspected at least once every twelve months. However they will not have been assessed for Thames House as it has reopened since the last inspection carried out to Ghyllgrove What the service does well: Both relatives who responded to the survey questionnaire commented that they were satisfied overall with the care provided by Thames House. Staff working on Thames House ensure that only people for whom the home can meet their needs are offered a place at the home. There is detailed information recorded about each person’s care and treatment including details of any risks to health and safety such as risk of injury from the use of equipment or in the pursuit of daily activities. Where it is deemed that there are risks, staff implement plans so as to minimise these risks. Staff act so as to ensure that all people living on Thames House receive medicines as prescribed for them. Ghyll Grove Residential and Nursing Home DS0000015535.V260837.R01.S.doc Version 5.0 Page 6 Residents are consulted about how they wish to spend their days including leisure time and the daily routines are flexible so as to meet the wishes of the people living in the house. What has improved since the last inspection? 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. Ghyll Grove Residential and Nursing Home DS0000015535.V260837.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 Ghyll Grove Residential and Nursing Home DS0000015535.V260837.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): 3&4 People are only admitted to Thames House following a detailed assessment of their mental health and general healthcare needs so as to determine that staff can meet the needs. EVIDENCE: Thames House had been opened for approximately eight months at the time of this inspection. There were thirteen people living in the house. There were detailed records in relation to the assessments carried out before a place at the home is offered to prospective residents. A dedicated team of staff who have received training specific to the needs of older people with mental health needs work on the unit which has been decorated and furnished in a manner which promotes recognition, including themed murals in corridors and darkened areas where residents are discouraged from exploring. Ghyll Grove Residential and Nursing Home DS0000015535.V260837.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, 8, 9 & 10 Information about the mental health and general needs including risks to residents health and safety is well recorded and updated regularly so as to ensure that staff are fully informed about the care and treatment each person is to receive. Care staff ensure that so far as it is possible that residents living on Thames House receive medicines, which have been prescribed for them. Staff working on Thames House act in a sensitive and caring manner when assisting residents and act so as to promote dignity and independence. EVIDENCE: Care plans and information in respect of residents care and welfare needs were generally well written and a number of care plans were written exceptionally well with good detail about the individuals care and treatment and preferences for daily activities. Ghyll Grove Residential and Nursing Home DS0000015535.V260837.R01.S.doc Version 5.0 Page 10 Risks to residents health and safety were well written and kept under review and there were detailed records kept in relation to the specific care and treatment delivered to residents following falls etc. Records maintained in respect of falls and injuries to residents indicated that risks were well managed. Staff were noted to administer medication at the times as directed by the individuals doctor. It was positive to note that staff spent time explaining what medicines were for where residents were resistant to treatment and it was positive to note that staff acted so as to take every reasonable action so as to ensure that residents received medicines as prescribed. It was also noted that staff acted in accordance with the homes policies and procedures when recording medicines received into the home and administered to residents. Ghyll Grove Residential and Nursing Home DS0000015535.V260837.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): 12, 14 & 15 Routines and staff practices are carried out in the best interests of the people who live on Thames House. Residents receive a varied diet, which meets their needs and preferences. EVIDENCE: Staff working on Thames House on both days of the inspection were noted to treat residents in a caring and supportive manner and to promote opportunities for maintaining each residents level of independence. Staff were observed to ask residents whether they would prefer to watch television or listen to music and choices in respect of both activities were sought by staff. It was noted that age appropriate programmes were made available by staff. Residents appeared happy and relaxed in the homes environment. In general care plans included specific details in respect of residents wishes about how they wished to receive care and treatment and to spend their time. The routines at both breakfast and lunchtime meals was noted to be flexible and suited to each individuals needs. Ghyll Grove Residential and Nursing Home DS0000015535.V260837.R01.S.doc Version 5.0 Page 12 A programme of activities is available and the home employs dedicated activities coordinators. The provision of activities at times when activities coordinators are not on duty such as in the evenings and at weekends was discussed and staff could do more to evidence the activities provided during these times. There was a good choice available at both mealtimes and staff offered extra portions to residents and checked that all residents had enough to eat before the end of the meal. Snacks and bread and butter were made available for residents who said that they were hungry in between meals. Three residents who were spoken with on the day of the inspection said that the food was very good. Resident’s weights are regularly monitored and appropriate action is taken if weight loss is persistent. Ghyll Grove Residential and Nursing Home DS0000015535.V260837.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): 0 These standards will be assessed at the next inspection. EVIDENCE: Ghyll Grove Residential and Nursing Home DS0000015535.V260837.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): 19, 20 & 26 Thames House has been recently refurbished to a very high standard and is suited to the needs of the people who live there. EVIDENCE: Each resident living on Thames House has their own bedroom and these have been decorated nicely. Communal areas and corridor are bright and welcoming and well maintained. The lounge area is very homely and there is a bistro style dining area. The house was noted to be clean and free from unpleasant odours during the time spent there over the two days of the inspection. Ghyll Grove Residential and Nursing Home DS0000015535.V260837.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): 27 & 30 Staffing levels are reviewed according to the numbers of residents living on Thames House and sufficient numbers of suitably skilled and trained staff work in the house so as to meet the needs of the people living there. EVIDENCE: Staff duty rotas indicated that staff working on Thames House do not work excessive hours without a break. The staff team have worked together for a number of years and work well as a team. Staff have received mandatory training and training specific to meeting the needs of older people who have varying degrees of mental health needs. Ghyll Grove Residential and Nursing Home DS0000015535.V260837.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33 & 38 Thames House is well managed and staff carry out care practices and implement routines which best serve the people who live in the house. EVIDENCE: A dedicated head of home carries out the day-to-day management of Thames House home supported by a team of senior care staff. It was noted that there were clear lines of accountability within the unit. In addition Ghyllgrove has appointed a new homes manager who has worked very hard with all of the homes staff and the Commission so as to improve the level of service provided by the home as a whole. Ghyll Grove Residential and Nursing Home DS0000015535.V260837.R01.S.doc Version 5.0 Page 17 Ghyllgrove has detailed policies and procedures in place in respect of the maintenance, repair and renewal of gas, electric, fire and mechanical appliances and equipment throughout the home. There were no health and safety issues identified during the course of the inspection and records in respect of maintenance will be assessed at the next inspection. Ghyll Grove Residential and Nursing Home DS0000015535.V260837.R01.S.doc Version 5.0 Page 18 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 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 4 4 X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X X X Ghyll Grove Residential and Nursing Home DS0000015535.V260837.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP7 OP12 Good Practice Recommendations Some care plans would benefit from some more detail in respect of resident’s preferences for receiving care and how they wish to spend their days including leisure time. Staff should evidence the range of activities provided for residents at times when the activities coordinators are not on duty at the home. Ghyll Grove Residential and Nursing Home DS0000015535.V260837.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Ghyll Grove Residential and Nursing Home DS0000015535.V260837.R01.S.doc Version 5.0 Page 21 - 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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