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Inspection on 07/06/05 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 June 2005.

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

Medway House provides clean, safe and comfortable accommodation for people who are over 65 years of age and who need nursing care. Staff and management work well together as a team to ensure that residents are well cared for. Staff spend time with residents and do not hurry them when assisting with daily activities and routines. The house provides meals, which are well presented and staff assist residents according to their needs. The house is clean, bright and well maintained.

What has improved since the last inspection?

There have been many improvements since the last inspection. Staff spend more time with residents and carry out their duties so as to make the home more comfortable and safe for residents who live there. Staff know the residents needs, likes and dislikes. The number of complaints received by the house has decreased since the last inspection and resident`s comments about the staff and the home were far more positive. The way in which staff record information about resident`s needs and how staff are to assist so that residents can have an improved quality of life has improved. The management of the house is more open and staff have a good approach to dealing with comments and concerns brought to them by residents and relatives.

What the care home could do better:

While there have been improvements in the way in which staff record information, records do not always contain enough detail about residents and what care they need so as to ensure that their needs can be fully met and that they are kept safe from potential injury and harm. Activities for residents could be reviewed so that there are opportunities for all residents living in this house, and not just those who are most able. Records for staff training could be more organised so as to evidence that staff are trained to meet the needs of residents living at the home.

CARE HOMES FOR OLDER PEOPLE Ghyllgrove Residential and Nursing Home - Medway House Ghyllgrove Basildon Essex SS14 2LA Lead Inspector Carolyn Delaney Un-announced 7th June 2005 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 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. Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ghyllgrove Residential & Nursing Home - Medway House Ghyllgrove Basildon, Essex SS14 2LA Address Telephone number Fax number Email 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 Ltd Mrs Christine Ann Walton CRH 150 Category(ies) of Older people (OP) 150, Dementia over 65 registration, with number (DE)(E) 30, Terminally Ill (TI) 4. of places Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14/9/04 Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: Medway House is one of five houses which make up Ghyllgrove Nursing and Residential Home. The home is situated in a residential area close to Basildon town centre. Medway House provides single room accommodation, all on ground level for up to thirty older people with nursing needs.Medway House has an open plan dining / lounge area with a small kitchen area where residents and their visitors may make drinks etc. There is also a quiet room where residents may receive visitors in private. Outside there is a small well-maintained garden area.The unit is managed overall by the homes registered manager, Kit Walton. The day to day management of the house is the responsibility of a senior nurse (Head of House). Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Medway House was carried out predominantly on 7th June with some time spent in the house on the 8th June 2005. Lead inspector, Carolyn Delaney and second inspector, Michelle Love, carried out the inspection. During this inspection assessment documents, care plans and assessments in respect of potential risks to residents, were examined and five residents were spoken with. Staff duty rotas and training files were examined and four members of staff were spoken with. The serving of breakfast, lunch and suppertime meals were observed. A brief tour of the house was carried out. As this is the first time that Roding House has been subject to an individual inspection and inspection report there have been no regulatory requirements or recommendations carried forward from the previous inspection. What the service does well: What has improved since the last inspection? Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 7 There have been many improvements since the last inspection. Staff spend more time with residents and carry out their duties so as to make the home more comfortable and safe for residents who live there. Staff know the residents needs, likes and dislikes. The number of complaints received by the house has decreased since the last inspection and resident’s comments about the staff and the home were far more positive. The way in which staff record information about resident’s needs and how staff are to assist so that residents can have an improved quality of life has improved. The management of the house is more open and staff have a good approach to dealing with comments and concerns brought to them by residents and relatives. 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. Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 8 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 Standards Statutory Requirements Identified During the Inspection Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 9 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 standard(s) 1,3&4 Residents living in Medway House are provided with detailed information about the house. Resident’s needs are assessed prior to their admission to the home and reviewed regularly, however not all assessments include sufficient information so as to determine and ensure that the home can meet these needs. EVIDENCE: Each resident has a copy of the homes service users guide, which includes information in respect of the services provided by Medway House. Assessment documents for three residents living at the home were examined. The records in respect of assessments carried out prior to people being offered a place at the home. These records were generally detailed, however some more information in respect of residents needs and how these needs affect their ability to carry out daily activities should be recorded. For example where it was recorded that residents had difficulty with communication, poor appetite it was not clear to what degree these needs affected the individuals ability with Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 10 daily activities of living so as to determine what measures staff should take to best meet these needs. Residents said that the staff were very ‘caring’, ‘helpful’ and ‘kind’. One resident commented that ‘this was ‘the first home he has been happy with’. Staff working on Medway are aware of residents needs Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 11 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 standard(s) 7,8,9,10 &11 Staff on Medway House act in a manner so as to plan nursing, care and treatment to meet the needs, safety and welfare of residents living at the home. However some documents did not include sufficient detail in respect of individuals needs. EVIDENCE: Care plans were generally well written and updated on a regular basis and when resident’s needs changed. Some plans were not specific in identifying how a particular need impacted upon the daily life of the individual or what actions staff should take to minimise this impact. For example where one resident had diabetes, it was not recorded how this was managed, such as what the resident could do and what assistance from staff was required. Care plans were updated regularly. Assessments in respect of identifying and minimising risks to residents of injury or harm associated with immobility (pressure sores / falls), use of bedrails (entrapment etc) was carried out for all residents living at the home. However some of these were written in very general terms and did not clearly indicate the risks to the individual or what specific measures staff were to take to minimise these risks. Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 12 Staff were observed to move and assist residents with care and attention. Residents were cared for and treated with dignity and staff were noted to be polite and respectful. Medication Administration Records (MAR) were not always clear in respect of whether residents had received their medication, and where records had been handwritten there was no countersignature as a safeguard against potential errors. Medway House has an open visiting policy and residents may receive visitors in private if they choose. Some records were made in respect of resident’s wishes for issues related to end of life and dying such as preferred arrangements following death. Care plans were in place for most residents, which recorded how to offer support to residents and relatives. However these care plans were standardised and not specific to individuals needs. Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 13 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 standard(s) 12 & 15 The provision of social, leisure and meaningful occupational activities are not always suited to the needs of all residents living at the home. Residents receive a choice of well-presented meals, which are served in an unhurried manner, and staff provide assistance to residents as required. EVIDENCE: Two activities coordinators are employed to provide activities for both Medway and Chelmer House. On the morning of this inspection both were working on Medway House, and while they were observed to interact well with the more able residents , there was little evidence that suitable activities and stimulation was provided for residents who were nursed in bed or those who due to the nature of their needs required a more ‘one to one ‘ approach. Residents said that the food provided was good and that there ‘was plenty of it’. Staff offer residents a three course lunchtime meal including soup starter and a choice of dessert. Food served looked appetising and was served nicely in an unhurried manner. At suppertime residents are served with individual teapots, milk and sugar which creates a more homely and pleasant experience. Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 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 standard(s) 16 & 18 Staff working in Medway House act in a manner so as to protect the interests, welfare and safety of residents living there. Resident’s complaints and concerns are received and dealt with appropriately. EVIDENCE: The number of complaints made about the services provided by the home had decreased and resident’s comments were generally positive. Records maintained in respect of complaints were well maintained. Residents said that they felt that if they had to make complaints that staff would listen and deal with their concerns. Staff have a positive approach to dealing with complaints made by residents and relatives. Staff receive training in respect of how to protect people living in the home from abuse. Staff could demonstrate that they were aware of the correct action to take if they suspected or witnessed abuse of residents living at the home. Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 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 standard(s) 0 These standards were not fully assessed during this inspection. EVIDENCE: A number of residents’ bedrooms were seen and were clean and comfortable with residents’ personal belongings and specialist equipment as required. The communal areas such as dining and lounge areas were clean and comfortable. Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28 &30 Residents living in Medway House are supported with staff who are skilled, trained and supervised in their roles, so as to best meet their assessed needs. EVIDENCE: Staff were employed in sufficient numbers to meet the needs of residents living in Medway House. Duty rotas were well maintained and accurately reflected the numbers of staff working in the house. Staff were observed to treat residents in an unhurried manner when assisting with daily activities such as mobilising and at mealtimes. The senior nurse for Medway House had moved from Thames House, which was closed temporarily. Michelle had reviewed the daily routines and made some changes to staff practices so as to allow more time to be spent with residents. Staff were aware of residents needs and demonstrated that they had the skills and had received training in respect of meeting these needs. Staff receive mandatory training in respect of the safe moving and handling of residents, health and safety, protecting vulnerable people from abuse. Staff have responsibility for ensuring that their training files are up to date, however staff do not do this consistently. Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,38 Medway House is maintained and managed in an open and positive manner where residents, staff and relatives can be involved in affecting changes in how care is carried out. EVIDENCE: Residents and staff were happy with the manner in which this house has been managed in the past few months. The senior nurse has affected changes with the input of residents and staff so as to benefit residents and improve the way in which care is delivered. Residents and / or their relatives are invited to attend meetings where the management of the home and the services provided can be discussed. Staff work well as a team so as to ensure that resident’s needs are met. Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 18 The home employs a maintenance man to deal with any repairs and to carry out routine maintenance checks. There were no issues identified during this inspection in respect of the safety of the premises. Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 2 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x x x 3 Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 20 N/A 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 OP3 Regulation 14(1)(2) Requirement Recorded assessments in respect of residents needs require more detail in respect of how needs affect daily life, so as to determine that the home cane meet these needs. Care plans require more detail in respect of each individual and what specific care and assistance they need. Records in respect of actual and potential risks to residents require more detail in respect of what level of risk is involved and how this can be minimised. Records maintained in respect of medication received, stored, administered and disposed of must be clear, up to date and accurate so as to ensure that residents receive appropriate medicines and to minimise the risks of mishandling of medicines. The provision of activities must be suited to the needs and so far as it is practicable, the wishes of all residents living at the home. Timescale for action 30/08/05 2. OP7 15(1)(2) 30/08/05 3. OP8 13(4) 30/08/05 4. OP9 13(2) Immediate & ongoing 5. OP12 16(2) (m) (n) 30/08/05 Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 21 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. 3. Refer to Standard OP11 OP12 OP30 Good Practice Recommendations Records maintained in respect of residents wishes for end of life and any associated care plans should be more specific to the individuals needs. The way in which the activities coordinators are deployed would benfit from a review, so as to ensure that this resource is best used for the residents living at the home. Records in respect of staff training would benefit from review and reorganisation, so as to evidence the training which staff undertake. Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 Page 22 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 Ghyllgrove Residential and Nursing Home - Medway House I56-I06 S15535 Ghyllgrove (Medway House) V233095 070605 Stage 4.doc Version 1.30 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. 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!