CARE HOMES FOR OLDER PEOPLE
Godwyne Hurst 2 Leyburne Road Dover Kent CT16 1SN Lead Inspector
Julie Sumner Unannounced 13/07/05 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. Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Godwyne Hurst Address 2 Leyburne Road, Dover, Kent CT16 1SN 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) 01304 206391 Mrs Doris Anne Hodgson Mrs Doris Anne Hodgson Registered Care Home 3 Category(ies) of Old Age registration, with number of places Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16th November 2004 Brief Description of the Service: Godwyne Hurst is registered to provide residential care for three service users over the age of 65. The property is a large building, which also contains rooms for independent private tenants on the upper two floors separate from the residential home. There is a shaft lift to enable service users with mobility difficulties to access the two floors of the registered residential part of the building. Service users all have single bedrooms. There are two small lounges and a dining room with adjoining kitchen that service users are able to use communally. The home is located within the town of Dover with local amenities close by. Godwyne Hurst is owned and managed by Mrs Hodgson. The home is mainly family run with three members of staff (one of whom is Mrs Hodgson’s son) working flexibly. Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was carried out over two visits to the home. The first visit started at 10:30am and ended at 12 o’clock. The second visit started at 10:15 until just after 1pm and was conducted with the owner, Mrs Hodgson present. Mrs Hodgson and the staff have continued to work towards improving the home and service for service users with success. Service users looked well and commented positively about the home. One service users said that “ I have everything I need” and was very pleased with the support he is receiving with his medical conditions. All requirements and recommendations from previous inspections have been actioned and met. The home is being well maintained with ongoing improvements to the building and decoration. The following methods of inspection and information gathering were used: One-to-one discussion and group discussion at different times with service users and staff, observing activity in the home, touring the home and reading and discussing policies, plans and records including individual service user plans, medication charts and maintenance records. What the service does well: What has improved since the last inspection?
Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 Page 6 This is a large old building that needs ongoing maintenance and repairs to ensure that it provides a pleasant place for service users to live. The owner has identified areas in the home that need maintenance work and redecoration and this is being systematically carried out. Two bedrooms have been decorated and new furniture has been bought. One of the toilet/washrooms has a flush floor shower and adaptations have been made with advice from the Occupational Therapist. There are two lounges and it is planned for one to be refurbished. 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. Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 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 standard(s) 3 Service users can be confident that their needs and abilities will be assessed which will form the basis of the support plan to meet their needs in the home and that if their needs change this will be reviewed. EVIDENCE: Full needs assessments have been carried out for all service users. One service user has been referred for psychiatric assessment of current mental health following some incidents of abusive behaviour towards the owner and staff. Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, 10 Service users are supported well with their health and medical needs. Service users are supported to administer their own medication if they are able but not all written information is up to date. Service users privacy is respected and their independence encouraged. EVIDENCE: Service users have been supported to attend medical appointments for monitoring and treatment. One service user is currently being supported with an eye condition and is being monitored and treated by an eye specialist. One individual was very thin when admitted to the home and his weight is being monitored. A diet to gain weight has been given and sweets and biscuits in between meals have been discouraged. A referral was made to an occupational therapist. Service users mobility aids are well maintained and appropriate aids have been obtained.
Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 Page 10 Each service user has a plan of care. These are well laid out with easy reference to areas of care and support provided. One plan needed updating with reference to current medication administration arrangements. Service users are supported with maintaining their continence. When difficulties were experienced a referral was made to the continence advisor and support has been given as needed. The home administers medication via monitored dosage system. One service user has been risk assessed to administer his medication and is able to administer some of this and has support where needed. A recommendation has been made to update the medication administration records in and the risk assessment in the individual service user plan where support is given and to continue to administer medication following the guidelines from the Royal Pharmaceutical Society and NMS. Medication was arranged but the tutor did not attend and the training needs to be rearranged. It is a recommendation for staff administering medication to rearrange and attend medication training. All personal care is given in private with the opportunity to maintain independence encouraged. Service users were complimentary of the care they received and of the staff. All service users have their own bedroom and their privacy and the way they want to arrange their bedroom is respected. Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 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 standard(s) 12, 15 Service users have opportunities to pursue chosen leisure activities within the home. Opportunities for outside activities could be increased. Service users are happy with the food provided and have good traditional home cooked meals. EVIDENCE: Service users were observed and discussed their interests. They are supported to pursue chosen activities in and around the home. They all said they were happy and had everything they wanted. There are limited opportunities for outside activities and although there were indications that this was the choice of the people living in the home it would be good practice to offer opportunities periodically. One service users does not wish to go out at present. One service user likes to go out for walks near the home and sometimes sit in the garden. One service user said that he was not able to go out as often as he liked at present because of a medical condition but when well liked to go out on his scooter and attended a diabetic club in the evening and liked to watch the local bowling. The main meal of the day is provided midday and the dinner was being prepared. The service users were having roast lamb, new potatoes, cauliflower, carrots and green beans.
Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 Page 12 Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 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 standard(s) EVIDENCE: Not inspected at this time. Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 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 standard(s) 19 Improvements to the environment are being made to enhance the service users quality of life. EVIDENCE: On a tour of the home with one of the staff it was evident that general maintenance and redecoration was continuing. Redecoration of individual bedrooms had continued with new furniture having been bought. One service user had a new commode that had decorative upholstery. There are plans to redecorate the first floor lounge. The water board have agreed that the drain cover in the centre of the room can be concreted over and inspection of drains can take place from a different location. The owner said that once this was done they would carpet the lounge and put new curtains up. Refurbishment in other areas of the home had been identified and this was going to be ongoing. The external areas of the home need attention and this was also included in the owner’s plan for improvements. A recommendation was made to continue to improve the overall environment. Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 Page 15 Overall the home was clean and there were no odours. Service users had arranged their own bedrooms as they wished. Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 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) EVIDENCE: Not inspected at this time. Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 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) 38 Overall the home is being managed well providing the service users with a comfortable place to live and overcoming difficulties with minimum disruption. EVIDENCE: All staff have attended statutory training as needed. The home has policies in place for safe working practice. Records were kept of weekly fire alarm, nurse call and emergency lighting checks carried out. The fire equipment had been safety tested by contracted fire safety agency. The shaft lift has been serviced 6 monthly and has been repaired as identified. At the last service a problem with the motor was identified which needed to be replaced. A new motor is being rebuilt as it was not possible to replace it due to its age and discontinuation. The last part in order to complete this task had been ordered and the engineer was waiting for it to complete the job. The lift
Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 Page 18 was out of action during the inspection and alternative arrangements were being made to enable service users to come downstairs to the second lounge and dining room via outside. There are appropriate recording formats for the reporting of incidents and accidents. Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 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 x 3 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x 2 Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 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 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. Refer to Standard 9 Good Practice Recommendations The medication administration records and the risk assessment in the individual service user plan where support is given need to be updated and the home needs to continue to administer medication following the guidelines from the Royal Pharmaceutical Society and NMS. For staff administering medication to rearrange and attend medication training. To continue to provide opportunities to develop social activities. To continue to make progress with ongoing maintenance and refurbishment of the home. To continue to ensure that the lift is repaired and is in working order as soon as possible. 2. 3. 4. 5. 9 11 19 19, 38 Godwyne Hurst H56-H05 S23200 Godwyne Hurst V222413 130705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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