Inspection on 19/01/06 for Godwyne Hurst

This inspection was carried out on 19th January 2006.

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.

Other inspections for this house

Godwyne Hurst 18/06/08

Godwyne Hurst 20/06/07

Godwyne Hurst 11/07/06

Godwyne Hurst 13/07/05

Godwyne Hurst 16/11/04

Godwyne Hurst 07/06/04

Godwyne Hurst 10/05/04

Godwyne Hurst 21/10/03

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

CARE HOMES FOR OLDER PEOPLE Godwyne Hurst 2 Leyburne Road Dover Kent CT16 1SN Lead Inspector Julie Sumner Announced Inspection 19th January 2006 10:00 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 Godwyne Hurst DS0000023200.V263135.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. Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Godwyne Hurst Address 2 Leyburne Road Dover Kent CT16 1SN 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) 01304 206391 Mrs Doris Anne Hodgson Mrs Doris Anne Hodgson Care Home 4 Category(ies) of Old age, not falling within any other category registration, with number (4) of places Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2005 Brief Description of the Service: Godwyne Hurst is registered to provide residential care for four 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. At present there are three service users living here. Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection starting at 10am and finishing at 1:30pm. The home was clean and welcoming. All three service users were in the home and participated in the inspection. Mrs Hodgson, a member of staff and a family member were in the home supporting service users. Service users described their lifestyle and spoke about how they like to spend their time. They all said they felt contented and comfortable and laughed and smiled in conversation. Examples of comments were: “nice home, pleasant, you can do what you like, what more can you want.” “We are well looked after, its not bad here” During the inspection a range of methods were used to gather information including: spending time with the service users talking about life in the home, walking around the home, discussing policies and future home improvements and development with the owner and staff, discussing and looking at individual service user plans, medication storage and records, maintenance certificates and staff training certificates. What the service does well: What has improved since the last inspection? The lift has had a new motor fitted and is in good working order. Information regarding individual’s medication has been updated in the service user plan. Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 Page 6 The hall, stairs and landing have been decorated and looked fresh and clean. What they could do better: Entries into the written care plans need to be signed and dated. Copies of the reviews that have been carried out by care managers need to be copied to the home and kept in the service users’ folders. Recommendations have been made for these. There have still been problems with the medication using the monitored dosage system and the owner has decided to discontinue with this method. Medication training has been booked and the owner and staff have still been unable to attend due to the courses being cancelled and the recommendation remains outstanding. The course has been rebooked. The home needs to be able to demonstrate that the service users are offered the opportunity to go out sometimes and that they have different activities to choose from. Although service users said they were happy and did not want to go out until the weather improved there was no record that they were given the choice. A recommendation has been made to record activities offered throughout the different seasons and whether they were accepted or refused. Most of the home was clean and several areas have been redecorated over the last year but one of the recently redecorated bedrooms had a strong odour of urine and needs attention. A recommendation was made to seek further advice from the incontinence nurse. Improvements have been made to the home and are ongoing. The manager needs to produce a written maintenance and renewal plan with estimated timescales to demonstrate the future plans and priorities for the home. The manager talks to the service users and finds out what they think of life in the home. This needs to be written so that it can be referred to and act as a basis to future development in the home and to make sure that what is being provided is what service users want. A recommendation has been made for this to make the quality monitoring system to be more formal. Please contact the provider for advice of actions taken in response to this Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 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 the following standard(s): EVIDENCE: Not inspected at this time. Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 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 Service user plans are well designed and contain relevant information. They need to be reviewed and added to as needs change. All entries need to be dated so that they are ongoing working documents. Service users are benefiting from really good care and support from the owner and staff with regard to their health and wellbeing. Changing the medication administration system will provide a safer and more practical way to make sure service users receive the medication prescribed. Service users feel that they are treated with respect and they have privacy when wished. EVIDENCE: Service user plans were viewed and contained a good range of information with guidelines for staff. There was ongoing documentation but this was not always dated. In discussion about individual care provided not all care and support given was included in the individual’s support plan. All needs that Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 Page 11 have been identified and the care provided need to be written in the plan and updated as needs change. A recommendation was made to update and review the care plans monthly, including all relevant information regarding individual care/support and to sign and date each new entry. The staff use a book to communicate between shifts and sometimes information regarding individuals is also written in this book. Personal and confidential information needs to be kept in the individual file and only made reference to in the communication book. One service user has continued to receive support from the owner and staff following surgery for 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. He said he had put on weight and he looked really well. One individual needs additional support with incontinence and behaviour towards it. A recommendation has been made to initially get further advice from the incontinence nurse. There have been some problems with medication using the monitored dosage system. There was a mistake with the prescription resulting in one of the service users not being able to have their medication. Only one service user has medication dispensed in this way and the owner is going to discontinue with the service. The medication records were viewed and they had been recorded accurately. A recommendation has been made to make sure that the new system ensures that medication is stored and administered following the royal pharmaceutical guidelines. Service users said they are able to go to their bedroom if they want some privacy. If they have visitors they can go into the quieter lounge downstairs if they prefer. Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 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, 15 Service users have lived together or known each other for many years and enjoy being in the home in each other’ company. They prefer to stay in and pass the time leisurely and do not wish to change anything. Good home cooked meals are provided keeping the service users healthy and interested in eating. EVIDENCE: One service user is quite confused and enjoys various activities like sewing, tapestry and some drawing and colouring. One service user has been quite ill but looked very well at the time of the inspection and likes to sit in the home listening to the radio. One service user said that he likes to go out but only in the finer weather. At present he prefers to sit and read the newspaper, listen to the radio or watch TV. He has had surgery on his eye that has healed really well but has not got full use of his sight back yet and is waiting until he feels confident enough to go out. All said they were happy with life in the home. The home prepares menus and keeps a record of meals eaten in the daily diary. The menus have been planned introducing different foods which service users are enjoying. These include curry, chilli and traditional home cooking. Service users have their main meal in the middle of the day and the dinner was observed to be hot, home cooked and a good sized portions varying to suit Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 Page 13 individuals preference. All service users were complimentary of the food provided in the home and were enjoying the variety. Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 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 Service users feel their views are listened to and any concerns are taken seriously and acted on by the owner and staff team. There is a clear complaints procedure. Staff have experience and knowledge in adult protection but would benefit from up to date training. EVIDENCE: There is a complaints procedure for the home and a complaints log to record any complaints and action. The home has had no complaints and service users said if they had any concerns they would talk to the owner or staff. Service users have regular reviews from their care manager. One of the staff has had training in adult protection. The owner and other staff plan to attend this training this year as the owner said the course was overbooked last year and they are on the list for the next available course. The owner and staff are experienced in working in care homes and supporting people and are aware of what constitutes abuse. They are aware of the adult protection process and know who to contact for advice. Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 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 Improvements continue to be made so that service users have a comfortable and pleasant home. Further action is required to make one of the bedrooms smell clean and fresh. Radiator covers need attention to make sure they are safe. EVIDENCE: A tour of the home was carried out. The owner is steadily redecorating and refurbishing the home. The hall, stairs and landing had been painted. Double glazing has been ordered for all the windows in the registered part of the home and will be delivered next week. One of the bedrooms had a strong odour of urine. The manager discussed the difficulties experienced. It is recommended that advice is initially sought from the continence nurse. It is recommended that all staff attend infection control training also. Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 Page 16 The radiator covers in two bedrooms have rough finishes at the top and corners. It is recommended that these are altered so that the tops are better fitting and fixed and the corners are rounded. Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 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 At present there are sufficient staff to support the three service users currently living in the home. There are adequate recruitment procedures. Staff demonstrate competency in care and support of service users. Further training would increase the staff knowledge and confidence with any changes in procedures and practices. EVIDENCE: Since the registration increased to four service users, there has been one vacancy. The manager agreed that if another service user was to be considered it would be necessary to increase the staff hours in the home and this has been planned. No new staff have been recruited but the manager has a recruitment policy that includes requesting CRB and POVA checks, references and proof of identification. One member of staff has achieved NVQ level 2 and wants to complete NVQ level 3. A recommendation has been made to make plans for 50 of the staff team to achieve NVQ 2 or above. Staff have attended basic training and are experienced in supporting older people. All appropriate referrals have been made to support with care given and advice taken into consideration. The manager has been considering what other training might enhance the staff Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 Page 18 skills and meet individually assessed needs in the future and has booked courses in challenging behaviour, adult protection and medication. Other areas like diabetes, ageing and dementia should also be considered. Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 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 The owner is experienced and competent in making sure service users get good care. Further training in management and care would give the owner confidence to manage the home with regard to relevant legislation and current good practice. Quality monitoring and taking into account service users’ views would enhance the development of the home and assist in making sure the support provided is what the service users want. Service users’ money and valuables is safeguarded. The owner is taking appropriate measures to make sure the home is a safe place for service users and staff. EVIDENCE: Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 Page 20 The manager, Mrs Hodgson, who is also the owner, has many years experience in running the care home. She has considered retiring but wants to continue to support the current service users but does not wish to study NVQ 4. Mrs Hodgson has attended training to keep up to date with current practice and health and safety. The manager is supported by experienced staff. It is a recommendation for the manager to study and achieve NVQ 4 in management and care. There needs to be a written plan, for improvement and development of the home and support, from finding out what service users want. There was a discussion about quality monitoring and planning-action–review. There needs to be evidence that service users are happy and that care managers are satisfied with what is being provided in the home. There needs to be a way of gathering service users’ views and opinions so that the home can reflect on what has progressed and what is still needed in order to improve and develop. The ongoing home improvements could also be included the development plan. A recommendation was made to design a quality monitoring system and produce a development plan for the home. Two service users have client financial affairs officers. One service user is independent and aware of money and if he needs anything signs his money out and receives his own bank statements. Statutory training has been completed for all staff and arrangements are being made to attend updated courses again. It is recommended that all staff attend infection control training also. Fire training has recently been attended and the fire log was completed and up to date. There is a contract to service and check all fire equipment. Health and safety and maintenance of building certificates were viewed. The lift is now working having had a new motor fitted and has been service 6 monthly. The recent service stated no problems and all in full working order. Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 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 x x x 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 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x 2 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 x x 3 Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? no 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. Refer to Standard OP7 Good Practice Recommendations Care plan entries, changes and guidelines for support need to be signed and dated to show that the manager has reviewed them and when. Care manager reviews need to be kept in the file and where these have not been given to the home they need to be requested from the care manager who has completed them. For staff administering medication to rearrange and attend medication training. To record, in the service user plan, offers of activities, opportunities to go out to evidence that service users are making the choice to stay in. To continue to make progress with ongoing maintenance and refurbishment of the home and to produce a written maintenance and refurbishment plan for the home. The radiator covers need to be altered so that they have a good and safe finish around the top, edge and corners. Need to seek advice from continence nurse regarding DS0000023200.V263135.R01.S.doc Version 5.0 Page 23 2. 3. 4. 5. 6. OP9 OP12 OP19 OP25 OP26 Godwyne Hurst 7. 8. 9. OP30 OP31 OP33 continence management and room odour. For staff to attend infection control training. Need to organise training to meet all assessed needs of service users. For the owner to study and achieve NVQ 4 in management and care. Need to design a quality monitoring system and produce a development plan for the home. Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 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 © 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 Godwyne Hurst DS0000023200.V263135.R01.S.doc Version 5.0 Page 25 - 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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