Inspection on 16/06/06 for Graham House

This inspection was carried out on 16th June 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

Graham House 15/11/05

Graham House 09/05/05

Graham House 17/08/04

Graham House 19/05/04

Graham House 03/02/04

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

CARE HOMES FOR OLDER PEOPLE Graham House 12 Graham Road Mitcham Surrey CR4 2HA Lead Inspector Jean Stuart Unannounced Inspection 16th June 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 Graham House DS0000027242.V299998.R01.S.doc Version 5.2 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. Graham House DS0000027242.V299998.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Graham House Address 12 Graham Road Mitcham Surrey CR4 2HA 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) 0208 646 0606 Mr Rudolph Edgar Lewis Mrs Ena Etheldina Lewis Mrs Ena Etheldina Lewis Care Home 3 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (3), Old age, of places not falling within any other category (3) Graham House DS0000027242.V299998.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Graham house is a registered care home for up to three elderly people, some of who may have past or present mental health needs. The home is the ground floor of a semi-detached property. The home is situated within a residential area of Mitcham, with a small number of shops within a short walking distance. Parking is to the front of the home. Public transport bus services are within a short distance of the home. Three single bedrooms are available in the home. The home has one resident, the fee charged is £450. Graham House DS0000027242.V299998.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on the 16 June 06, with both providers present. This inspection involved a discussion with the service user, examination of care documentation and a brief tour of the premises. The inspection took three hours. The home continues to work on improving the service. What the service does well: What has improved since the last inspection? What they could do better: The home needs to improve the paper work to ensure they can evidence the quality of care being delivered. Records of an individual’s supervision must be maintained. Graham House must ensure all members of staff have a current Criminal Record Bureau (C.R.B.) check. Graham House DS0000027242.V299998.R01.S.doc Version 5.2 Page 6 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. Graham House DS0000027242.V299998.R01.S.doc Version 5.2 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 Graham House DS0000027242.V299998.R01.S.doc Version 5.2 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): 2,3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Every new resident is assessed before moving into the home to ensure the resident’s needs can be met.. The choice of home is suitable for the resident. EVIDENCE: A resident reported that they are “so well looked after”. The inspector met with a resident and their family during their first week at the home. The family reported that they had visited the home to make sure it was suitable. The residents’ needs are assessed prior to commencing with the service. Each service user has a contract provided by social services or if paying privately a contract is drawn up by the home. An example of a private contract was seen. The home has a Statement of Purpose, which documents the facilities and is given to the resident and family when moving into the home. Graham House DS0000027242.V299998.R01.S.doc Version 5.2 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are recognised as individuals. Each service user has a care plan setting out their needs and a monthly review is carried out. EVIDENCE: Residents’ needs are reflected in their care plans. Good information was seen on personal and health care needs of residents in the daily record. A resident spoke of going to the hospital and of an appointment with the optician. This was seen on the daily record. By recording information, residents’ wishes will not be overlooked by staff. The home follows good practice in the recording of medication. The possibility of self-administration is reflected in the medication policy and procedure. Staff, with one exception have received training in the administration of medication. This is planned for the autumn. Training promotes a positive and safe environment for all in the home. Graham House DS0000027242.V299998.R01.S.doc Version 5.2 Page 10 One resident reported that they like “quiet” time in the bedroom. This time is spent reading and knitting, a good supply of novels provided by the family. The right of the resident to spend time alone is respected by the manager. Graham House DS0000027242.V299998.R01.S.doc Version 5.2 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): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents if they wish are encouraged to maintain contact with family, friends and the local community. EVIDENCE: A resident spoke of grandchildren who help when attending the hospital and a son who frequently visits. Maintaining the individual’s family links are important and the home will ensure that the social, cultural needs of this person are met. Residents are encouraged to leave their rooms to watch quiz shows in company, or as observed spend the day knitting and reading. Residents are able to maintain their old life styles. For one resident independence is important and the manager respected this. The resident was seen walking freely between the rooms in the house. A varied diet is maintained and a record kept of all food served. In a resident’s bedroom a board states what is on the menu today, plus information on the Graham House DS0000027242.V299998.R01.S.doc Version 5.2 Page 12 day of the week and weather conditions. The resident used this when speaking about lunch. The meals are “enjoyed” “I eat so much”. The home monitors the residents weight and a record of this was seen. Graham House DS0000027242.V299998.R01.S.doc Version 5.2 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): 16,18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents rights are respected. individuals feel safe and confident in the service provided by Graham House EVIDENCE: None of the residents spoken to had any concerns at the time of the inspection visit. A resident reported “I have nothing to complain about”. The home keeps a record of any complaint and actions taken. The last complaint was received in 2003. Information on what action needs to be taken, should there be an allegation or suspicion of abuse, is in place. Staff have received training in the protection of vulnerable adults. The manager plans for all staff to attend a refresher course in abuse awareness this summer. The manager must ensure that all members of staff hold a current C.R.B. check. This should be carried out prior to starting work at Graham house. Evidence that all staff have CRBs must be sent to the CSCI. Graham House DS0000027242.V299998.R01.S.doc Version 5.2 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): 19,20,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Graham house provides a well maintained, safe, and comfortable home for residents. EVIDENCE: One residents reported that this is a “good room” with” plenty of space” Individual bedrooms provide comfortable homely accommodation for residents. Rooms were observed to be clean and free from offensive odour. The bedrooms were personalised to resident’s own tastes. The communal area of the home are homely in appearance. One room serves as both the lounge and dining area, and provides a pleasant area for residents to use. In the summer there is a seating area outside in the garden. Graham House DS0000027242.V299998.R01.S.doc Version 5.2 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): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents can have confidence in the staff that care for them are well trained. EVIDENCE: A resident reported that they “feel cared for”. The service has a small group of staff all of which have completed National Vocational Qualifications to improve the care they deliver. Basic care plans are maintained, daily recording is being consistently completed, and the recruitment procedure ensure adequate staff checks are completed. CRBs can no longer be transferred between jobs, and new CRB checks must be completed when applying for a job at Graham House. (see also the Section on Complaints and Protection). Staff receive one to one supervision but supervision is not recorded. A record of supervision must be maintained. Care staff must receive formal supervision at least six times a year. Graham House DS0000027242.V299998.R01.S.doc Version 5.2 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): 31,33,35,36,38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home must ensure that all policies and procedures are fully utilised to protect the residents’ best interests. EVIDENCE: The manager is a qualified nurse who has many years experience in the field and is currently studying for the NVQ four for managers. The management process ensures that staff receive feedback on their work but supervision sessions must be recorded. Graham House DS0000027242.V299998.R01.S.doc Version 5.2 Page 17 The home has a rigorous system for managing residents’ money if required. Currently this is not utilised by residents. An annual action plan is now in use and a statement of cash flow statement supports this. Each year the service sends questionnaires to relatives and stakeholders seeking their opinion of the service. Graham House DS0000027242.V299998.R01.S.doc Version 5.2 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 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 3 x x 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 2 x 3 Graham House DS0000027242.V299998.R01.S.doc Version 5.2 Page 19 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 OP18 OP29 Regulation 19(4) Requirement The registered person must ensure a criminal record certificate is issues for each member of staff and this confirmed with the CSCI. The registered person must ensure that a record is maintained of care staff receiving formal supervision at least six times a year. Confirmation of this happening must be sent to the CSCI. (Previous time scale of 31/01/06 not fully met). The registered person must ensure that policies and procedures are used in full. Timescale for action 31/08/06 2. OP36 18(2) 31/08/06 3. OP38 12 28/08/06 Graham House DS0000027242.V299998.R01.S.doc Version 5.2 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Graham House DS0000027242.V299998.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Graham House DS0000027242.V299998.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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