Inspection on 17/11/05 for Graywood

This inspection was carried out on 17th November 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Graywood 21/07/08

Graywood 30/08/07

Graywood 03/10/06

Graywood 09/05/05

Graywood 09/11/04

Graywood 06/04/04

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

CARE HOME ADULTS 18-65 Graywood 10 Northdown Avenue Cliftonville Margate Kent CT9 2NL Lead Inspector Josie McCabe Announced Inspection 17th November 2005 10:00 Graywood DS0000037757.V252780.R01.S.doc Version 5.0 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 Graywood DS0000037757.V252780.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 Adults 18-65. 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. Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Graywood Address 10 Northdown Avenue Cliftonville Margate Kent CT9 2NL 01843 220797 01843 220797 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) Mrs Rassoolbie Haq Vacant Care Home 13 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (13) of places Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th May 2005 Brief Description of the Service: Graywood is registered to provide accommodation and personal care to a group of thirteen adults who are under the age of 65 years on admission to the home. The residents have all had experience of mental health problems and require ongoing support. The home is located in a residential area of Margate, near to shops, local amenities and the sea front. Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and started at 10.00 a.m. It took place over seven hours during the day whilst residents were in the home. The inspector spoke to residents, two members of staff and the proprietor. Requirements and recommendations given at the last inspection were followed up with the proprietor. A tour of the house was made and records were also examined. There were twelve residents living in the home. At the time of the inspection, there was a manager’s vacancy and the proprietor was overseeing the day-to-day management of the home. The previous manager’s replacement was being advertised for in the local papers. What the service does well: What has improved since the last inspection? What they could do better: The proprietor should continue with the refurbishment and redecoration programme to provide a home-like environment for the residents and to follow the business plan. Completion of NVQ Level 2 training for care staff to meet the national minimum standard. The home to be organised into clusters of ten, which follows the national minimum standard. The inspector has been made aware by the proprietor of planning permission for an extension to the home being submitted in order to achieve this. Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 6 The employment of a manager with the appropriate experience and qualifications. The proprietor has informed the inspector that this post is being advertised. The statement of purpose needs to reflect the changes in the management of the home and the staff list needs updating. The written complaints policy needs updating to have the name of the previous manager removed and the commissions name (Commission for Social Care Inspection) rather than the previous ‘national care standards commission’ name in it. The proprietor agreed to address these issues. 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. Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 The home has policies and procedures for prospective residents admission to the home. Resident’s needs are assessed and they are informed of terms and conditions. EVIDENCE: Residents have told the inspector they had received information about the home before moving in to include the resident’s guide. A senior member of staff and the proprietor described how a newly admitted resident had been show around the home and had stayed for a meal before making a decision about moving in. He has been assessed by his care manager and has an individual service user plan, which would be reviewed in six weeks following admission. The resident confirmed this process and said that he was being helped by staff to settle into the home and also visits his own accommodation. Residents are given a statement of terms and conditions and key workers help them to understand their rights, which are contained within the home’s statement of purpose, residents guide and is given out to residents, relatives and placing authorities. Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6-10 Residents care plans and risk assessments contain assessed needs to ensure individual choices are met and that their independence is promoted. Residents make decisions about their lives from good support from staff and they are consulted about any changes. Staff follow policies, which ensures that information about residents is kept confidential. EVIDENCE: The care plans, risk assessments and community psychiatric nurse assessments clearly described assessed needs and goals, which were being achieved. The residents meeting minutes showed the proprietor and staff encouraging residents to make choices about life in the home. The completed residents quality assurance questionnaires showed feedback from the residents and ideas for change in the home. Individual risk assessments showed residents living their lives as they wished in a safe environment to include travelling on their own, developing relationships and experiencing new activities. Staff demonstrated their awareness for the need to keep information about residents confidential and to share information with appropriate persons. Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11-17 Residents are encouraged to use community facilities, which give them the opportunity for personal development, and to take part in appropriate activities. Residents are supported by staff in having contact with relatives and friends and to build personal relationships. Resident’s rights are respected by staff in the care being provided in the home. Residents receive meals that they have chosen and the menu is discussed in residents meetings. EVIDENCE: The residents said they enjoyed playing board games and watching videos and were looking forward to Christmas. A group of residents had gone to the local air show during the summer and the proprietor will be arranging a trip to London to see the Christmas lights. One resident goes to college to learn computer skills and one resident has joined the local bowls club, which he said he enjoys. During the inspection, a resident told the inspector about his holiday he had taken to South Africa in the summer, on his own with a holiday group. Several residents had chosen to go out on their own during the day to the local shops and for walks. Records seen showed residents contact with Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 11 their families by way of telephone calls, visits to the home and staying with families for short breaks. The proprietor informed the inspector that she would be looking to arrange short breaks or several days out next year, which residents liked rather than residents having a seven day holiday. Staff were seen respecting residents privacy in bedrooms and treating residents with patience and respect. Staff have confirmed there are policies in place, which they follow with regard to respecting residents rights and this is covered in induction training. The residents meeting minutes showed food being discussed and changes to the menu is made as needed. Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18-20 The health needs of residents were being met with evidence of multidisciplinary working taking place. Personal support is offered to meet individual residents needs. There are systems in place for the management of medication administration, which are monitored by the proprietor. The home has purchased a lockable fridge for the storage of medicines. EVIDENCE: Evidence was seen in records and during the inspection of health appointments being made and attended and the home provides transport and key worker support for this. Health needs and appointments attended were recorded in care plans and daily records. Resident’s medication is regularly reviewed by psychiatric nurses and psychiatrists. The proprietor uses a checklist to monitor appropriate medication administration and storage. Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. The home has a satisfactory complaints system and residents know their complaints will be listened to and acted upon. Staff have knowledge of adult protection issues and there are procedures in place for them to follow. EVIDENCE: Residents said that they knew who to go to if they had any concerns and staff sorted them out. They also said that they felt safe living in the home. Residents had no complaints during the inspection. The record of complaints from residents in the home, showed concerns made against two other residents, who are now no longer in the home due to their challenging behaviour. Residents are encouraged to discuss any worries with their key worker or at the residents meetings and records seen confirmed this. Staff confirmed that they have gone through the adult protection procedure during their induction training and formal refresher training has been booked for January 2006 for staff requiring it. Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24-30 The home was clean and free from odours. Residents have chosen to keep their bedrooms they way they want them. Resident’s privacy was being respected and there is equipment to meet their needs. There is a refurbishment and redecoration plan, which follows the home’s business plan. There are still areas of the house that need to be refurbished and redecorated and a requirement is given for this to continue. A recommendation is also for the home to be made into clusters of up to ten residents to meet the minimum standard. EVIDENCE: During the tour of the home areas were seen to be clean, free from odours and comfortable for the residents. Residents have made their bedrooms individual to their style and needs. There is still refurbishment and redecoration to be completed which follows the business plan, to create a more home-like environment, however some w.c.’s and a bathroom have been refurbished, new carpet to two rooms and a lounge and repainting of hallways and the kitchen ceiling, since the last inspection which is good to see. Records seen showed appropriate fire safety and health and safety checks being carried out and monitored by the proprietor and staff. There are two lounges, one of which is a non-smoking lounge. Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 15 The business plan includes the building of an extension in the future, for the organisation of the residents, in up to clusters of ten, to provide a more homelike environment and the facilities to be more independent. Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32-36 Policies and procedures are in place, which ensures residents are receiving care from staff who have been appropriately vetted and supervised. Staff receive induction and core training and are working toward completing the NVQ Level 2 training. A requirement is given for 50 of staff to complete this training. EVIDENCE: Records were seen of satisfactory employment checks on staff. Supervision records showed staff having supervision with the proprietor, in the absence of a manager and staff meetings are held. Staff said that they had received appraisals and induction training and records seen confirms this. A senior member of care staff has completed NVQ Level 3 training since the last inspection and two staff are hoping to enrol on NVQ Level 2 training in January. Staff have received physical intervention training with refresher training booked for February 2006. Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 40, 41, 42 and 43. The home is managed to meet the needs of the residents. A quality assurance system has been introduced by the previous manager, which includes questionnaires being given out to residents to seek their views. The policies and procedures in place ensure that the welfare of residents and staff is being promoted and protected. EVIDENCE: The manager’s position is being advertised for and the proprietor is overseeing the management of the home with help from the staff. Questionnaires have been given out to residents, relatives and professionals to seek their views on how the home is run and the quality of care given. Policies and procedures have been developed for safe working practices and there is a health and safety checklist, which is completed by the proprietor and senior carer. There were few accidents recorded in the home and fire safety checks were up to date. Staff interviews and records seen, confirmed they have received first aid, food hygiene, fire safety and medication administration training and refresher courses are planned for 2006. Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 18 Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Graywood Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 3 3 3 3 DS0000037757.V252780.R01.S.doc Version 5.0 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. 2 Standard YA24 YA32 Regulation 23 18 Requirement The home to continue with its refurbishment and redecoration programme. 50 of care staff to complete NVQ Level 2 training. Timescale for action 01/05/06 01/05/06 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 YA24 Good Practice Recommendations Premises to be organised into clusters of ten residents Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 21 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 Graywood DS0000037757.V252780.R01.S.doc Version 5.0 Page 22 - 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. 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