Inspection on 09/05/05 for Graywood

This inspection was carried out on 9th May 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Graywood 21/07/08

Graywood 30/08/07

Graywood 03/10/06

Graywood 17/11/05

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 2 NL Lead Inspector Josie McCabe Unannounced 09/05/05 at 10:00 am 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Graywood Address 10 Northdown Avenue, Cliftonville, Margate, Kent, CT9 2 NL 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) 01843 220797 01843 220797 Mrs Rassoolbie Haq Care Home 13 Category(ies) of Mental Disorder (13) registration, with number of places Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 09 November 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 H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 10.00 a.m. It took place over four and a half hours during the morning whilst residents were in the home. The inspector spoke to six residents, two members of staff and the manager, who is new to the home. A tour of the house was made with the manager and records were also examined. Requirements from the last inspection were mostly completed and recommendations are being acted upon. A requirement was given for staff to complete physical intervention training and the manager has booked training for July 05. Recommendations were given for residents to be offered a seven day annual holiday, a fridge is to be purchased for the storage of medication and the premises to be organised into clusters of ten residents to provide a homely environment. What the service does well: What has improved since the last inspection? What they could do better: Whilst most requirements from the last inspection had been completed, 50 of care staff need to complete NVQ Level 2 training. Staff training in physical intervention should be completed for the safe management of behaviour and the manager confirmed that staff would be attending a course. Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 6 Recommendations made from the last inspection were in the process of being completed by the manager. Residents still need to be offered a choice of a seven day holiday and the manager said that this was being discussed with the placing authority with regard to funding and that day trips had been discussed in the residents meeting. A lockable fridge to house medication needing temperature control should be purchased to provide safe and appropriate storage and the home needs to be organised into clusters of ten people to provide a more home-like environment. 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 H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 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 standard(s) 2, There have been no new residents since the last inspection, in view of this the standard was unable to be assessed on this occasion. EVIDENCE: Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 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 standard(s) 6, 7 and 9 Service user plans and risk assessments contain assessed needs to ensure individual choices are met. Residents make decisions about their lives from good support by staff. EVIDENCE: The service user plans, risk assessments and community psychiatric nurse assessments seen clearly described assessed needs and goals, which were being achieved. The residents meeting minutes showed the manager encouraging residents to make choices about life 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. Residents said that they received a lot of support from staff which helped them to be as independent as they wanted to be. One resident said that he thoroughly enjoyed going to the local college for further education and he had been encouraged by staff to do this. Residents confirmed they attended residents meetings and records of the meetings showed choices being ascertained, to include ideas for activities and day trips out for the summer. The completed residents quality assurance questionnaires showed feedback from the residents and ideas for change in the home. Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 10 Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 11 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 standard(s) 12, 13, 14, 15, 16 and 17 Residents are encouraged to be independent. Relationships are maintained with family and friends. A recommendation is given for the home to provide the option for long-stay placements to have a seven day holiday, which will offer a greater choice. Residents rights are respected by staff. Residents receive a healthy diet. EVIDENCE: The residents said they enjoyed the activities and were looking forward to their afternoon bingo game with the manager. Several residents had chosen to go out on their own during the morning to the local shops, to college and for walks. One resident goes on holiday on his own which is his choice. Records seen showed residents contact with their families by way of telephone calls, visits to the home and staying with families for short breaks. A recommendation was given for residents to be offered a seven day annual holiday which is being addressed by the manager and placing authority. Staff were seen knocking on bedroom doors before entering and treating residents with patience and respect. Staff have confirmed there are policies in Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 12 place which they follow with regard to respecting residents rights and this is covered in induction training. The record of menus seen showed a well balanced diet being provided and the residents meeting minutes showed discussion upon changes to the menu. Residents said that they had asked for bigger meal portions, which had been provided and a request for egg and chips which they liked to have occasionally. Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 13 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 standard(s) 18. 19 and 20 The health needs of residents are well 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 manager. A recommendation is given for the home to have a lockable fridge for medication storage. EVIDENCE: One resident explained how the manager supported them with their health needs and this included being referred to the chiropodist. The manager joined the discussion and confirmed this. She was also seen organising health appointments and the home provides transport and key worker support for this. Health needs and appointments attended were recorded in care plans and daily records. Residents medication is regularly reviewed by psychiatric nurses and psychiatrists. The manager uses a checklist to monitor appropriate medication administration and storage. A lockable fridge to house medication needing temperature control should be purchased to provide safe and appropriate storage. Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 14 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 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 showed no concerns recorded and 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 with the manager and have received adult protection training. Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 15 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 standard(s) 24 and 30 The home was clean, free from odours and has been made comfortable for the residents. The manager has a good understanding of the areas in which the home needs to improve which follows the refurbishment plan. A recommendation is given for the home to be organised into clusters of up to ten residents to provide a more home-like environment. EVIDENCE: During the tour of the home all areas were seen to be clean, free from odours and comfortable for the residents. Residents showed their bedrooms which they have made individual and some are being redecorated and refurbished. Records seen showed appropriate fire safety and health and safety checks being carried out and monitored by the manager. There are two lounges, one of which is a non-smoking lounge. The manager went through the home’s development plan and areas for completion which includes providing an extension to the house in order to organise residents in up to clusters of ten to provide a more home-like environment and the redecoration of residents bedrooms and other areas of the house. Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 16 Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34 and 35 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 was given for 50 of staff to complete this training and for staff to be trained in physical intervention. EVIDENCE: Records were seen of satisfactory employment checks on a new member of staff. Supervision records showed staff having regular supervision with the manager and staff meetings had been carried out. Staff have received appraisals. Staff confirmed they receive good support from the manager and proprietor. Staff had completed induction training and the manager is using a specific learning pack with staff to achieve this. Staff training records seen confirmed this. One member of staff said that they enjoyed completing the NVQ Level 2 training and is now enrolled to study for the NVQ Level 3 course. More staff are nearing completing their courses. The manager has booked staff training in physical intervention and it is hoped to be completed in July 05. Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39, 40 and 42 The manager has appropriate experience and qualifications. She has introduced a quality assurance system to ascertain the views of residents. The policies and procedures in place ensure that the welfare of residents and staff is being promoted and protected. EVIDENCE: The manager has completed the NVQ Level 4 and Registered Managers Award and has several years experience of caring for residents in a residential setting. The quality assurance system seen ensures that residents views have been collected and taken into account in the development of the home. The manager is extending this to families and professionals involved in the residents care. Residents are also asked for feedback in their meetings with the manager and through the key worker system and records seen showed this. Residents said that they could discuss anything with the manager and changes had been made as a result of this. Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 19 Policies and procedures have been developed for safe working practices and the manager has introduced a new health and safety checklist, which was seen completed with monitoring checks carried out. There were few accidents recorded in the home and fire safety checks were up to date. Staff confirmed they have received first aid and medication administration training. Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 20 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 x x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 2 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME 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 x 3 x H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 21 yes 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 32 Regulation 18 Requirement Staff to be trained in physical intervention . (Previous timescale of 01/04/05 not met) Timescale for action 31 August 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 14 20 24 Good Practice Recommendations Residents to be offered a seven day annual holiday Lockable fridge for medication storage to be provided Premises to be organised into clusters of ten residents Graywood H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 22 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 © 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 H05 H56 S37757 Graywood V226020 09052005 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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