Inspection on 26/01/08 for Greengate Lodge

This inspection was carried out on 26th January 2008.

CSCI found this care home to be providing an Adequate service.

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

Greengate Lodge 02/06/06

Greengate Lodge 16/12/05

Greengate Lodge 29/06/05

Greengate Lodge 21/01/05

Greengate Lodge 02/08/04

Greengate Lodge 24/02/04

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

CARE HOMES FOR OLDER PEOPLE Greengate Lodge Greengate Lodge Cave Road Plaistow London E13 9DX Lead Inspector Rob Cole Unannounced Inspection 10:00 26th January and 7 February 2008 th 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 Greengate Lodge DS0000034843.V359580.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. Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greengate Lodge Address Greengate Lodge Cave Road Plaistow London E13 9DX 020 8430 2000 020 8548 0193 farook.ruhomally@newham.gov.uk 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) London Borough of Newham Mr Farook Ruhomally Care Home 33 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0), Physical disability (0) of places Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd June 2006 Brief Description of the Service: Greengate Lodge is a thirty two bedded residential home providing care for older people in Newham. The home is owned and run by the London Borough of Newham (LBN). Twenty six beds are available for permanent service users and six for respite care. The home is currently arranged to deliver care to service users in four different units. The Abbey unit provides care for more independent older people. The Dundee unit provides care for older people with mental health support needs. The Emotan and Roshni units provide culturally specific residential care for older people from the African Caribbean and Asian communities respectively. The home is a purpose built dwelling on one level. There are thirty-one single rooms and one double. All rooms have their own en-suite facilities. The home has a central courtyard with protected pond and there are additional patio areas with outdoor seating. The home is located in a residential area in Plaistow, close to shops and amenities. A range of nearby bus routes can be easily accessed. The nearest underground stations are Plaistow and Upton Park on the District Line. The home has a small car park. The average fee charged by the home is£759.93 per week. Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection took place over the course of two days, on the 26/1/08 and the 7/2/08, and was unannounced. The inspector had the opportunity of speaking with service users, staff from the home, and the homes deputy manager was present on the second day of the inspection. The inspection also included a follow up telephone conversation with the homes manager. The inspector checked records, policies and other documents, and conducted a tour of the premises. Staff were observed in the provision of care, and this has contributed to judgements reached about the home. The home makes use of Assistive Technology (AT), this was examined as part of the inspection, along with a discussion with a member of the Local Authorities staff who has responsibility for AT within the Borough of Newham. The home completed an Annual Quality Assurance Assessment (AQAA) prior to the inspection at the request of the CSCI, and this was used to form part of the overall inspection process. What the service does well: What has improved since the last inspection? What they could do better: Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 6 Despite these improvements, there are still some issues that must be addressed. In particular, the home must ensure that all medications in the home are stored, administered and recorded appropriately to help ensure the health, safety and wellbeing of service users. The home must ensure that all staff undertake adult protection training, and that clear and comprehensive records are maintained of any medical appointments. 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. The summary of this inspection report can be made available in other formats on request. Greengate Lodge DS0000034843.V359580.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 Greengate Lodge DS0000034843.V359580.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. It is the inspector’s judgement that the home provides prospective service users with sufficient information about the home to enable them to make an informed choice as to move in or not. This information is provided through written documentation, and the opportunity of visiting the home. EVIDENCE: The home has a Statement of Purpose in place. This has not been reviewed since October 2002, and consequently contains out of date information, for example the responsible person named in the Statement is no longer the responsible person, and the Statement says that the home provides intermediate care, which it no longer does. To ensure that service users and prospective service are given accurate information about the home, the home Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 9 must ensure that the Statement of Purpose is subject to regular review, and that it contains accurate and up to date information. A Service User Guide has been produced, this doubles as a contract/statement of terms and conditions, and all service users are provided with their own copy. These documents have been signed by the service user and a representative of the home. The Guide provides details of fees payable, what they cover and what they do not include. The Guide also includes the aims and objectives of the home, stating that “Our philosophy of care aims to provide a caring and homely atmosphere, which respects the individuality, dignity and rights to privacy of each resident.” However, the Guide is not fully in line with National Minimum Standards (NMS), for example it does not include a summary of the Statement of Purpose, or a copy of the homes complaints procedure, and this must be addressed. The home has an admissions procedure in place. This states that assessments will be carried out before service users move into the home, and that prospective service users will be given the opportunity of visiting the home before making a decision as to move in or not. Service users will initially move in on a six week trial basis, after which a placement review meeting will be held. Comprehensive pre admission assessments are carried before admission by a social worker and someone from the home’s care/management staff. Assessments are of a satisfactory standard, covering needs around mobility, health and mental health and personal care. The home does not provide intermediate care. Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Although the inspector was satisfied that the home is meeting the personal care needs of service users, more needs to be done around meeting their health needs. For instance, the home must ensure that all medications are stored, administered and recorded appropriately, and that all health appointments are monitored and recorded. EVIDENCE: Care plans are in place for all service users, these are of a satisfactory standard. Plans are clear and easy to follow, and subject to regular review. Plans cover needs around personal care, communication and mobility. Care plans also cover needs around equalities and diversity issues, such as cultural Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 11 and religious needs. Daily logs are also maintained, and these are linked to care plans. All service users have a risk assessment in place around falling, and these are of a satisfactory standard. Generic risk assessments are now in place for some service users, covering issues such as smoking or wandering, but for several service users they still only have a risk assessment around falling. In order to promote the health, safety and welfare of service users and others, the home must develop and implement comprehensive risk assessments for all service users, covering all areas of potential risk to themselves and others, and that these assessments are subject to regular review. All service users are registered with a GP. Records are maintained of GP appointments, including details of any follow up action necessary. However, the home does not keep clear records of other medical appointments, for instance, for two service users there was no records to evidence that they have had any access to dental or eye care in the past year. In order to verify that service users have appropriate access to relevant health care professionals, and to help monitor and ensure that service users access health care professionals as appropriate, the home must keep clear records of all medical appointments. These records must include the date of the appointment, who it is with, the reason for the appointment and details of any follow up action necessary. The home makes use of the Continence Advisory Service, and used continence products are disposed of appropriately. Medications within the home are stored in a locked medication cabinet, and in a designated medication fridge. The home checks the fridge temperature on a daily basis. However, the fridge is not locked, and the medication within the fridge is not stored in a locked container. Further, the medication cabinet is freestanding, and not attached securely to a wall. It is required that all medications within the home are stored securely. All staff undertake training before they are able to administer medications. No service users are currently on any controlled drugs. The home maintains records of any medications returned to the pharmacist. On inspection of the medication cabinet, it was noted that the home had received a box of BUCCASTEM tablets prescribed on an “as required” basis for one service user, the day before the inspection. One of the tablets was missing from box, indicating that it had been administered to a service user. However, the Medication Administration Record (MAR) chart for the service user made no mention of this medication whatsoever, or when the medication had been administered, and their were no guidelines in place around when this “as required” medication should be administered. Staff spoken to during the course of the inspection were unable to say when this medication had been administered, or why the medication had not been entered on the MAR chart. To help ensure that service users safety is promoted by the safe administration of medications, it is required that all medications are recorded and Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 12 administered appropriately. It is further required that guidelines are in place for the administration of mediations prescribed on a “as required basis.” The home has recently introduced Assistive Technology (AT) or Telecare. At present, this consists of mats fitted to some beds that indicate when the mattress gets wet, or when someone gets out of bed. The home also has the technology to detect when someone has a seizure in bed, or when they leave their bedrooms. However, these systems are not currently in operation, as they do not help to meet the needs of any of the service users currently at the home. When the systems are activated, they send an alert to a pager, which states what sort of alert it is, e.g. someone has left the bed, or the bed is wet. There are two staff on duty at any given time who always carry a pager each. This means that staff are able to attend to service users in a prompt and appropriate manner. Assessments are done with individual service users prior to the use of AT, to determine what, if any, technology would be appropriate. Service users are involved in the decision, and have the right to refuse the use of AT. The inspector was satisfied that it can provide a useful tool in supporting service users, for example if a service user is know to be at risk from falling, when they get out of bed a bleeper will alert staff, who will be able to check on the service user. Likewise, the bleeper can indicate if the service user has been incontinent, the staff can then provide appropriate support, without having to disturb the service user throughout the night. One service user has been identified at been at risk from falls, but is also able to use the toilet independently. Therefore, to help promote their independence and dignity, the bleeper on the pager sounds 15 minutes after they have left their bed, so that if they have just got up to use the toilet, staff will not intervene. Staff have been provided with training around the use of the technology, and the devices are serviced annually by an engineer. The use of the technology forms part of the ongoing review process for service users. Since the introduction of this technology, the home has not reduced staffing levels. The deputy manager informed the inspector that there were no current plans to reduce staffing levels. Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The inspector was satisfied that the home supports service users to live valued and fulfilling lives, and that efforts have been made to meet the equalities and diversity needs of service users. EVIDENCE: The home arranges various social and leisure activities, some of which help to meet service users needs around equalities and diversity issues. For example, a musical performer visits the unit for people from the Asian community, and plays culturally appropriate music. Similarly, the other units have culturally appropriate music available, as well as videos and films from particular cultures. Service users are able to visit an African-Caribbean hairdressers. Service users are able to wear culturally appropriate clothing, such as saris. The home seeks to meet the religious needs of service users. Service users are available to visit a place of worship of their choice, currently service users visit Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 14 temples, mosques and churches. A Catholic priest visits the home, as does a choir from the Pentecostal church. Service users spoken to informed the inspector that they very much enjoyed this choir. The home arranges various trips out, recent trips have included to pantomimes, Christmas lights and a fish and chip supper. The home runs a weekly gentle exercise class, and other leisure activities are provided, such as television and puzzles, and the community library visits the home regularly. Four service users regularly attend day services, these arrange day trips, for example to the National Art Gallery. Day services also provide activities, such as bingo and art sessions, and provide service users with an opportunity to socialise and develop friendships. Through observation and discussion there was evidence that the home has taken steps to promote the privacy and dignity of service users. Staff were seen to knock and wait before entering bedrooms. Service users have access to a telephone they can use in private, and are given their own mail to open. Records are kept of menus, and these evidenced that service users are offered a varied, balanced and nutritious diet. The home has a central “industrial” type kitchen, which cooks the food for three of the four units, while the unit for people from the Asian community has its own kitchen which is suitable in scale to prepare food for service users on that unit. Food provided helps to meet the equalities and diversity needs of service users, for example through Asian and Caribbean food, and staff from the same cultural backgrounds as service user are employed in the home, and have a good understanding of service users cultural needs, including around food. Service users are involved in planning the menu, and were seen to be offered a choice on the day of inspection. Support provided to service users at mealtimes was done in a sensitive manner, and mealtimes were observed to be relaxed and unhurried. Kitchens were clean and tidy, and food was stored appropriately. Staff involved in food preparation have undertaken training in food hygiene. Service users were seen to be offered drinks and snacks throughout the day. However, it was noted that fresh fruit was not available throughout the home on the day of inspection. Staff informed the inspector that the home only provides fresh fruit twice a week, and that for those service users who require fruit more then this, they are expected to pay for this themselves. Service user contracts state that food is provided by the home as part of the basic contract price, and it is required that the home provides fresh fruit daily to those service users who want it. Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. It is the view of the inspector that the home has appropriate polices and procedures in place around complaints and protection, but that to further ensure that service users are safe from the risk of abuse, the home must ensure that all staff undertake adult protection training. EVIDENCE: The home has a complaints procedure, which includes contact details of the CSCI, and timescales for responding to any complaints received. Details of how to complain were on display within the home, and all service users are provided with their own copy of the procedure. The inspector was pleased to note that the complaints procedure has been produced in other formats then written English, such as on audio tape, to help make it more accessible to service users. The AQAA states that the home also maintains a complaints log. The AQAA also states that service users are encouraged to enlist on the electoral register, and that they are supported to vote in elections if they choose. Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 16 The home is run by the London Borough of Newham, and consequently operates within their adult protection policy and procedure. A copy of this procedure was available in the home for staff to refer to. Leaflets were also available in the home to service users and relatives providing information about adult protection, these were written in several different languages, thus helping to make them more accessible to service users, and to meet their needs around equalities and diversity issues. However, staff spoken to demonstrated only a limited understanding of their roles and responsibilities with regard to adult protection. The senior member of staff on duty said that as yet not all staff have undertaken adult protection training, and the homes manager confirmed this to the inspector in a follow up telephone conversation. Indeed, the AQAA states that more adult protection training for staff is required over the next twelve months. It is required that all staff employed in the home, including domestic and administrative staff, undertake adult protection training as appropriate, and that they have a good understanding of the issues involved with adult protection. Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. It is the inspector’s judgement that the home is suitable to meet its stated purpose with regard to its physical environment. Service users are provided with adequate communal and private space, and the home was generally well maintained. EVIDENCE: The home is situated in the Plaistow area of the London Borough of Newham, close to shops, transport networks and other local amenities. The home is single storey and purpose built. The space is divided into four units and each provides a homely atmosphere. Each unit is individually decorated and the hallways between them display pictures representative of the service user Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 18 group. The home also provides offices for administration and management, a staff room, hairdressing salon, industrial style laundry facilities within a dedicated laundry room and sluice rooms. There is also a central industrial style kitchen. Externally there is a large rock garden with covered pond. Each unit is individually decorated and comprises of a lounge, dining room and a domestic style kitchen. Each unit has access to a specialist bathroom where service users can utilise specialist equipment such as parker baths with staff support. Several service users showed the inspector their bedrooms and it was noted that each contained a bed, a wardrobe, a chest of draws, a bedside table, an armchair, en-suite toilet facilities, and in some cases an ensuite shower. Service users are able to personalise their rooms with mementos and pictures. Bedrooms meet NMS on size requirements, and have adequate natural light and ventilation. The inspector noted that the premises were clean, hygienic and free from offensive odours. The home is generally well maintained, furniture and fittings around the home were domestic in character. Steps have been taken to reduce the risk of infection, protective clothing such as gloves and aprons are available to staff, and hand washing facilities are situated throughout the home. COSHH products are stored securely. Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. It is the view of the inspector that the home is staffed in sufficient numbers to meet the needs of service users, and that staff are suitably experienced and qualified. EVIDENCE: The home provides 24-hour support, including waking night staff and an emergency on-call procedure. There was a staffing rota on display, this accurately reflected the staffing situation on the day of inspection, and clearly identified who was in charge of the home at any given time. As well as care staff, the home employs designated kitchen, domestic and administrative staff. Through observation and discussion there was evidence that staff have a good understanding of their roles and responsibilities, and of the individual and collective needs of service users. Through the selection of staff the home is able to help meet service users equalities and diversity needs, for instance some service users speak Punjabi as a first language, and the home employs staff who also speak Punjabi. Staff were also observed to have a good ability to communicate with service users who have complex communication needs. Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 20 Staff were seen to interact with service users in a friendly and respectful manner. The inspector witnessed positive examples of staff interactions with service users, such as working out puzzles with them. The AQAA completed by the home states that 75 of care staff have achieved an NVQ Level 2 in Care or equivalent qualification, well above the 50 required by NMS. Staff spoken to informed the inspector that they undertook an induction programme on commencing work at the home, this included health and safety, service user issues and the opportunity of shadowing more experienced members of staff. Staff receive regular training, and records are maintained. Recent staff training includes value based training, the Mental Capacity Act, manual handling and managing continence. The home has appropriate employment related policies in place, including on equal opportunities and recruitment and selection. The inspector was unable to check employment records, as these are stored securely by the manager, who was not on duty at the time of inspection. The AQAA states that employment checks are carried out as appropriate, and will be tested as part of the next key inspection of the home. Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,37 and 38. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. It is the view of the inspector that the homes manager is suitably qualified and experienced, and that health and safety is managed appropriately within the home. EVIDENCE: The homes manager was not present during the course of the inspection, but staff and service users spoken to informed the inspector that they found the manager to be approachable and accessible. The AQAA supplied by the home states that the manager has a nursing qualification and NVQ Level 4 in Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 22 Management and Care. The home also employs a deputy manager, who shares their duties between Greengate Lodge and another home run by the Local Authority. The home has a quality assurance policy in place. Care plan reviews and staff meetings contribute to the quality assurance process within the home. It was positively noted that the home has arranged for someone from Age Concern to meet with service users to enable them to provide feedback and contribute to quality assurance. Surveys are issued to service users and their relatives, to help gain their feedback on the level of care and support provided. Copies of previous inspection reports were available to view in the home. However, there was no evidence of any Regulation 26 visits having taken place since June 2007. To help improve quality assurance in the home, it is required that monthly unannounced Regulation 26 visits take place, and that a copy of the report from those visits is available to view within the home. Record keeping in the home was generally of a good standard, (with the exception of risk assessments and medication as mentioned elsewhere within this report). Confidential records are stored securely, staff and service users can access their records as appropriate. Staff spoken to informed the inspector that they receive regular formal supervision, and that they have access to their supervision records. Supervision covers performance, service user issues and training and development needs. The home has relevant health and safety policies in place, for example around infection control and fire safety, and staff undertake health and safety training. Fire extinguishers were situated around the home, these were last serviced on the 8/3/07. Fire exits were clearly signed and free from obstruction. Fire alarms are tested weekly, and the home holds regular fire drills. Fire alarms have been serviced within the past twelve months by an engineer. The home had in date safety certificates for gas safety, PAT testing and electrical installation, along with in date employer’s liability insurance cover. Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 23 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 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X X 3 3 3 Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 24 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. 1. Standard OP1 Regulation 4 and 5 Requirement The registered person must ensure that the Statement of Purpose and Service User Guide are accurate, up to date and that they are subject to regular review. The registered person must ensure that comprehensive risk assessments are in place for all service users, covering all areas of potential risk to themselves and others. These assessments must be subject to regular review. The registered person must ensure that service users have access to all relevant health care professionals, and that comprehensive records are maintained of these appointments, including details of any follow up action necessary. The registered person must ensure that all medications are stored securely. The registered person must ensure that all medications within the home are DS0000034843.V359580.R01.S.doc Timescale for action 31/03/08 2. OP7 13 31/03/08 3. OP8 13 29/02/08 4. 5. OP9 OP9 13 13 29/02/08 29/02/08 Greengate Lodge Version 5.2 Page 25 6. OP9 13 7. OP15 16 8. OP18 13 9. OP33 26 administered and recorded appropriately. The registered person must ensure that guidelines are in place around the administration of any medications prescribed on an as required basis. The registered person must ensure that the home provides fresh fruit throughout the week to any service users who want it. The registered person must ensure that all staff undertake adult protection training as appropriate, and that they have a good understanding of their roles and responsibilities with regard to adult protection. The registered person must ensure that monthly unannounced Regulation 26 visits take place, and that a report of those visits is available in the home for the purposes of inspection. 29/02/08 31/03/08 30/04/08 31/03/08 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 Greengate Lodge DS0000034843.V359580.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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