Inspection on 04/10/06 for Gregory House II Care Home

This inspection was carried out on 4th October 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 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

Gregory House II Care Home 30/07/07

Gregory House II Care Home 07/02/06

Gregory House II Care Home 15/03/05

Gregory House II Care Home 19/10/04

Gregory House II Care Home 20/10/03

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

CARE HOME ADULTS 18-65 Gregory House II Care Home Gregory House II 391/393 Mansfield Road Carrington Nottingham Nottinghamshire NG5 2DG Lead Inspector Steve Keeling Key Unannounced Inspection 4th October 2006 9:00 Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 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 Gregory House II Care Home DS0000002231.V314658.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 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. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gregory House II Care Home Address 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) Gregory House II 391/393 Mansfield Road Carrington Nottingham Nottinghamshire NG5 2DG 0115 969 2320 0115 924 5232 gregoryhouse2@aol.com Mrs Pam McKale Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th February 2006 Brief Description of the Service: Gregory House II was originally a pair of semi - detached houses that have been converted into a care home to accommodate 12 people with mental health needs. It is located on a main road in the Carrington area of Nottingham, offering easy access to bus routes, shops a post office and local facilities and amenities. The house has a frontage laid to tarmac for car parking and there is a small, enclosed rear garden. Accommodation is provided on 3 floors and the premises are unsuitable for anyone with significant mobility problems as the home does not have a passenger lift. The fees currently charged range from £282.99 to £330.03 per week. Additional charges for podiatry services and hairdressing services are not included in the fees charged at the home. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Mr S.A. Keeling conducted the unannounced inspection on the 4th October 2006 over a 6-hour period. The main method of inspection was case tracking, this is a method of selecting service users within the home and discussing with them their expectations and experiences within the home together with the care practices utilised within the home environment. The case tracking method also examines the records of the service users to ascertain if the service users identified needs are being addressed appropriately within the care home setting and that their safety and well being is being maintained. On this occasion two service users were case tracked. Also as part of the inspection process a two staff members within the home were informally interviewed to further evidence the quality of care afforded to the service users. A range if information was used to determine the outcome of this inspection and the report, these included the previous judgments and findings, information received from service users in response to the Commission for Social Care Inspection questionnaires and the pre-inspection information provided by the registered provider in August 2006. What the service does well: What has improved since the last inspection? The acting manager at the home has effectively addressed the requirements set at the previous inspection in an attempt to maximise the safety of service users. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 6 What they could do better: 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. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 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 Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 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): 2. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users needs are assessed effectively. EVIDENCE: The case tracked service users at Gregory House have been in residency for several years. The inspector was unable to establish the quality of the initial pre admittance assessment, as the assessment documentation was not unavailable at the time of the inspection. The senior carer on duty stated that the needs of the service users are evaluated on a monthly basis and that all the service users risk assessments are reviewed on a monthly basis. The inspector examined two service users notes and it was evident that the resident’s risk assessments are evaluated on a monthly basis thus ensuring the health and well being of the service users in the home. Both service users spoken with confirmed that the risk assessments are performed on a regular basis and that they are fully involved in the risk assessment process. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 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): 6,7,9. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The service users care plans did not provide sufficient information to inform staff at the home of the changing needs and personal goals of the service users. Service users are encouraged to make independent decisions about their lives. Service users are encouraged to take risks as part of an independent lifestyle. EVIDENCE: An examination of the two case tracked service users documentation evidenced that care plans had been formulated in an attempt to address the holistic needs of the service users. The care plans lacked detail to inform staff at the home as to the appropriate actions to be taken to manage the service users identified needs. An example of the content of a care plan related to the management of a service users susceptibility of seizures was “the service user could experience seizures due to epilepsy” with no documented actions to be taken by staff at the home to manage the service users seizures effectively. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 10 The senior carer stated that the actions to be taken by staff in the event of the service user experiencing a seizure was documented within the service users risk assessment documentation. The inspector examined the risk assessment documentation within both the case tracked service users documentation and it was evident that the risk assessments did provide staff with the necessary information to manage the service users care needs effectively. The senior care appreciated that the care planning process currently utilised at the home was ineffective. To ensure that the care plans are “fit for purpose” the registered person should ensure that care plans are formulated to ensure that staff are fully aware of the appropriate actions to be taken to manage all the identified needs of the service users in the home. In ensuring that service users are encouraged to make decisions about their lives and encouraged to take risks as part of an independent lifestyle the senior carer stated that the service user are always encouraged to make independent decisions and that their decisions are respected. The senior carer said that she ensures that residents are listened to and are actively involved in the care planning and risk assessment process thus ensuring that any activities that the service users participate in are, as practically possible, free from risk. The inspector confirmed that the services users are actively involved in the care planning process, as the resident’s signatures were evident on the care plans. The service user who had a history of seizures had been given the opportunity to interact within the community independently. To ensure his safety the service users wallet contained emergency information such as current medication, his diagnosis and the service users general practitioner name and telephone member together with the telephone number of the care home. Service users spoken with confirmed that they feel they are able to make decisions about their own lives. A service user spoken with stated “the staff respect my decisions and I feel independent at the home. I decide the activities I participate in, such as going out to the shops, the pub etc but mostly I spend my days in my room watching television and listening to my radio as this is my preference”. A second service user spoken with stated, “I always make my own decisions and the staff respect them. I do not feel pressured to comply to do anything in the home. I do not like trips out as I have poor mobility, I would sooner stay in my room or in the home”. The service user went on to say the he believed that the staff would support him if he wished to participate in social activities beyond the homes environment as the staff as so accommodating. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 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 the following standard(s): 12,13,15,16,17. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are able to able to participate in age, peer and culturally appropriate activities. Service users are encouraged to be part of the local community. Service users have appropriate personal, family and sexual relationships. Service users rights are respected and responsibilities recognised in their daily lives. Service users are provided with a wholesome well balanced diet. EVIDENCE: The senior carer stated that the home provides some social activities such as cards and dominoes, DVD nights and karaoke nights. Special occasions such as Christmas and Easter are celebrated in the home. Trips to the coast and areas of local interested within Nottinghamshire have also been provided. On the day of the inspection a trip to Goose Fair was being planned. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 12 The carer confirmed that the residents play cards dominoes, karaoke (karaoke machine evidenced) and painting. The carer also stated that residents are encouraged to interact within the local community (once a risk assessment has been performed), and go to shops, the local pub, trips to the coast and local areas of interest. A service users stated that he enjoyed drawing, playing dominoes, watching television and DVDs stating, “I am very satisfied with the social provision at the home. At the time of the inspection several service users were observed by the inspector leaving and entering the premises and going about their daily activities. A service users spoken with stated that service users at the home come and go as they please. The senior carer stated, “we always encourage our service users to go out into the community but we also perform risk assessments to ensure they are safe. Sometime residents are accompanied whilst in the community to ensure their safety is maintained. A carer stated that she has accompanied service users to the cinema, a trip to the coast, shopping in Nottingham City centre and trips to the park and café. The senior carer stated that service users who occasionally go to the shops will not have risk assessments performed as only service users who go out on a regular basis will have risk assessments performed. To ensure the safety of all the service users at the home the registered person should ensure that risk assessments are performed for all service users who venture beyond the homes immediate environment. A service user spoken with stated, “ I do not feel part of the community as people in the city can be unfriendly. I do not like attending social clubs, but I do enjoy going to the pubs. I feel part of a community within the home, which is nice”. Another service user stated, “ I have always felt part of the community as I have worked in this area. I do not get out much now, which is my choice, but I still feel part of the community”. The senior carer stated that the home operates an open door policy and that resident’s family and friends came come and go as they please. A service user stated “I have a large family and they can come and visit me at any time, and the staff are friendly and accommodating. The service user went on to say that “I have never developed a personal relationship whilst in the home but I am sure the staff would support my decision if I did”. Another service user confirmed that the home operates an open door policy and the staff are nice and do their best for the visitors. Both case tracked service users paid particular compliments about the quality of food at the home. One service user stated that “the food is lovely, we always have a choice, and the choices are displayed on the menu board”. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 13 At breakfast I can have cereals or a full English breakfast if I wish. Another service users stated that “the food is always good and plentiful, we are always given a choice, I especially like the fry ups but I usually have cereals, the lunch time meal is always nice”. Both service users stated that they could have snacks and drinks when they wished. Service users spoken with stated that the provision of meals are discussed at service user meetings so that the service users preferences can be identified and provided at the home. Both carers spoken with stated that the service users are always provided with healthy options, which includes fresh vegetables and fruit. The menu is always displayed for the service user perusal and that any preferences identified from residents meetings are catered for at the home. An examination of the food temperature monitoring records within the food record book evidenced that the temperature of the residents food had only been recorded sporadically over the month of September as the 7th, 11th, 17th, 22nd, 28th and the 30th September meals had not been temperature monitored which could compromise the safety of service users at the home. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 14 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): 18,19,20. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users receive personal support in a way they prefer and require. Service users physical and emotional needs are met. The current practices in relation to the administration of medicines at the home could compromise the safety of service users. EVIDENCE: The senior carer stated that she encourages the staff to be flexible in relation to the provision of personal care. She ensures that the staff understand the importance of listening to the residents and appreciating the importance of promoting the service users autonomy The senior carer also said that the service users physical and emotional needs are identified via the risk assessment process utilised within the home and that the service users are involved in the risk assessment process. The inspector examined two service users notes, it was evidenced that the personal preferences of the service users were documented effectively in relation to what the service users likes to wear, the service users preferences in relation to meal provision together with the service users preferred social activities. The service users notes also evidenced service user participation, as Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 15 the service users signatures were evident on the risk assessment documentation. A carer spoken with on the day of the inspection stated that information can be gleaned from care plans and risk assessments so as to identify the physical and emotional needs of the service users. The carer stated that she appreciated that all the residents are individuals and as such their requirements are individualistic. The carer stated that the most important thing is to listen to the service users and give them time to express their needs effectively. A service user said that staff always respected his wishes, and that he receives all the support he needs. The service user confirmed that the staff are very flexible in their approach to running the home and could not identify any shortfalls in the care provision at the home. A second service user believed that his physical and emotional needs are met effectively at the home and his independence is promoted. The resident stated that he feels contented, happy and safe within the home environment. The senior carer stated that no service users were responsible for the selfadministration of medication at the time of the inspection. The senior carer stated that should a service user request independence, a risk assessment would be performed which would involve the service users Community Psychiatric Nurse (CPN). If the service user were deemed competent and safe a care plan would be formulated from the risk assessment to promote the service users independence in the administration of medicines. A service user stated that he is happy that the staff manages his medication for him. The service user did not wish to be responsible for his medication, as he believed he would forget to take it. Another service user stated “the staff administer my medication for me and that’s fine by me, it all sorted out by them”. The inspector witnessed the administration of medicine to a service user, and it was evident that the staff member used her un-gloved hands to put medication into a medication pot. The practice of handling medication is unacceptable due to the potential risk to staff and service users in the home. The registered person will be required to take appropriate actions to ensure that staff at the home adhere to policies and procedures appertaining recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 16 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): 22,23. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users feel their views are listened to and acted on. Service users are protected from abuse and neglect. EVIDENCE: In ensuring the service users have the opportunity to express any concerns and opinions the senior carer stated that residents meetings take place on a monthly basis and that the carer on duty documents the minutes of the service users meetings. The carer on duty at the time of the inspection confirmed that it was her responsibility to minute the residents meetings and she evidenced the minutes of the meeting to the inspector on the day of the inspection. Both service users spoken with confirmed that residents meetings are performed on a regular basis and that the meetings provide an effective forum to discuss issues appertaining to the service provision within the home. Two service users spoken with on the day of the inspection confirmed that the service users are listened to, and any concerns are taken seriously and acted upon by the staff and manager at the home. The “Have Your Say” Survey asked service users “ Do the carers listen and act on what you say”, 100 of the respondents stated yes. One service user stated, “ I believe that my opinions are valued and that the consultation process in the home is good”. Another service users stated “I feel valued, I do express my opinions, and yes they are listened to”. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 17 Both service users spoken with confirmed that they feel safe in the home environment and that the staff are observant and attentive to the their needs. The senior carer stated that all staff receives training appertaining to the protection of the vulnerable adult. The inspector was able to confirm that staff at the home had received appropriate training in the protection of the vulnerable adult as the staff training certificates were on display in the foyer of the home. The carer on duty at the time of the inspection also confirmed that she had attended training appertaining to the protection of the vulnerable adult on 30th April 2005. The carer stated that effective observation of the service users is crucial in detecting signs of abuse, such as bruising or the service users behaving differently. The carer stated that it she suspected abuse was happening she would liaise with the homes acting manager or the senior carer to ensure that any concerns were highlighted and dealt with effectively. The “Have Your Say” Survey asked service users “ Do you know who to speak to if you are unhappy” the response was yes to the aforementioned question within 100 of the returned surveys. The survey also asked “do you know how to make a complaint” once again 100 of the respondents stated yes. The homes complaints procedure was on display in the foyer of the home but the inspector could not examine the documentation relating to a complaint that was received by the Commission for Social Care Inspection on 7th March 2006 as it was locked in the manager office. The senior carer stated that in the past the manager had ensured that complaints forms were made available in the foyer of the home so that service users or visitors to the home could easily initiate the complaint procedure. The complaint documentation was not available for service users or their significant others to utilise on the day of the inspection and as such the facility to report any concerns or complaints was compromised. The registered person shall re-establish a complaints procedure for considering complaints made to the registered person by a service user or person acting on the service users behalf. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 18 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. Quality in this outcome group is poor. This judgement has been made from evidence gathered both during and before the visit to this service. The home provides a comfortable homely environment but the overall cleanliness and standard of décor within the home was unsatisfactory. EVIDENCE: An examination of the case tracked service users bedrooms evidenced that service users are encouraged to have personal belongings in their bedrooms to promote a homely atmosphere. The service users spoken with on the day of the inspection said that they were satisfied with the overall standard of cleanliness the home, which included their bedrooms and the communal areas. The inspector performed a partial inspection of the home, which included resident’s bedrooms and communal areas. The inspection process evidenced that several areas within the home were not maintained to a satisfactory standard. Bedroom Seven. The curtains in the service users room were frayed at the bottom and the curtains were coming off the curtain rail. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 19 The shower in room seven was faulty as the shower hose was missing. Cigarette burns were evident on the carpet floor near the bay window. Bedroom One. The Floor was stained around the toilet area. Bedroom Two. The Toilet area was in a poor state of repair, a resent problem with damp had resulted in the paint flaking and extensive mould growth around the toilet area. Bedroom Nine. Two sets of drawers were present in the room. One set of drawers was broken and the second was severely stained from the top. The bath taps were missing and the shower was faulty. The main light in the room did not have a light bulb present which constitutes a risk of falls. A section of loose carpet was also in the room near the door, which constitutes a falls risk to the service users. The corridor outside bedroom nine was dirty, the walls were dirty and plaster was cracked in the ceiling area. Bedroom Twelve. Plastic bags full of paper and magazines were stacked in the shower cubicle (the shower was faulty) and around the shower area and next to the toilet. The inappropriate storage of flammable products constitutes a risk of fire, especially as it was evident that the service user smokes in his room. The woodwork behind the toilet in room twelve was falling apart and the toilet seat was stained. Mobility aided bathroom. The bath that had a bath hoist in situ, the hoist cover to the hoist was severely stained and mould was growing behind the taps on the bath. The bath panel was also coming away on the left hand side and the bathroom area was generally dirty with flaking paint below the radiator. Downstairs toilet. The downstairs toilet, next to the smoke room, had a stained floor and the room was dirty and very dusty. First floor bathroom. The bathroom on the first floor had mould growing around the bath and the bath side was falling off. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 20 The top floor smoke room The wallpaper on the left wall was falling off, the ceiling was stained, and cigarette burns were evident on the linoleum floor. The Kitchen and food preparation area. The Health and Safety of the service users could be compromised at the home as the food preparation area and kitchen area were not maintained to a satisfactory standard. Broken tiles above a food preparation area were evident. The ceiling and walls in the kitchen area were greasy and stained. The cupboard door above the cooker was falling off (only one hinge present) and the cupboard below the cooker had the laminate strip missing, exposing a chipboard interior. The chipboard had degraded and was creasy and stained. Surfaces above the fridge and freezers were dirty and greasy as was the interior of the bread bin. The registered person will be required to evidence to the Commission for Social Care Inspection what actions will be taken to ensure that the premises to be used as the care home are of sound construction and kept in a good state of repair both externally and internally. The registered person should also ensure that the equipment provided at the care home for use by service users or persons who work at the care home are maintained in good working order and all parts of the care home are kept clean and reasonably decorated. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 21 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): 32,34,35. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Appropriate training is provided to ensure that staff are competent and appropriately qualified to perform their role in the residential home. The inspector was unable to fully evidence that the recruitment practices within the home protect the service users. EVIDENCE: The inspector examined the staff training certificates that were on display within the foyer of the home. It was evident that staff had received the required mandatory training to ensure the safety of service users within the home. The senior carer stated that all staff received video based mandatory training and said that she felt confident that all the staff employed at the home were suitably qualified and competent to perform their roles effectively. Both members of staff spoken with on the day of the inspection demonstrated a thorough understanding of the needs of the service users at the home and demonstrated a strong commitment to the welfare of the service users. Both service users spoken with on the day of the inspection said that they believed that the staff are well trained and competent in performing their duties. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 22 Information provided by the acting manager within the pre-inspection questionnaire, relating to the national vocational qualification status of the carers at the home evidenced that 60 of the staff at the home have a NVQ level 2 or above qualification. The senior carer stated that staff only commence employment at the home following Criminal Records Bureau Checks (CRB), documentary proof of identity has been provided together with evidence of a permanent place of residency. A carer spoken with in the day of the inspection also confirmed that she had undergone an effective interview process approximately 4.5 years ago. She confirmed that she had to wait for a CRB check prior to employment and had also provided the manager with two references prior to employment. The inspector was unable to examine any staff files appertaining to staff recruitment as the necessary documentation was locked in the manager’s office and the senior carer was unable to access recruitment documentation. The inspector examined the homes policies and procedures appertaining to the recruitment of staff at the home. The policy did not mention the acquisition of CRBs prior to employment. The registered person will be required to ensure that the policy is revised and meets the regulations identified within the National Minimum Standards Act (2000). Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 23 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): 37,39,42. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Standard 37 could not be fully assessed at this inspection as the acting manager was not available for comment on the day of the inspection and the inspector could not access essential documentation. Service users are encouraged to actively participate in any developments within the home and their views and opinions are valued. The health and safety of service users is promoted within the home. EVIDENCE: As mentioned earlier in the report, the registered person, in meeting the requirements identified within the National Minimum Standards Act (2000) and to ensures that the home is well run, will be required to address the environmental concerns identified within the report. The registered person shall also ensure that records are at all times available for inspection in the care home by any person authorised by the Commission for Social Care Inspection to enter and inspect the care home. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 24 The content of this report has provided the opportunity for the inspector to establish that effective communication systems are in place in the form of service user meetings and risk assessments to ensure that service users views underpin all self-monitoring, review and development in the home. Both service users spoken with confirmed that the meetings are effective in the promotion of the service users input to the home. In determining that the service users are safe within the homes environment a range of Health and Safety records were provided by the acting manager within the pre-inspection questionnaire, relating to Fire Safety training (May 2006), fire equipment checks (June 2006), emergency lighting checks (December 2005) hoist and adaptation checks (May 2006), Gas Safety Certificate (November 2005) and all were found to be satisfactory. Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 25 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 1 STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 2 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 3 X Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 26 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 YA24 Regulation 13 (4) (C) Requirement The registered person shall ensure that any unnecessary risks to the health or safety of service users are so far as possible, eliminated and the inappropriate storage of flammable materials is ceased. Timescale for action 12/10/06 2 YA30 23 The registered person must 31/10/06 provide an action plan to address the environmental issues identified within report to ensure that the health and safety of service users is safeguarded. 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 YA6 Good Practice Recommendations The registered person should ensure that care plans provide sufficient information to inform staff at the home of the changing needs and personal goals of the service users. The registered person should ensure the safety of all the service users at the home and risk assessments are performed for all residents who venture beyond the homes DS0000002231.V314658.R01.S.doc Version 5.2 Page 27 2 YA13 Gregory House II Care Home 3 4 5 6 YA17 YA20 YA23 YA34 immediate environment. The registered person should liaise with the local Environmental Health Officer to ensure that food preparation and handling is safe. The registered person should ensure that policies and procedures appertaining to the handling of medicines are followed. The registered person should ensure that an effective system for reporting complaints or concerns is in initiated. The registered person should ensure that the homes policies and procedures relation to recruitment is updated to satisfy the regulations identified within the Care Standards Act (2000). The registered person shall ensure that the records are at all times available for inspection in the care home by any person authorised by the Commission for Social Care Inspection to enter and inspect the care home 7 YA37 Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Gregory House II Care Home DS0000002231.V314658.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!