Inspection on 07/11/06 for Gresham Care Home

This inspection was carried out on 7th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Gresham Care Home 17/04/07

Gresham Care Home 13/02/06

Gresham Care Home 13/06/05

Gresham Care Home 18/01/05

Gresham Care Home 19/08/04

Gresham Care Home 03/02/04

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

CARE HOMES FOR OLDER PEOPLE Gresham Care Home 49 John Road Gorleston Norfolk NR31 6LJ Lead Inspector Mrs Ginette Amis Unannounced Inspection 7th November 2006 10:30 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 Gresham Care Home DS0000015640.V319161.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. Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gresham Care Home Address 49 John Road Gorleston Norfolk NR31 6LJ 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) 01493 661670 01493 658735 shahaza@hotmail.com Mr. Naim Mohammud Ruhomutally Mrs. Vidia Ruhomutally N/A Care Home with Nursing 28 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (28) of places Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Twenty eight (28) Older People may be accommodated. Eleven (11) service users may be accommodated within the categories of DE(E) or DE. From time to time the home may accommodate up to two service users under the age of 65 years. Total number not to exceed twenty-eight (28). Date of last inspection 13th February 2006 Brief Description of the Service: Gresham Care Home is a home that provides care with nursing to a maximum of 28 service users. Accommodation is situated on the ground and first floor in single and double rooms. There is a large lounge with a dining room attached and a small quieter lounge for those that prefer it. The home is situated close to Gorleston seafront and to the high street with shops and other facilities available within walking distance. Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups, which assess how well a provider delivers outcomes for the people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others that work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. What the service does well: What has improved since the last inspection? Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 6 The provider has strengthened her recruitment practices by ensuring the pre validation of references from any would be staff coming from overseas. Residents and relatives have been surveyed as to their views about the service provided. 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. The summary of this inspection report can be made available in other formats on request. Gresham Care Home DS0000015640.V319161.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 Gresham Care Home DS0000015640.V319161.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care home had a comprehensive statement of purpose and informative service user guide. A colour brochure about the care home was also available. One newly admitted resident and 2 of her relatives confirmed they had been well informed about the care home and invited to visit prior to making a decision to live there. The majority of residents had been referred to the care home by social services and issued with social service contracts. The care home also issues contracts that contain the terms and conditions of residence. Each of the 9 residents who returned CSCI surveys, collected on the day of the inspection, confirmed that they had a contract with the care home. Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 9 The files of 6 residents were examined and each contained evidence that assessments as to their needs had been conducted prior to admission being agreed upon. Gresham Care Home DS0000015640.V319161.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans examined when visiting the care home were found to be clear and contained appropriate information in relation to health, personal care, social profile and recreational needs, risk assessments, moving and handling and medication. Residents and their relatives were informed as to the outcome of assessments and care planning and residents’ files contained a signed acknowledgement of this. Only one resident had a pressure sore and this had been present on their admission and was now considerably improved. Pressure care was well monitored in the care home. When examined the accident book revealed no concerning pattern or large number of injuries. Accidents were monitored every 3 months. The 6 residents and 7 relatives spoken with in conjunction with visiting the care home generally praised the standards of personal and health care offered. Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 11 One person commented on the improvement observed in their relative’s state of health since admission to the care home. It was noted how all residents appeared clean, tidy and well cared for and relatives commented how they too always found this to be the case, when-ever they visited. Appropriate facilities were in place for the safe storage of medication, which was found to be generally well managed. However, a requirement was made for the provider to ensure that any instructions given by a GP to vary the accepted mode of administration of a drug, along with necessary consent by resident or next of kin, be given in writing and retained in that resident’s file. The provider related how, over the course of past months, the nursing home had frequently been asked to accept from hospital persons who were known to have little time left in which to live. She believed she and her team were sufficiently experienced and well trained to offer appropriate care and supported one another well through these times. This was a view also held by the 3 care staff spoken with about their roles during the inspection visit. Cards expressing thanks from relatives for the care past residents had received were on display in the foyer. Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the 2 days when the nursing home was inspected, all four relatives who happened to be visiting the care home were interviewed and a further four family members of residents were telephoned so that their views of the care home could be taken into account. The over riding view expressed was that the standards set by the provider were high and the majority of staff were kind and helpful and that any problems, however large or small were very promptly put right. Some relatives expressed concern over how residents passed their time. While it was accepted that many residents were too physically frail to take part in organised activities, it was suggested that those who were more able might benefit from wider stimulation than music and bingo and a recommendation was made for the whole area of activities for residents to be re examined, with the possible introduction of activities aimed at particular groups. It was however noted that when surveyed residents did not share their relatives concerns over limited availability of organised activities. Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 13 All those residents and relatives conversed with, in addition to others returning surveys were, with one exception, very pleased with the quality and quantity of the food provided. Reservations were expressed to the provider about the practice of residents being served their meals on trolleys brought up to their arm-chairs. While acknowledging how some residents were too frail to sit at the table it was recommended that those who were able should be encouraged to do so as a means of socialising together and affording an opportunity for meal times to become more significant a daily event. Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the previous inspection, there have been no formal complaints made to CSCI about this service and none had been logged in the home’s official record. Relatives and residents who expressed a view were clear they believed that the provider and other members of the staff team would work to resolve any issue of concern that might arise and said they thought the provider always wanted to ensure their satisfaction. Members of staff had all been trained in the protection of vulnerable adults from abuse. Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: When the home was inspected, all areas were found to be clean and tidy and there were no offensive or unpleasant odours anywhere. Residents and their relatives made it plain that their findings were the same. The home was found to have good access with a small but pleasant garden area. The building and grounds appeared well maintained. The 3 lounge areas were comfortable and homely, one being available for relatives to use when visiting or if staying because a resident was ill or near to death. There were dining tables in two of these areas. The TV was only put on during the afternoon. Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 16 Residents’ rooms showed that they were encouraged to make the space their own, to bring in familiar items, TVs and radios, books and pictures. All rooms were comfortable, well lit and furnished, radiators were covered and water temperatures governed to safe levels. Some rooms had en suite facilities and all had wash hand basins. The single reservation raised was over the continued use of 4 rooms for double occupancy and a requirement was made for the provider to plan to phase out double rooms unless being let to a couple who came in together. A fire inspection had taken place on the 18th October last and the single recommendation had been dealt with on the 26th. The sluice and laundry areas were well kept and contained appropriate equipment. The care home carried an extensive range of equipment designed for use by residents in the form of specialist beds, hoists and other moving and handling aids. The 2 bathrooms and one shower room were reasonably comfortable looking and roomy. Corridors were clear and exits well marked. Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As was found during previous inspections, this care home benefits from having an experienced and well-trained staff group, with low turnover and core members of the team having been employed there over many years. Records obtained from the provider showed how the recruitment procedures had been strengthened in line with the recommendations of a previous inspector. The care home’s induction programme was of a particularly high and useful standard. Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The provider takes active responsibility for the day to day running of the home but when absent can rely of the commitment of her deputy nurse, who was in charge during an inspection visit and exhibited considerable calm and competence. Records revealed all members of the staff team to be appropriately supervised on an individual level and while performing their everyday duties. Records also showed that health and safety matters were well attended to, with detailed risk assessments, good maintenance of equipment, such as fire Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 19 fighting equipment, regular fire drills, training on health and safety and infection control. There have been some improvements to the quality assurance system though further work was recommended involving long and medium term developmental projections and the application of time scales to such plans. Residents and relatives had been surveyed and the results sent to CSCI. Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 20 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 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 2 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 2 X X 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 X 3 3 X X 3 X 3 Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 21 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 OP9 Regulation 13 (2) Requirement The provider must ensure that any instructions from a GP, and consent from a resident or relative to alter the accepted mode of administering any medication is received in writing and held on the resident’s file The provider must produce a plan showing how the use of the 4 rooms retained for double occupancy will be converted for single use save in the event of a couple requiring to share Timescale for action 30/11/06 2 OP23 23 (2) e f 30/06/07 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. Refer to Standard OP12 OP15 Good Practice Recommendations The provision of activities should be re-evaluated with regard to the needs of different groups of residents Efforts should be made to encourage those residents who are able to take their meals together at the dining table DS0000015640.V319161.R01.S.doc Version 5.2 Page 22 Gresham Care Home rather than sitting in their habitual arm chairs 3. OP33 The quality assurance system should be further developed to include longer and medium term projections, including time scales for making any desired improvements to the service. Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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. Extracts may not be used or reproduced without the express permission of CSCI Gresham Care Home DS0000015640.V319161.R01.S.doc Version 5.2 Page 24 - 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. 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