Inspection on 09/02/06 for Gresham Residential Care Home

This inspection was carried out on 9th February 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 Residential Care Home 28/02/07

Gresham Residential Care Home 30/08/05

Gresham Residential Care Home 17/01/05

Gresham Residential Care Home 01/06/04

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

CARE HOMES FOR OLDER PEOPLE Gresham Residential Care Home Gresham Residential Care Home 47-49 Norfolk Road Cliftonville Margate Kent CT9 2HU Lead Inspector Christine Grafton Unannounced Inspection 9th February 2006 14:10 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 Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 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 Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Gresham Residential Care Home Address Gresham Residential Care Home 47-49 Norfolk Road Cliftonville Margate Kent CT9 2HU 01843 220178 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) Jonathan Anthony Smith Mrs Brenda Anne Smith, Anthony David Smith Jonathan Anthony Smith Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Gresham Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st January 2003 Brief Description of the Service: Gresham Residential Care Home is a detached building with accommodation for residents on three floors. Bedrooms are mainly singles with some double rooms, currently occupied as singles. 23 out of the 26 bedrooms in the home have ensuite toilet facilities and there are plans to provide ensuite toilets in the other 3 bedrooms soon. There is a shaft lift to all floors. All bedrooms have a call bell, television point and some have telephone points. There is a large lounge/diner, a separate TV lounge, a conservatory area, where residents may smoke and a small enclosed garden with fish pond, raised flower bed and seating area. The home is located within easy reach of local shops and all public amenities, with the seafront at the end of the road. This is a family run business that has been operating as a residential care home for 13 years. The staff team is lead by the registered provider/manager, Mr Jonathan Smith, and a team of carers, who work a rota that includes one staff member on waking duty at night and one person on sleeping in duty. Additional staff are employed for cooking and cleaning. According to the homes statement of purpose, it aims to provide a good, safe environment, with a happy atmosphere, where residents are encouraged to be interested in each other and staff offer encouragement, to enable residents to maintain their independence, but offer care as needed. Gresham Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection covered an afternoon period. It consisted of speaking with the manager, 2 staff members, 3 residents, looking round some parts of the home and checking some records. At the time of this inspection there were 25 residents. What the service does well: What has improved since the last inspection? What they could do better: The manager has clearly worked hard to address the issues raised at the last inspection. This was not a full inspection, but it was pleasing to note that of the things checked, there was nothing identified that needed improvement to meet the standards. A recommendation has been made to continue work started on assessing residents’ dependency levels. Gresham Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 Page 6 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. Gresham Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 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 Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The home has a thorough assessment process that makes sure the care needs of new residents can be met upon admission to the home. The home does not provide specialised intermediate care, so standard 6 is not applicable. EVIDENCE: A care plan was checked for a resident admitted since the last inspection. A thorough pre-admission assessment of needs had been carried out and documented. This information had then been used to inform the care plan and needs assessment carried out following admission. The care plan identified risks and showed the risk management strategies. The documentation seen covered all the components specified in the standards. The resident had settled in well and from the documentation seen it was clear that their needs were being met in this home. Gresham Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7&8 The home’s care planning system provides staff with the information they need to meet residents’ needs. The personal and health care needs of residents are being met. EVIDENCE: Three care plan files were checked and seen to contain detailed information, including personal profiles, full needs assessments and action plans. A new monthly review sheet has been created since the last inspection and provides more useful information. There was evidence of contacts with health care professionals and daily records gave a picture of the care provided. The information gained from reading the care plans and speaking with the residents and staff indicates that the residents’ health care needs are being met. Weight records are recorded and the home has a set of ‘sit on’ chair scales. A new dependency assessment tool has been developed but is in its infancy, so no judgement was made regarding its usefulness. Gresham Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Residents are provided with a good, well balanced, varied diet and enjoy their meals. EVIDENCE: Since the last inspection, the manager has devised a way to ensure that residents know they can have alternatives to the main menu. This involved giving every resident a copy of the four week menu plan, plus another form with all the foods listed for them to tick if they like them, or dislike any of the options. The manager is in the process of altering the menu accordingly and said he would record the alternatives. The minutes of a residents’ meeting dated 20th January 2005 were seen to cover the topic of food choices. A resident confirmed they are offered a choice of menu and said the food is “very nice”. Gresham Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 Page 11 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: Gresham Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24 & 26 The continuing improvements to the home have been completed to a high standard, providing residents with a very pleasant, homely, comfortable environment in which to live. Infection control procedures have been improved since the last inspection to ensure safe hygiene. EVIDENCE: Work on the refurbishment of the premises has continued. Since the last inspection, the main lounge/diner has been redecorated with new carpet, colour coordinating curtains and two new matching settees. New chandelier light fittings have been added, plus dining tables and a new dresser. Residents said they like the new look. The manager said that the electrics had been renewed as part of the lounge upgrade, ceiling cornices redone and that the carpet has a ‘gel middle’ so that stains do not penetrate. The floor had to be latexed first before the carpet was laid. The manager stated that the refurbishment had been completed to a high cost. Walls had been re-plastered in the corridor off the lounge. A new spacious shower room has been created in place of an old bathroom, with flush shower Gresham Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 Page 13 base, toilet and washbasin. The door has been widened to improve access. This change has provided an extra shower and toilet facility. Further improvements include the removal of three stairs at first floor level. This has been changed to provide a sloped corridor. Another bedroom has been completely upgraded and a new sky light window has been added on the top floor to provide more light. The manager stated that a new master key system has been fitted to bedroom doors and hand washing facilities with paper towel dispensers have been provided in every room. Gresham Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 29 The number and skill mix of staff on duty are appropriate to meet the current needs of residents, but this needs to be more formally evidenced. Recruitment procedures ensure that staff are properly vetted and that residents are in safe hands. EVIDENCE: The manager has developed a new dependency assessment tool to use with the Department of Health Guidance to calculate the staffing numbers required. He already uses the guidance, but the method for assessing residents’ dependencies could not be properly validated at the last inspection. As the new format has not been brought into use for all residents yet, it was agreed that this would be followed up at the next inspection. Staff on duty during this inspection included two carers, a cleaner, who went off duty at 15.00 hours, the manager, assistant manager and Mrs Smith, registered provider, who also does some care hours. One new staff member had been employed since the last inspection. The staff file contained all the relevant information, including details of a full employment history, interview record, three references, appropriate criminal records bureau (CRB) checks and a first day induction checklist. The Skills for Care Induction record was not available, as the staff member was still working through it. Staff rotas indicated the named supervisors when the person first started working at the home, following the protection of vulnerable adults (POVA) register first check, but before the return of the full CRB disclosure. Gresham Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed on this occasion. EVIDENCE: Gresham Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 Page 16 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 4 3 3 3 3 3 X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x x Gresham Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 Page 17 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. Standard Regulation Requirement Timescale for action 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 OP27 Good Practice Recommendations That the new dependency assessment tool is used for all residents and the results used to calculate the staffing numbers required. Gresham Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Gresham Residential Care Home DS0000035039.V278785.R01.S.doc Version 5.1 Page 19 - 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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