Inspection on 08/09/08 for Grove House

This inspection was carried out on 8th September 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Grove House 20/08/07

Grove House 20/06/06

Grove House 06/12/05

Grove House 11/08/05

Grove House 21/10/04

Grove House 27/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 26/11/2008.

CARE HOMES FOR OLDER PEOPLE Grove House 7 South Hill Grove Harrow Middlesex HA1 3PR Lead Inspector Clive Heidrich Key Unannounced Inspection 10:00 8 September 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 Grove House DS0000017573.V365949.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. Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grove House Address 7 South Hill Grove Harrow Middlesex HA1 3PR 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) 020 8864 5216 020 8864 5216 ndmca.kritikos@virgin.net Mrs Dympna Kritikos Mr N Kritikos Mrs Dympna Kritikos Care Home 5 Category(ies) of Old age, not falling within any other category registration, with number (5) of places Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 5 20th August 2007 Date of last inspection Brief Description of the Service: Grove House is a care home that provides personal care and accommodation for up to 5 older people. The service can meet Greek and Italian language needs. Additionally, Mr and Mrs Kritikos live on the premises with their family. The home is located in Sudbury, Harrow, on a quiet residential road. It is a few minutes walk from local shops and other amenities. There are local public transport facilities in the vicinity. Sudbury Town underground train station is a few minutes walk from the home. The care home was opened in 1995. It consists of a semi-detached house, with parking for approximately four cars at the front drive area of the house. There are two single bedrooms for resident accommodation on the first floor, and one on the ground floor. There is also a shared bedroom on the ground floor. The home has an enclosed, well-maintained garden with a seating area, which is accessible to residents. The current scale of fees is £480 to £515. There were two vacancies at the time of the inspection. A service user guide is available on request. Grove House DS0000017573.V365949.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 to consider the overall quality of service experienced by people at the home, and to check on compliance with requirements from the last inspection. To enable this process, the service was first requested to complete an Annual Quality Assurance Assessment (AQAA) well in advance of the inspection. This provides the service with the chance to explain how it meets the National Minimum Standards. This pre-inspection paperwork was returned to the CSCI in good time. We also sent the manager a number of surveys to distribute to people involved in the home. We consequently received surveys from three people living in the home, one relative, two health professionals, and two staff. The views from surveys were very positive. They have been incorporated throughout this report. The inspection visit lasted for four hours in total. During this period, we met with people who live in the home, staff working there, and the manager who was present throughout. Much of the environment was checked, and care practices were observed in communal areas. A number of records were analysed. Feedback was provided to the manager at the end of the visit. We are grateful to everyone involved in the home for their patience and helpfulness before, during, and after the inspection. What the service does well: We received a great deal of positive feedback about the service from everyone involved. Residents’ comments include, “I am very happy here and I hope I’ll continue living here till the end of my days” and “Everyone is very kind and friendly to me. They make me happy and I laugh a lot.” A relative told us that their relative is treated as part of the family, which in part reflects that fact that service is provided from the registered people’s family home. The service has a consistent and long-standing staff team who have received much training. The team consists mainly of the manager’s family. The manager herself is experienced and well-qualified. There was good feedback about people working in the home, a resident telling us for instance that, “They are always there with a smile and a helpful approach.” Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 6 People told us that they are confident that any concerns or complaints are listened to and addressed. A resident’s comment here was, “I can always speak to the manager. She is very kind and helpful.” The home is kept pleasantly clean, safe, and well-decorated at all times. As one resident put it, “It is always very clean and there are no smells.” What has improved since the last inspection? What they could do better: It is of significant concern that there is sometimes a lack of signature on medication records after residents are supported with their prescribed medication. The safety of medication processes is therefore insufficient. There were concerns in this area at the previous inspection. We are consequently taking enforcement action to ensure that the necessary improvements take place. This consists of sending the registered people a Statutory Requirement Notice about the medication shortfalls. Failure to comply with this notice could result in prosecution. We were told that a professional inspection of gas safety in the home took place recently, however no record of this could be found during the inspection. A certificate must be in place at the home to indicate appropriate safety procedures. A few recommendations are additionally made, to improve resident safeguarding processes and health and safety matters. A full list of requirements and recommendations is available at the end of this report. Please contact the provider for advice of actions taken in response to this Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 7 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. Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 8 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 Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 9 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): 3, 4 and 5. People who use this service experience a good outcome in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives are able to visit the home in advance to access its suitability. The service at the home assesses people’s needs appropriately before offering placement. People who move into the home can be confident that their needs will be met by the service. EVIDENCE: The manager stated in pre-inspection paperwork that, “Grove House when assessing a client ensures that the individual has every opportunity to say how their needs are to be met. They have the opportunity to visit Grove House for afternoon-tea before pre-admission assessment takes place in order that they can meet the other residents and staff.” The manager told us during the visit that the pre-admission assessment forms have been revised but had not yet been used through lack of opportunity. Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 10 People have recently come to look around the home in an informal manner. Their needs would be fully assessed if they then express an interest in moving in. We saw that the forms contained a strong consideration of the person’s health needs and useful questions about such things as food preferences. Residents’ and relatives’ surveys told us that people got enough information about the home to make decisions, before moving in. The manager explained that in addition to informal discussions and the formal needs assessment, people are given a pack of written information about the home to help them decide whether this would be the right home for them. All three residents’ surveys stated that they always receive the care and support they need, one person adding, “They are very kind and helpful.” The relative’s survey was similarly positive, noting additionally that individual needs are met. Our overall observations, discussions with management at the home, and records seen, confirmed the positive and supportive care being provided at the home. Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 11 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 and 10. People who use this service experience an adequate outcome in this area. This judgement has been made using available evidence including a visit to this service. Residents’ health care needs are appropriately met at this home, although procedures for recording medication are sometimes not safely followed which could have significant impact on individual residents. Residents are respectfully treated by staff, with individual needs sufficiently documented within care plans. EVIDENCE: The manager highlighted to us the importance of treating residents respectfully, both in discussion and in the pre-inspection paperwork. The resident we spoke with, and residents’ surveys, raised no concerns in this area. One health professional stated in their survey that the care service always respects residents’ privacy and dignity. We saw examples of appropriate practice, for instance the manager hearing and responding to a quiet request from a resident in one of the downstairs toilets, and carers sitting with residents to chat with them. Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 12 We checked in detail the care file of one resident. Their plan included details of the person’s personal and health care needs, along with appropriate information such as religious wishes and food preferences. Where relevant, the care plan reported about how each need or preference would be supported by the service at the home. Records showed some evidence of resident and representative involvement in these plans. Staff surveys stated that they are always kept up-to-date about the needs of residents such as through care plans. The care plan we saw was backed by timely assessments of dependency, cognition, nutrition, and risk of falls. We saw a document about the person’s typical daily routines and the support they would need, and detailed ongoing records about their day and the support provided. Additionally, when we asked for relevant information from other people’s care files, it was provided. Surveys from everyone noted that health care needs are always met at this home. For instance, residents stated that they always receive the medical support they need. Health professional surveys answered ‘always’ to the question of whether the service seeks advice and acts on it to improve residents’ health. The health records of the resident’s file that we checked contained good reference to visits from professionals. This included recent input from a dentist, a chiropodist, a community nurse, and the GP. The latter included for timely reviews of medication. One resident told us about having a pain in their mouth, but that it was being treated. Shortly afterwards we saw the manager give the resident a mild pain-relief gel for them to rub into the affected area. The manager told us that none of the residents currently self-medicate. We found that there is a personal and secure supply of each medication listed in the prescribed medication records of each resident. The medications are supplied by a pharmacist in dosette boxes that each last a week, with records of quantities received by the home being in place. From our checks of the medication of residents, it was noted that one resident had been prescribed one particular medication twice daily. However on reviewing the Medication Administration Records (MAR) staff had, from 25th August 2008 until 7th September 2008, only signed for administering the medication once a day. Records were checked for the same time frame for another resident. The MAR evidenced that one of their medications, prescribed for twice a day, had been administered once a day. The manager advised us that the residents had been given their medications twice daily and that she was unaware that the medications had to be signed for each time it had been administered. The failure to accurately record on the MAR when a medication has been administered or not, is evidence that the service is unable to demonstrate that residents had their medications as prescribed. Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 13 Review of a further resident’s MAR evidenced gaps on 23rd and 24th August 2008. The manager stated that these gaps were because that resident was unwell. However no such explanation for the non-administration of the medication was recorded on the MAR. We showed the manager the codes that should be used to explain non-administration of a prescribed medication. We also noted that there was a blank entry on the MAR on 26th August 2008 for another resident’s morning dose of one medication. As we have identified medication shortfalls here, as at the previous inspection, we are now taking enforcement action to ensure that necessary improvements take place. This consists of sending a Statutory Requirement Notice, separate but concurrent to this report, about repeated non-compliance with medication requirements. Failure to comply with this could result in prosecution. Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 14 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): All of them. People who use this service experience an excellent outcome in this area. This judgement has been made using available evidence including a visit to this service. Great efforts are made to ensure that residents’ lifestyle preferences are known and where possible acted on. The service helps residents to go out to a variety of places, and provides a good amount of leisure activity in the home. A strong standard of home-cooked food is provided that meets individual preferences and dietary needs. EVIDENCE: The manager stated in pre-inspection paperwork that, “Residents at Grove House enjoy a varied lifestyle that reflects their views and interests. They are given the opportunity for leisure and recreational activities in and outside the home.” Many general examples were provided, such as Exercise & Movement sessions, Reminiscence Hours, and shopping trips. Additionally some specific examples were given, showing that activity needs are also addressed at an individual level. Additionally we were told that for trips out, “the expense is met by the home.” Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 15 Surveys from residents told us that there are always activities arranged that they can take part in. One person added, “Plenty - I can decide what & when I want to take part in. There is never any pressure put on me.” Surveys from a relative and a health professional told us that the care service always supports residents to live the life they choose. We were told a great deal of information from the manager about this in respect of community and leisure choices. Examples included helping one resident to eat at a Pie & Mash restaurant in Shepherd’s Bush based on discovering a food preference of theirs, helping another to start visiting their sister, and a third to continue with their passion for gardening. One relative told us, “They recently brought her to visit me” when confirming that the care services helps people to stay in touch. The home has a small, friendly dog, which one resident confirmed as a companion. We also saw one resident having the video set up so that they could watch a TV program that had been recorded from yesterday evening. Discussions with them confirmed that this was a program that they enjoy. Daily records for residents confirmed the strong levels of community support and activity provision at the home. We were shown some very detailed, embroidered, and impressive life history books for each resident. The books had lots of photos of both the resident and important people to them. The manager explained that they were put together with the resident and their families, and are used for reminiscence sessions. The manager also explained that one resident was taken to where they used to live, to have a look round, as part of this process. The manager stated in pre-inspection paperwork that, “We pride ourselves at Grove House on the quantity and variety of good food available in the home. All the fruits and vegetables are organic or home-grown for our local Grocery Shopkeeper.” Residents told us by surveys that they always like the meals at the home. Comments include, “Very nice and tasty” and “We always have a choice. Nothing is too much trouble for the manager or her staff.” We saw the food being cooked for lunch. A variety of vegetables and herbs including fresh tomatoes and parsley were being used, some of which came from some shopping that was undertaken that morning. Within one resident’s care files, we saw that their food preferences and support needs are recorded, and that their daily records include the meals and snacks that they had. We noted home-made soup and night-time Horliks from this, for instance. The four-week rolling menu was varied and nutritious. Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 16 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 and 18. People who use this service experience a good outcome in this area. This judgement has been made using available evidence including a visit to this service. Residents and their representatives are confident that any concerns or complaints are listened to and addressed. Procedures in the home are generally sufficient to help protect residents from abuse. EVIDENCE: All surveys received stated that people know how to make complaints and that the service is always responsive to them. One resident stated, “There is a complaints procedure”, another that “I feel I can come and speak to anyone in the home & I know if I have any concerns it will be sorted out for me.” A staff survey noted about anyone raising concerns, that “I have been trained fully on what to do if the situation arises.” The service’s complaints book referred to one recent issue, of three large paving slabs having been made safe on the patio, an issue that the providers themselves raised. They similarly noted an older issue of one resident’s nightdress being ruined in the wash. Both cases show a clear willingness to be open about any shortcomings of the service. There were no complaints by residents or relatives. We similarly have not received any complaints about the service since the last inspection. We also saw a very full compliments folder, from across the years that the service has been provided. Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 17 The manager stated in pre-inspection paperwork that, “All the staff at Grove House have had POVA training awareness, and there are procedures in place to respond to evidence or suspicion of neglect or abuse.” We saw training certificates to confirm that staff and management have had recent training on abuse-prevention. We also saw policies on whistle-blowing and abuse. The manager was aware of the need to notify relevant people including the local social services department should an allegation to abuse come to light. The abuse policy would benefit from being reviewed, to bring it more in line with the Local Authority’s Safeguarding Procedures. Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 18 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, 25 and 26. People who use this service experience a good outcome in this area. This judgement has been made using available evidence including a visit to this service. The home, which the owners live in, is kept pleasantly clean, safe, and welldecorated at all times. It has a reasonable amount of communal space, and is very homely. There are enough lavatories and washing facilities. EVIDENCE: The manager stated in pre-inspection paperwork that, “This is a family-run home. It is a relaxed and pleasant environment for all to share. It is decorated and furnished to a high standard, yet homely where residents can feel safe, relaxed and happy living there.” We found the environment to be kept to a reasonable and comfortable standard. The main lounge has enough space, whilst the kitchen has a dining Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 19 area where residents were seen to have lunch. The resident we spoke with had no concerns about the environment. We saw that the main downstairs toilet has now been fitted with two adjustable arm-rests, to help residents to get up and down if needed. There is another toilet and a shower area also available downstairs, where all current residents live, along with similar facilities upstairs. The garden is accessible via a few steps, and is greatly used to grow plants. There is a covered seating/decking area leading to the garden, where residents can sit if they choose. The manager stated in pre-inspection paperwork that, “We take cleanliness very seriously in the home as it is the only way to control infection and bacteria spreading and good hygiene practices are paramount.” Surveys from residents confirmed that the home is always kept fresh and clean. One person stated, “No ugly smells.” The home was clean and tidy from the start of the unannounced inspection. People working there were finishing off cleaning jobs when we first arrived. We saw that disposable gloves and aprons are available, which assist with infection control. We also saw that the home has a washing machine and tumble drier, both of which were in use at the time. Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 20 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): All of them. People who use this service experience a good outcome in this area. This judgement has been made using available evidence including a visit to this service. The service meets residents’ needs through providing a consistent and longstanding staff team who are well trained. Recruitment procedures generally protect residents. EVIDENCE: The surveys that we received from people provided positive feedback about staffing at the home. For instance, residents all stated that staff always listen to and act on what they say, one person adding, “The staff are always kind to me & they have special times where they just talk to me on my own each day.” A relative stated, “Staff seem very competent, as far as I can assess.” Residents also stated that there are always staff available when needed, one person telling us during the inspection that the manager is always available, even at night. The manager told us that they have not employed anyone new at the home since the last inspection. We note that four people work at the home, mainly the manager, two family members, and a long-standing carer. We checked the Criminal Record Bureau (CRB) disclosures of a sample of people who work there. These were in place and up-to-date, however they referred to different employment. To help ensure that previous employers have not referred the Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 21 person to the POVA-list (the list of people legally banned from working with vulnerable adults), the CRB for all staff should refer to employment at this home. Staff fedback positively about the training provided by the service. They noted that they receive training relative to the role, one stating, “At the present time we are doing dementia stage 2 training which is very interesting.” The manager explained that a dementia tutor visits regularly, and showed a good knowledge in the area of dementia. We saw certificates and records of this. The manager and a staff member also demonstrated good working knowledge of emergency first-aid, a course that they told us they had attended just the other week. We were additionally informed that all staff have completed at least level 2 NVQ in care, the industry standard qualification, a process that was ongoing at the last inspection. Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 22 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, 33, 35 and 38. People who use this service experience a good outcome in this area. This judgement has been made using available evidence including a visit to this service. The home is run by an experienced, capable, and qualified manager, in a manner that generally promotes the views and best interests of residents. The home does not look after residents’ money, but has a system for making purchases on their behalf where needed. Health and safety systems in the home generally protect people there. EVIDENCE: The manager has run this care home with her husband, the other registered person, for in excess of ten years. She has completed relevant management qualifications at NVQ level 4, and continues to undertake relevant training such as at NVQ assessment and with understanding dementia care. Her learning Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 23 from this is evident from the informative pre-inspection paperwork provided to us, and with the clear improvements made in areas of social activity that we found. The manager also had good knowledge of each resident’s needs and preferences. We received a staff survey that stated, “Grove House is run to a high standard where priority is always for the resident’s benefit. And yet we the staff are made to feel that we are invaluable to the manager and her home.” We also received positive feedback about the management of the home from residents and other involved people. The manager stated in pre-inspection paperwork that, “Feedback is sought on how the home is performing through anonymous user satisfaction questionnaires. These are sent to the residents and all parties who have an interest in the home. We also have individual and group discussions where people can raise any relevant issues.” We saw one such survey, received from a relative in 2008, and are satisfied from our own surveys that people feel consulted about how the home operates. The manager stated that they do not look after any resident’s finances. Residents, their families or social workers have this role. Personal shopping is undertaken by the service, with invoices sent to the person in charge of the resident’s finances based on receipts that are kept. We saw that the service achieved a four-star (maximum of five) rating from the local environmental health team this year, in respect of food safety practices. We were told that thermostats are in place on all hot water taps. A random check at one residents’ washbasin confirmed that the thermostat works. We were told that regular checks of the thermostats take place. It is recommended that these be recorded, on a monthly basis. We also found that all radiators in the home are covered to prevent scalding. We saw some written risk assessments in place, identifying key hazards around the home such as for risk of scalding from the kettle. Residents’ files contained environmental risk assessments in respect of each of them. We considered the use of a bed-rail for one resident. The manager showed us a risk assessment about the hazard of this person potentially slipping off the bed, including the resident’s views on the situation. Other paperwork confirmed that the bed-rail had been agreed as the best solution, based on input from the manager, the resident, and an occupational therapist. We were shown that the resident uses a very large cushion as a buffer for the bed-rail. An assessment should be made to justify why this cushion is a better option than the buffer supplied with the bed-rail, showing that safety factors have been considered. Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 24 We checked the home’s accident book and found two entries since the last inspection. Both were about residents having accidents, and the first aid treatment they received. The entries were appropriate and raised no concerns. The manager capably explained to us about some very recent first aid refresher training that a few people at the home had received. We saw records from the local fire authority confirming that their visit in March 2008 found “all in good order.” We were shown fire safety records including weekly fire alarm checks and regular fire drills. We asked to see a couple of professional safety checks. The check of portable electrical appliances was up-to-date, however the gas safety check dated from 2006. The manager told us that a check took place in December 2007, and that the certificate must have been misfiled. At the time of writing, it had not been produced as evidence for the inspection. An up-to-date certificate indicating appropriate safety must be provided to us. Grove House DS0000017573.V365949.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 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X X 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes 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 Ensure that medications received into the home are properly recorded, handled, administered and disposed of safely. Previous timescale of 1/10/07 not met. Enforcement action is being taken. An up-to-date gas safety certificate indicating appropriate safety must be in place at the home and available for viewing to authorized people. Timescale for action 03/11/08 2 OP38 23(2)(c) 16/10/08 Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 27 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 OP18 OP29 Good Practice Recommendations The abuse policy would benefit from being reviewed, to bring it more in line with the Local Authority’s Safeguarding Procedures. To help ensure that previous employers have not referred the person to the POVA-list (the list of people legally banned from working with vulnerable adults), the Criminal Record Bureau disclosure for all staff should refer to employment at this home. The regular checks of the thermostats should be recorded, on a monthly basis, to evidence that checks of safety are taking place and are effective. For the resident that uses a bed-rail, an assessment should be made to justify why a large cushion is a better option than the buffer supplied with the bed-rail, to show that safety factors have been considered. 3 4 OP38 OP38 Grove House DS0000017573.V365949.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Grove House DS0000017573.V365949.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. 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