Inspection on 13/04/05 for Paulmay Dementia Care

This inspection was carried out on 13th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Paulmay Dementia Care 25/07/07

Paulmay Dementia Care 04/04/06

Paulmay Dementia Care 01/11/05

Paulmay Dementia Care 28/09/04

Paulmay Dementia Care 08/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE PAULMAY RESIDENTIAL HOME 17 Dukes Avenue Finchley London N3 2DE Lead Inspector Tola Akinde-Hummel Announced 13 April 2005 at 09.45 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 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. PAULMAY RESIDENTIAL HOME Version 1.10 Page 3 SERVICE INFORMATION Name of service Paulmay Residential Home Address 17 Dukes Avenue, Finchley, London N3 2DE Telephone number Fax number Email 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 8346 3642 020 8349 3424 Kevin & Marjorie Gurry Marjorie Gurry Care Home 8 Category(ies) of Dementia over 65 years of age (8), Old age not registration, with number falling within any other category (8) of places PAULMAY RESIDENTIAL HOME Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 28th Septebmber 2004 Brief Description of the Service: Paulmay is a large, converted house situated in a quiet residential area in Finchley, North London. The home is registered to provide care for eight older people who may have some form of Dementia. The home has two floors with one single and one double room on the ground floor. there are three single rooms and one double room on the first floor. The home has a stair lift to the first floor. There is a large lounge/ dining area on the ground floor leading to the well maintained garden. The stated aim of the service is to provide total professional and skilled care for residents within a friendly, family atmosphere and to ensure that freedom, choice and dignity are maintained. PAULMAY RESIDENTIAL HOME Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over one day and lasted approximately five hours. The inspector was able to speak to the manager Mrs Marjorie Gurry and during the feedback, her husband Mr Kevin Gurry. There were three members of staff on duty whom the inspector spoke to individually and in private. The inspector also attempted to speak to all of the service users. Two service users refused and one has recently developed communication difficulties. A member of staff gave the inspector a full tour of the building and gave information relating to the care of service users. The inspector was also able to communicate with two relatives the GP and a local authority care manager. The inspector would like to thank all service users, staff, relatives and professionals who assisted with this inspection. What the service does well: What has improved since the last inspection? The level of training for staff has improved since the last supervision as this was lacking before. Staff feel more valued and more up to date with changes in practice and legislation. The medication policy and procedure is more robust PAULMAY RESIDENTIAL HOME Version 1.10 Page 6 allowing safer handling, recording and administration. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. PAULMAY RESIDENTIAL HOME Version 1.10 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 Standards Statutory Requirements Identified During the Inspection PAULMAY RESIDENTIAL HOME Version 1.10 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 standard(s) 2,3,5,6 Service users and their relatives can be confident that an extensive assessment is carried out prior to entering the home. Service users and relatives are welcome to visit the home prior to admission. EVIDENCE: The inspector looked at the files of the seven service users currently residing in the home. The inspector was also able to speak to 2 relatives. The service user files indicated that extensive assessments were carried out prior to admission to the home. The placing authorities and the registered manager completed these. The inspector saw that all service users had a signed statement of terms and conditions, which included information relating to fees and the room to be occupied. The home now has the variation of conditions of registration relating to a particular service user. The relatives advised the inspector that they had visited the home prior to admission. The home does not provide short- term intensive rehabilitation. PAULMAY RESIDENTIAL HOME Version 1.10 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 standard(s) 7,8,9,10 The individual plans are very informative, sensitive and build a clear picture of the service user. These are completed competently, respecting the individuality of the service users and their needs. EVIDENCE: The inspector was able to speak to service users and two relatives. All service users were clean and well presented. Service users where possible informed the inspector that they were well looked after and content. Only one service user spoken to was upset and angry for a short period of time during the inspection. Relatives advised the inspector that they thought staff are very caring and do a good job. One relative told the inspector “ The home are big on promoting dignity here” The individual plans of care were examined in great detail by the inspector. These plans were very individualised and demonstrated how well the staff team knows service users. Service users plans clearly outline what they can do for themselves and where assistance is required. The plans include bathing records, weight charts, and appointment records for outside agencies PAULMAY RESIDENTIAL HOME Version 1.10 Page 10 such as chiropody and dentistry. The records kept by staff of daily activities were informative and clear. There are detailed risk assessments on all files including actions taken to minimise all risks as well as how to deal with difficult behaviour and how to comfort and reassure distressed service users. The plans include input from district nurses ad GP’s where relevant. The plans are updated and reviewed monthly. The home has improved its medication policy and procedures following the CSCI phamacist inspectors visit. There is a clear procedure for medicines brought forward and disposed of, written agreements for service users who self medicate, and a temperature checking system. Records of medication administration were found to be satisfactory. Service users, relatives, the GP and care managers advised that staff are very respectful of service users privacy. The inspector watched the interaction between service users and staff and believed this was genuinely friendly and appropriately familiar. PAULMAY RESIDENTIAL HOME Version 1.10 Page 11 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 standard(s) 12,13,15 Contact with friends and members of the community is encouraged and staff try to maintain the balance between choice, independence and dignity. Service users have a degree of stimulation in the home that should be developed to reflect their interests and to further improve their quality of life. EVIDENCE: The inspector spoke to service users who were unable to consistently describe their daily activities. Two service users advised that they go to the high street with members of staff on occasions. However the manager is now keeping a record of what activities service users are engaged in. Service users were observed singing and listening to music on the day of the inspection. One service user no longer socialises in the lounge with others and his wishes to remain in his room are respected. Some service users participate in light gardening, Ludo, dancing and singing. The range of activities on offer should be extended for service users to try. The inspector examined the daybook and found that service users had plenty of visits from relatives and professionals providing a service to the home i.e. GP‘s district nurses, chiropody etc. Service users rooms are personalised and those people that share have a screen provided to maintain privacy. The inspector was able to look at the food preparation for service users. Food hygiene procedures appeared to be observed in the kitchen where the inspector saw fresh vegetables being prepared. The food was balanced and attractively presented. Service users PAULMAY RESIDENTIAL HOME Version 1.10 Page 12 take their meals in a calm environment and one service user is now assisted by a staff member to eat her meals. This gradual change in support from staff was well recorded in the service users individual plan. PAULMAY RESIDENTIAL HOME Version 1.10 Page 13 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 standard(s) 16,17,18 PaulMay take complaints from service users and their relatives seriously and act upon these in an appropriate manner. The adult protection and whistle blowing policies are clear and understood by staff at the time of inspection. Service users have the opportunity to vote. EVIDENCE: The inspector spoke to relatives who advised that they had made complaints in the past and felt that these were properly dealt with. The manager informed the inspector that all service users are registered to vote and at the time of inspection one service users confirmed to the inspector her desire to take part in the electoral process. The home has an adult protection procedure, which contains all the elements required. This includes reference to the local authorities adult protection unit and the whistle Blowing policy. The inspector was able to confirm with staff that they understood this policy. PAULMAY RESIDENTIAL HOME Version 1.10 Page 14 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 standard(s) 19,-26 Paul may is a small, cosy, clean home. The facilities are appropriate for the number of service users living there and a programme of repairs must take place following a blocked toilet. EVIDENCE: The Inspector looked around the home with a member of staff and was given permission to enter the rooms of service users. The home has a comfortable and homely atmosphere. All the service users rooms are personalised. Shared rooms have screens in order to maintain privacy. The home was pleasant and bright. The home has a large lounge with a dining area looking out onto the garden. There are sufficient toilets for service users living in the home. All rooms have sinks and the only bath in the home has appropriate adaptations. The rattling window on the first floor has been repaired. One shared room is in need of redecoration due to a blockage from an upstairs toilet. The registered provider is to claim for the repair on the insurance, which may take some time to settle. The vent in the upstairs toilet requires cleaning. PAULMAY RESIDENTIAL HOME Version 1.10 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29,30 Staff morale is good and the team are committed to the service users and the owners. Training is now being delivered and staff and service users benefit from this. Recruitment practices in the home have improved but are still short of the required standard as new Criminal records checks have not been completed. EVIDENCE: There were sufficient numbers of staff on duty at the time of the inspection. The manager and 3 staff were present throughout the day. Two staff have completed their NVQ level 2 training. The registered manager is aware that 50 of staff should be NVQ level 2 qualified by 2005. Staff advised the inspector that they enjoy working in the home with service users and their relatives and have a good relationship with their employers. “ My manager is very supportive, she knows your problems and will listen”. The inspector looked at the recruitment and selection of two new members of staff. Both staff members had all of the relevant paperwork on file demonstrating that their procedure had been followed. However the Criminal record checks are from the previous employer and are not transferable to the current post. The inspector advised the registered person that these staff members must not provide personal care to service users unsupervised until their CRB’s are received and satisfactory. The manager has organised training for day and night staff members in recent months. Staff confirmed that they have had medication training from the pharmacist; 4 day first aid course, fire awareness, food hygiene, manual handling and health and safety training. PAULMAY RESIDENTIAL HOME Version 1.10 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33, 38. PaulMay is run well in terms of the physical care given by staff to service users. Staff receive supervision from a highly experienced manager with clear ideas about quality of care for the service users. Some areas of administration require more attention in PaulMay, such as invoicing. The health and safety aspects of the home have been overlooked posing risks to service users and staff alike. EVIDENCE: The manager at PaulMay has thirty years experience in the care setting including an MA in care management and a BA in Social sciences. Staff in the home told the inspector that they have a very good relationship with each other “ The managers are really good, when I am off work I feel I am missing here” staff confirmed that they have regular supervision and staff meetings. The GP for the home informed the inspector that in his view the home is well managed. The previous inspection required the home to gain the views of service users and their relatives as to the effectiveness of the home and PAULMAY RESIDENTIAL HOME Version 1.10 Page 17 provide feedback. Whilst the views have been sought and analysed the feedback has not been given. Comments were made to the inspector about the inconsistency around the invoicing to relatives. Whilst this is not a major issue for relatives it highlights that more organisation is required to complete this consistently. The inspector looked at records of maintenance at PaulMay and found that the annual Gas safety check, the legionella certificate and fire alarm servicing certificate were all overdue for renewal. This seriously compromises the health and safety of service users. PAULMAY RESIDENTIAL HOME Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 2 x x x x 1 PAULMAY RESIDENTIAL HOME Version 1.10 Page 19 YES Are there any outstanding requirements from the last inspection? 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 12 Regulation 16 (n) Requirement Timescale for action 01/07/05 2. 19 23 (b) 3. 29 19 (1)(b) Sched 2 (1-7) 4. 33 24 (1) (a) (b), 2, 3 The registered person must improve upon the present activities programme, ensuring variety is offered based on the previous intersest of service users and that this is recorded. 01/07/05 The registered person must ensure that a programme of repair and decoration is made to the ground floor double room following the upstairs blockage The inspector must be informed of the progress of the insurance claim and timescale of the work to be undertaken and how this might affect service users in the home. The registered person must 30/05/05 ensure that new Criminal records checks are completed for staff taking up a position in their employment. Recent previous checks are not acceptable. Staff must not provide personal care to service users until a check has been completed and all contact with service users must be supervised by an experienced member of staff. The registered person shall make 1/06/05 public the survey undertaken to Version 1.10 Page 20 PAULMAY RESIDENTIAL HOME 5. 38 service users their relatives, and to the commission 13 (4) (c), The registered person must ensure that the gas safety testing, legioella tests and fire alarm tests are carried out by qualified operatives and thses certificates are renewed and copies sent to the Commission. 30/05/05 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 19 Good Practice Recommendations the ventilation in the toilet is cleaned following the completion of building works in the neighbouring house PAULMAY RESIDENTIAL HOME Version 1.10 Page 21 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London N14 6HA 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 PAULMAY RESIDENTIAL HOME Version 1.10 Page 22 - 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. 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