Inspection on 02/09/05 for Perrygrove

This inspection was carried out on 2nd September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Perrygrove 08/05/08

Perrygrove 25/06/07

Perrygrove 05/09/06

Perrygrove 11/04/05

Perrygrove 26/04/04

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 Perrygrove Rectory Fields Crescent Charlton London SE7 7EW Lead Inspector Sue Grindlay Announced 2 September 2005 00:00 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. Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Perrygrove Address Rectory Fields Crescent Charlton London SE7 7EW 020 8856 3995 020 8319 1663 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) Kent Community Housing Trust Terrance Heslington CRH 43 Category(ies) of OP 43 registration, with number of places Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 11/4/05 Brief Description of the Service: Perrygrove is a Care Home for up to 43 older people. It is run by Kent Community Housing Trust, and is situated in a quiet road in Charlton. Local shops and bus routes are a short distance away, and the town centres of Lewisham, Greenwich and Woolwich are easily accessible from the Home. Accommodation is provided over three floors, in single occupation rooms. Fifteen rooms have ensuite toilet and hand wash facilities, and there is a range of communal space on the ground floor, including a small courtyard garden. Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection over six and a half hours on a hot summer’s day. Residents were seen enjoying the fresh air in the garden, sitting in one of the three lounges or in their rooms. The manager and five staff members were spoken to, a total of eight residents were happy to chat, and a visiting psychiatric social worker gave his view of the Home. Paperwork looked at included accident reports; complaints, fire drill records and several care plans. Person in charge reports were also used to provide information, as was the pre-inspection questionnaire. No questionnaires were returned to the Commission from service users, professionals or relatives. What the service does well: What has improved since the last inspection? What they could do better: Risk assessments should be regularly reviewed and revised according to changing needs. Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 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. Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 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 Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 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) 3 and 4 Residents admitted to the Home know that their needs will be met. EVIDENCE: Three residents who were fairly new to the Home were spoken to. Two said that they had positively chosen the Home, one adding, “I made up my own mind”. All were very happy with their care, two commenting favourably on both the food and the staff! One resident clearly felt he had settled in when he said, “They make you feel very welcome”. Another described the atmosphere as “free and easy”. One care plan had noted on the assessment of health care needs that the Home could meet the resident’s needs. The manager stated that he does not routinely write to residents to confirm that the Home can meet their needs and this is a recommendation. Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 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 and 10 Residents’ emotional and physical health needs are well met in the Home. EVIDENCE: Residents all have an individual plan of care that sets out aspects of their health, personal and social care derived from the assessment of needs. The daily log for one resident showed close monitoring of a new resident in his eating, drinking, emotional state and general wellbeing. However the social history component had not been filled in, and, particularly as this resident is sometimes confused, it is recommended that this be completed soon after admission so that staff are aware of the resident’s background and personal circumstances in order to help his orientation. Bathing and showering records were inaccurate on the last inspection, and the manager has introduced a log to record when residents are bathed. The manager checks this and it is recommended that it be countersigned at the same time. Details are also recorded on the client file, although one entry had not been made on the important dates chart. There is no nursing care at Perrygrove but the health care needs of residents are met by regular visits from the G.P., the district nurse, community psychiatric nurse, and referral is made if necessary to the psycho-geriatrician. Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 Page 10 The Home has a number of diabetic residents who are diet or pill controlled. No residents self-administer medication. Risk assessments were seen in respect of mobility and moving and handling. One resident had had seven falls in the last month, but the risk assessment deemed her only at ‘medium risk’. Risk assessments must be reviewed and revised according to changing circumstances and this is a requirement. At the last inspection some residents commented adversely on the way staff spoke to them, and the manager acted promptly to address this with staff. On this visit, residents all said that they were well treated by staff. Staff delivering meals to residents in their rooms stopped to have a chat and there was a relaxed atmosphere in the Home. Residents looked well turned out, and the laundry was clean and well ordered. The manager has been unable to locate a labelling machine but relatives are asked to ensure that clothes are labelled. One resident complained that she had lost five cardigans, and this matter was passed to the manager for investigation. The domestic in the laundry was using a wheelchair to move baskets of washing, and it is recommended that a lightweight trolley be purchased for this purpose. Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 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, 14 and 15 Residents at Perrygrove enjoy a comfortable and stimulating lifestyle. EVIDENCE: The Activities Co-ordinator has introduced a range of activities into the Home, for example sewing, cooking, gardening, crafts and hand massage. Residents had planted tomatoes and a raised herb bed, and the handyman had constructed a water feature using a half-barrel. A number of residents were sitting in the garden enjoying these features. A pool table has been placed in one of the lounges. Entertainers have been brought in to run a music hall, a sing-along with a Charlie Chaplin impersonator, a line-dancing team and reminisce work with old records. A speaker is coming in to talk about industrial history (one resident recalls working in the factory on the site of the Home). Residents were taken out to a tea dance at a neighbouring Home, and trips have been made to country pubs, a hop farm in Kent and the Eagle Heights, birds of prey centre. Birthdays are celebrated and the Home recently decorated the dining room for a centenarian birthday. The scope of activities available is commendable, and this standard is exceeded. Friends and relatives are free to visit at any time, and there is a Friends of Perrygrove Association, whole role is principally fundraising. Relatives support Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 Page 12 social events such as the fete. A telephone booth just off the main lobby enables residents to make private telephone calls. One lady said that she was an animal lover, and the manager, knowing this, sanctioned her friend to bring in her dog that afternoon. Residents are free to move around the building, sit in one of the communal areas or remain in their rooms. Residents were asked if they wanted to go out for a picnic in Greenwich Park that day. One resident said that he goes out during the day. He finds communication with some of the other residents in the Home difficult, and likes to seek company elsewhere. Meals follow a four-week rota, with a main meal at lunchtime and a choice of a cooked tea or sandwiches later on. Sample meals included Beef stew and dumplings, chicken casserole and roast pork and apple sauce. The meal on the day of the inspection was fish and chips, fried eggs or salad. The day’s menu was written fairly illegibly on a whiteboard outside the dining room, and the suggestion made at the last inspection for a menu card on the table has not been taken up for everyday use. This is a renewed recommendation. Reactions to questions about the food were mixed, with positive comments generally from the men, “The food’s good. I can’t fault it” and “the food is good”, and from the women comments like, “The food is all right sometimes” and “It isn’t always wonderful” and perhaps significantly, “It isn’t how I would do things”. It is recommended that residents be asked perhaps in residents’ meetings to make comments about how they would like food to be prepared. One Vietnamese lady is taken out each week for a meal at a Chinese restaurant where she knows the owners. Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 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 and 18 Residents at Perrygrove are safe. They are treated with respect and their views are listened to. EVIDENCE: There have been 22 complaints recorded since the last inspection, and this is indicative, not of poor practice, but of the Home’s responsiveness to residents. Most of the complaints were about other residents or mislaid items, and nearly all were resolved on the same day. When one resident complained that his newspaper arrived too late for him to read at breakfast, the manager arranged for a staff member to collect the paper on his way to work at 7.30 a.m. The manager comments, “The resident was very satisfied with the result”. One resident complained during the inspection about a staff member and this matter was passed on to the manager to follow up. A letter of compliment, received in May this year reads as follows: “I guess you’ve all read or heard on TV about the witch [sic] report stating that all the homes for the elderly are not giving value for money – well here’s one family who are quite satisfied with the general care, food which is excellent and general attention to the people who are in Perrygrove. So when someone in authority comes round to check every aspect of these attributes, you can show them my letter of satisfaction in every respect”. This standard is therefore exceeded once again. One resident described being in the Home, saying, “It makes you feel safe”. Staff spoken to understood how to approach residents with patience and understanding. One said, “If they shout, I come closer, make them feel OK”. The manager has taken a robust view of staff raising their voices, and there have been no further complaints of this nature. Residents have a lockable Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 Page 14 drawer in their rooms, and can have a key to the bedroom door if they wish. Service users’ financial records were seen. Only the manager and administrator have access to the cash, which is administered as required. Receipts are given to relatives who deposit cash for the residents. The records are well ordered. Two accounts were checked and were found to be accurate. Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 23 and 26 The Home is clean, bright and homely in feel despite its size. EVIDENCE: The Home was bright, spacious and well maintained. Carpets were secure, pictures were attached to the wall with mirror plates, and there were no hazards observed during a tour of the building. The small courtyard garden looked well tended, and there was a range of shrubs and plants for residents to see and smell. The manager confirmed that the one double room is only used for single-occupancy now. There are three large lounges, in addition to seating in the main vestibule, a communal dining room and a garden seating area. A room on the first floor is used for craft activities. There was ample comfortable seating. Residents’ bedrooms were all clean and tidy, with adequate storage and evidence of personal ornaments and photographs. One resident was pleased to show the paintings displayed on his wall that he had done himself, one from Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 Page 16 memory of a blacksmith’s cottage he had stayed in as an evacuee during the war. All the areas inspected were clean and tidy and there were no odours. The manager confirmed that the lady who was reluctant to have her room cleaned has now been persuaded to allow domestics to come in. Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 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 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 and 28 The staff team is skilled and competent to meet the needs of the residents. EVIDENCE: The rotas show there is a sufficient number of staff to attend to residents’ needs. The manager said that if additional staff are needed, for a special event, cover would be through staff overtime or agency care workers. All staff members have had training in dementia care and moving and handling. New staff have a three-day induction. A community psychiatric nurse came in recently at the request of the manager to do some sessions with staff as the manager had identified that some staff members were not confident to work with mental health issues. Six staff members have left in the last year but the manager was pleased to report that they had recruited two new male carers. The manager took one new staff member with him onto the floor, showing him how to engage with residents to help him understand the task. One staff member who is new said that the Home was a good place to work because, “They take the residents to be the number one priority”, and emphasised the teamwork that goes on. Residents endorsed this throughout the day, saying that the Home was “absolutely wonderful”, and one added, “It’s like being on holiday without the seaside”. The Home employs 26 care staff and 3 ancillary staff. There is a commitment to training. Twelve carers have achieved NVQ level 2 or above, making a total of 46 . One assistant manager has achieved NVQ3 and one has the NVQ4. Two staff members are currently attending management training. Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 Page 18 Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 Page 19 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) 32, 33, 35 and 38 The manager runs the Home sensitively and with the safety and wellbeing of the residents paramount. EVIDENCE: The manager is uncompromising in setting standards for the Home, and many of the residents and staff spoken to said that he was very approachable. The manager was fully involved with what was going on in the Home on the day of the inspection, and used the opportunity during handover to pass on information and advise staff on how to manage a particular situation. A professional colleague described him as “a fantastic manager”, and this seemed to be endorsed by staff, who when the manager was asked about his plans for retirement said that they would not let him leave! Responsible Person visits are done on a monthly basis and copies sent to the Commission. Regulation 37 notifications are sent appropriately for events Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 Page 20 affecting the well being of residents and are written in sufficient detail to know what action was taken and what the outcome was. Service users’ financial records were seen. Only the manager and administrator have access to the cash, which is administered as required. Receipts are given to relatives who deposit cash for the residents. The records are well ordered. Two accounts were checked and were found to be accurate. Hot water in one bathroom tested at 47 degrees. Plastic thermometers had been nailed to the wall, but were clearly not in use as the hole was too small for the head of the nail, and the nail came out of the wall when the thermometer was taken down! A fire drill was undertaken on 13/5/05 and staff names were recorded. Fire extinguishers were serviced and/or replaced in January this year. Fire alarm tests are conducted weekly and took place during the inspection. The manager has requested a routine visit from the fire officer. Gas installation, electrical wiring, water heating check and central heating checks have been made this year. Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x x 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 x 3 x 4 3 x 3 x x 3 Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 Page 22 NO 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 8 Regulation 15(2) Requirement Risk assessments should be reviewed and revised according to changing circumstances. Timescale for action 28 Oct 2005 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. 3. 4. 5. 6. 7. Refer to Standard 3 7 7 10 15 15 22 Good Practice Recommendations It is recommended that the manager confirms in writing to any prospective resident that the Home can meet their needs. It is recommended that the social history of a new resident be completed soon after admission so that staff can be aware of their background and personal circumstances. It is recommended that the bathing and showering record be auduted by the manager on a regular basis, and that the manager signs the record to confirm this. It is recommended that a lightweight trolley be purchased for the laundry. It is recommended that residents be asked to comment in residents meetings about how they would like food prepared. It is recommended that a daily menu is placed on each dining table so that residents can have some anticipation of the meal and the choice for that meal. It is recommended that the complaints are logged G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 Page 23 Perrygrove numerically for ease of cross-referencing. Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 Page 24 Commission for Social Care Inspection Riverhouse 1 Maidstone Road Sidcup Kent DA14 5RH 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 Perrygrove G51G01s6855Perrygrove.v.239451.7.9.2005stage4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!