Inspection on 11/08/05 for Perth Green House

This inspection was carried out on 11th August 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

Perth Green House 12/09/08

Perth Green House 24/09/07

Perth Green House 01/11/06

Perth Green House 08/02/06

Perth Green House 29/09/04

Perth Green House 05/05/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Perth Green House Inverness Road Jarrow Tyne and Wear NE32 4JX Lead Inspector Andrea Goodall Unannounced 11 August 2005 at 10:00am 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. Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Perth Green House Address Inverness Road, Jarrow, Tyne & Wear NE32 4JX 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) 0191 489 3007 0191 489 3007 South Tyneside MBC Moira Workman Care Home 35 Category(ies) of OP Old Age 35 registration, with number of places Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The service may from time-to-time admit persons between the ages of 60 and 65 years of age Date of last inspection 29 September 2004 Brief Description of the Service: Perth Green House is registered as a care home and is operated the Local Authority. The home was purpose built in the 1970s and originally designed as a long-term residential care home for 35 older people. However, the service has been changing over the past couple of years, and until recently provided both a residential and a rehabilitation service. Perth Green House now intends to provide intermediate care services only, including rehabilitation, convalscence and short breaks, in partnership with the Health Authority and Primary Care Trust. There are now no long-stay residential places at Perth Green. There are currently 15 rehabilitation places, and the remaining bedrooms are being used for short-break care. It is proposed that Perth Green will provide 30 places which will include the 15 rehabilitation places, 8 convalscence places, and 7 short-break places (2 of which may be used for emergency placements.) The building is situated on a small housing estate and is close to local amenities. The accommodation for service users is on the ground floor and there is level access into and around the building. The house provides single rooms to all service users. One of the bedrooms has an en-suite facility. The radial layout of the corridors allows for separate self-contained units, each providing bedrooms, lounge, and bathroom, and all leading to a central large dining area. (On the second floor there are a number of offices for social and health care staff, with a separate entrance.) Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by 2 Inspectors over one full day in August 2005. One Inspector spent the time talking with people who were using the service, examining the building, checking medication and talking with staff. The other Inspector spent time with the Manager and senior staff discussing the progress and changes to the service; looking at information for potential service users; and examining care records, staff numbers and training, and health and safety records. At the time of this visit there were 14 people receiving a rehabilitation service and 6 people staying for a short-break. Inspectors spoke with 12 service users and 7 visiting relatives during this inspection to gain their views of the service. What the service does well: What has improved since the last inspection? The care records are much more streamlined and easy for staff, and service users, to follow. These now reflect the specific areas of help that people need during their stay and how staff should support them. Several parts of the building have been redecorated and refurbished since the last inspection. This has been possible because parts of the home have been empty while it has been changing to all short-term care. Staffing levels were better than previously, because there were fewer people staying here at this time. Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 6 Most staff have now had training in POVA (Protection of Vulnerable Adults) so that they would know what to do if they think someone is being treated badly. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 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 Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 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) 1, 2, 3, 5 and 6. Prospective service users of the rehabilitation service have information about the service before they are admitted, but short break service users do not. Each service user has a written contract of the terms and conditions here. The needs of each service user is assessed to ensure that only those people whose needs can be met are admitted. Prospective short-break service users may have the opportunity to visit the home before their stay, and service users of the rehabilitation unit have good information about the service. Service users who are assessed for the rehabilitation service are supported to maximise their independence in order to return home. EVIDENCE: Perth Green House does have a Statement of Purpose, which briefly outlines the aims and objectives of the rehabilitation service it provides. Perth Green House has recently begun to provide a short-break service but details of this have not yet been included in the Statement of Purpose. The Statement of Purpose will also need to be revised to include the proposed convalescence service, if this goes ahead. There is very clear information for potential service users of the rehabilitation unit in a Service Users Guide. This is written in plain English and includes Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 9 descriptions and photographs of the accommodation and types of therapy people might receive here. In this way potential service users have good information about what to expect from the service before they arrive. This is particularly important for the people who use the rehabilitation service as they usually do not have the opportunity to visit the service before their stay here. At this time there is no Service Users Guide for the short-break service. People who stay at Perth Green are provided with a comprehensive contract which details all the terms and conditions of a residential stay. This is a standard contract that is used in long-stay settings and so some of the information does not apply to an intermediate service. Referrals to the service may be received from a range of health and social care professionals. Care managers assess the potential service users needs. The assessments are then considered by the Manager, Deputy Manager and senior staff to ensure that only people whose needs can be met are admitted to the Perth Green. The short break service provides up to 2 weeks stay to residents of South Tyneside who are over 65 years old and are medically stable. This service is mainly used to support people during planned changes to their own homes or whilst they are awaiting support packages in the community. There is a charge for this service. The rehabilitation unit provides 15 places for older people who are recovering from illness, either from hospital or from home, who no longer need medical care but need support to regain daily living skills so that they can return home. This service involves the Occupational Therapists, Physiotherapists and care staff. The period of stay for this service is usually up to 6 weeks, and there is no charge to the service user. The criteria for receiving such services is that the person must be over 65 years old, a resident of South Tyneside and be assessed as being potentially able to achieve rehabilitation. In this way, those service users who are referred only for intermediate care are supported to return home. Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9 and 10. Service users care needs are set out in an individual plan of care. The medication procedures and practices are not sufficiently clear to ensure that people are supported in the right way. Not all service users are given a key to their rooms on admission so that they cannot ensure their own privacy. EVIDENCE: There are care plans in place for each of the people who stay here, and a sample was examined. These include a clear flow from initial assessment to the plans of support. Most goals are set by occupational therapy and physiotherapy staff. The care files are well ordered and easy to follow, so that staff can see at a glance the needs of each person and how to support them. There are weekly reviews of the progress of each person that includes the input of senior care staff and therapy staff. Not all of the care plans were signed by service users to show their involvement in their own care planning. There are currently 2 forms in care plans for service users to sign, which is unnecessary repetition. There are clear goals but these are not cross-referenced with daily reports so the progress of peoples goals is not shown. Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 11 The nature of intermediate care is that people are supported to maximise their independent living skills for when they go home. However, the Service Users Guide informs service users that they can choose whether or not to keep their own medication, and there is no risk assessment in place to ensure that people are supported with their medication in whichever is the right way for their individual needs. People arrive at the service with a variety of medication containers as they have come from either hospital or their own homes. No procedures are in place that reflect the various systems being used or the protocols for supplying sufficient quantities of medication. Also there is no written procedure about ordering medication, although senior staff could describe the system they used which matched Royal Pharmaceutical Society guidelines. On a couple of occasions in the last few weeks when people have come from their own home to Perth Green they had run out of some of their medication. The staff are aware of this shortfall in the medication systems, and are in the process of reviewing them. Two of the senior staff hold certificates in safe handling of medication and the other three staff are in the process of completing this award. Currently staff use one medication trolley for the whole building across both services. There is also only one recording file for recording administration of medication where staff have supported a service user with their medication. As the service develops this single trolley and single recording system may not be sufficient to meet the different levels of independence or support needs that 30 people might have. Service users are not automatically given a key to their bedroom door on admission. Again people are receiving a rehabilitative service that aims to maximise and regain peoples skills. If service users are not given a key it does not safeguard their privacy in this communal setting, and does not promote their independent living skills. Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15. Service users are able to continue their own lifestyles whilst being supported to maximise their independent living skills, although there are limited recreational activities. Service users stated that there are usually good quality meals. EVIDENCE: The people staying here discussed how they were encouraged to be as independent as possible and were planning to return home. The people who took part in discussions said they were unable to go out to the local shops as their health precluded this, but that their relatives brought them in the things they needed. People said that other than visitors taking them out, there was no opportunity to go out on trips or pop up to the shops if they needed staff support. Staff were engaging people in one-to-one conversations and people spent time listening to music or television in the lounges. However most people seemed to spend most of the day in their bedroom. The physiotherapist ran an exercise class on the morning and staff ran a bingo session on the afternoon. Some of the service users said that they often had little to do and what was on offer was limited. Staff were very optimistic that as the home got fully established this would become less of an issue. One person said the service is top class whilst others said the staff are very dedicated and caring. Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 13 An occupational therapist works with residents to assess how much support they will need in the kitchen on their return home. There are two small kitchens used for this work, one has an electric cooker whilst the other is a gas cooker. Other kitchenettes are located throughout the home and these contain the very basics for making tea and coffee, but no additional sandwich or snack materials to assist people to remain as independent as possible. The two cooks were off at the time of the inspection and agency staff were covering their shifts. People staying here said that the quality of the food had been poor recently. The Manager confirmed this and said that this would improve when the permanent cooks returned to work. At previous inspections service users had reported that the food was always very good. Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 8. Service users and their representatives have written information about how to make a complaint, and complaints are acted upon. The service has robust procedures and staff training to safeguard service users from abuse. EVIDENCE: Perth Green provides written information for service users about how to make a complaint. This is in the Statement of Purpose and Service Users Guide for people who use the rehabilitation service. There is no information about complaints in a suitable format for the people with a visual impairment who stay here, i.e. on cassette tape. The Manager stated that discussions had been held with the Complaints Officer and the Sensory Disability Team about this. There was evidence that the staff do listen to, act on and record informal complaints and suggestions. There were 6 records of informal complaints about missing clothes, all of which had been later found. As with all care services for adults in South Tyneside, Perth Green endorses the local authority POVA (Protection of Vulnerable Adults) policy and procedures. These are robust procedures for dealing with suspected abuse. Most staff have now had training in POVA procedures and the rest will receive this training as part of a rolling programme. Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 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, 22 and 26 The building is warm, comfortable and reasonably decorated. The lack of distinction between units does not assist people to orientate themselves in the short period they are at the home. The range of baths that are available do not meet the needs of all of the people using the service. The home is clean and tidy, but lacks storage space. EVIDENCE: Perth Green is in the process of having the function of some of the rooms changed so that all of the offices will be in one area of the home so that they do not impinge on service users accommodation. At present there are no signs to assist people to find their way around and a large number of service users discussed how they were often lost in the building. This is compounded by the fact that the 5 identical corridors are all decorated in exactly the same way. People are only at the home for a short period of time so need quick and easy ways to find their respective unit. The Manager acknowledged these difficulties and undertook to put up signs at eye level that would state which service/corridor they were entering. Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 16 Most areas of the home have recently been redecorated but other areas need attention, especially some of the communal areas. Also one of the kitchenette’s units are showing signs of wear and tear. The service does not have on-site maintenance staff. Instead the staff have to formally request the input of Neighbourhood Services for every minor repair. This means there is no immediate attention to the building, so potential delays in repairs being addressed. The range of bathing facilities is limited. Although there are different bath hoists, all of the baths except one are low baths, so there is very little room left for the water. The other bath is a medi-bath, which means that the service user has to sit in it while the bath fills. This is unsuitable for rehabilitation purposes and also poses health and safety issues for staff as they have to lean down to assist people to wash. The Manager said that this bath is to be replaced. All areas of the home were seen to be clean and tidy. However, in one bathroom there were nailbrushes and combs that could be mistakenly used by several service users and so could pose a risk of cross-contamination. In the physiotherapist’s room there was a very large number of walking frames and other items being stored, which were in the way of therapy equipment. The physiotherapist said that this was not a problem and they needed all of the walking frames. The lack of storage facilities poses problems for the service and this will increase, as more equipment may be needed for the intermediate service. Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 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, 28 and 30. There were sufficient staff to meet the number and needs of current service users at the time of this inspection. Staff are being trained to demonstrate their competency to do their jobs. EVIDENCE: The care staff team consists of the Manager, Deputy Manager, 3 seniors, 23 care staff, 8 domestic staff, 1 laundry staff and 2 catering staff. At this time 7 care staff have achieved NVQ level 2 or above in Care, which is less than 25 of the team. However 4 more staff are engaged in this training, and 4 more will commence this in the near future. The Manager stated that it is proposed that staff will then train towards NVQ level 3 in Promoting Independence, which will demonstrate their competence in the role they carry out within this intermediate service. At this time there are also vacancies for 4 full-time and 1 part-time care posts, which were held for the potential redeployment of staff from another home that has now closed. As a result the service has been using agency staff for around 2 care shifts each day for the past couple of months. However the Manager stated that the vacant posts can now be advertised, so that the care team will be complete. There are also health care professionals at Perth Green who are involved with the care of the people who stay here. These include an Occupational Therapist, a Physiotherapist, and 2 Rapid Response nurses, who are available in the service throughout the day to promote the therapy, rehabilitation and physical wellbeing of the service users during their stay. The service also has access to Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 18 a GP who is contracted to Perth Green House 2 days a week, and to the Falls Co-ordinator who has an office above the service. At the time of this visit there were 14 people staying in the rehabilitation unit. There were 3 care staff on duty in this unit. There were 6 people staying in the short-break unit with 2 care staff on duty there. The service provides 3 care staff through the night, one of whom is a senior who carries out a sleep-in duty. These staffing levels were sufficient to meet the number and needs of the people staying here at this time. Discussions with the Manager confirmed that the home uses a variety of training agencies including the Tyne & Wear Care Alliance and local colleges, as well as the Social Services Department Training Section. Discussions with staff and training records indicated that they have frequent opportunities to attend appropriate training courses. Recent courses have included POVA, Depression in Older Age, Continence, Falls Awareness, Safe Handling of Medication, and Putting People First. In this way staff receive training that equips them to support the people who stay here in the right way. Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 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) 31, 33, 36 and 38. The Manager is competent, experienced and qualified but does not have sufficient administrative support. Service users views are not being formally sought in order to review the service. Staff do not receive sufficient individual supervision. The lack of reception services compromises the security of the building. EVIDENCE: The Manager has many years experience in social care and residential settings. She has attained a number of appropriate qualifications including NVQ level 4 in Care and has recently completely the Registered Managers Award. She is responsible for all aspects of the management of the care service, and is the gatekeeper for all admissions. However at this time the service has no reception staff and no administrative staff. As a result the Manager, and seniors, have to act as reception staff if Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 20 they are available in the office, which can take up much of their time and removes them from their respective management and care tasks. The entrance to the home is unlocked, and throughout the day large numbers of visitors came and went but no checks were made to ensure they had legimate rights to be there. There is a signing-in book available but people are not directed to sign this, so in the event of a fire staff could not be certain that all the people were accounted for and safe. There is a clear line of accountability within this service and within the organisation. A representative of the organisation is required to visit the service at least once a month and report to the CSCI on their findings. Whilst these visits may take place, the subsequent reports have not been received for several months. The views of service users were previously sought via postal satisfaction questionnaires. However the lack of administrative staff for most of this year means that this has not been carried out. In this way service users views have not been formally included in a review of the service. The Manager stated that a specific quality assurance system is being designed for this service that will include methods of gaining service users views. It is also anticipated that this complex, developing service will also have some administrative support in the near future. The service aims for staff to have individual supervision sessions with a line supervisor about every 2 months. Records of supervision showed that most staff have only had around 3 supervisions or less in the last 18 months. The Manager stated that she has been absent from the service for part of each week for some months whilst acting up to a senior position within the department. As a result senior staff had to take on increased responsibilities during her absence and consequently supervision sessions were not carried out. Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 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 2 3 3 x 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 3 x x 2 x x x 3 STAFFING Standard No Score 27 2 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 3 x 2 x x 2 x 2 Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 22 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 1 Regulation 4(1)b Requirement Details of the other services provided at Perth Green House must be included in its Statement of Purpose, i.e. the short-break service and, if agreed, the convalscence service. (Previous timescale of 30.11.04 not met.) There must be a Service User Guide in respect of the other services the house provides, i.e. short-breaks and, if agreed, a convalscence service. The home must demonstrate that service users are involved and included in their own care planning, or record on the care file where this not possible. There must be a risk assessment in place to identify the individual level of support required by each service user to manage their medication. Policies and procedures must be developed for the medication protocols used in each specific services operated. Procedures must be developed that accurately reflect the process used for ordering and receiving medication. Medication systems Timescale for action 1.1.06 2. 1 5 1.1.06 3. 7 15 1.10.05 4. 9 12(2)b & 13(4)b 1.10.05 5. 9 13(2) 1.11.05 Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 23 6. 12 16(2)n 7. 16 22 8. 9. 31 33 26 24 10. 38 13(4)c must be reviewed to ensure service users do not run out of medication. The range of activities provided at the home must be broadened and should include opportunities to access the community. The Complaints Procedure must be made available in a suitable format for people with a visual impariment. Reports of the Regulation 26 visits must be forwarded to the CSCI. An effective quality and monitoring system must be put into place.(Previous timescale of 30.11.04 not met.) A reception area and receptionist must be in place to ensure the security of the building, and to be able to account for the number of people in the building in the event of a fire. 1.11.05 1.11.05 1.10.05 1.11.05 1.11.05 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. 2. 3. 4. 5. Refer to Standard 1 2 7 7 10 Good Practice Recommendations The Service User guide should be amended to reflect that risk assesments should be used to determine whether service users can manage their own medication. The contract should be amended to reflect the short term nature of the services provided here, and references to long stay conditions be removed. There should be just one agreement form in care files for service users to sign. Daily reports should be cross-referenced with care plan goals to show any progress or change in these areas. All service users should be given a key to their bedroom door on admission, unless a risk assessment determines otherwise, and they should be supported where necessary to keep their bedroom door locked when they choose. B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 24 Perth Green House 6. 7. 8. 9. 10. 11. 12. 13. 15 19 19 26 27 31 33 36 The kitchenettes should be stocked with items for service users to be able to make their own snacks. Consideration should be given to the provision of dedicated on-site maintenance/handyperson staff to address minor repairs and redecoration. There should be clear signage around the home to inform service users of the different units, and to support their orientation around the building. Staff should ensure that personal grooming equipment is not left in communal bathrooms. There should be a minimum of 50 of the care staff team with NVQ level 2 or above. There should be dedicated administrative support for the intermediate services provided at Perth Green House. The quality assurance system should include methods of seeking the views of service users. Individual staff should have the opportunity for supervision sessions with their line supervisor at least 6 times a year. Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Baltic House Port of Tyne South Shields Tyne and Wear NE34 9PT 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 Perth Green House B52-B02 S37978 Perth Green V217641 110805 Stage 4.doc Version 1.30 Page 26 - 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!