Inspection on 08/02/06 for Perth Green House

This inspection was carried out on 8th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 11/08/05

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 Miss Andrea Goodall Announced Inspection 8th & 10th February 2006 10:00 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 Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Perth Green House Address Inverness Road Jarrow Tyne and Wear NE32 4JX 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) 0191 4893007 0191 4893007 South Tyneside MBC Moira Workman Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service may from time to time admit persons between the ages of 60 and 65 years of age. 11th August 2005 Date of last inspection Brief Description of the Service: Perth Green House is registered as a care home for older people and is operated by the Local Authority. The home was purpose built in the 1970s and was 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. Perth Green House now intends to provide intermediate care services only, including rehabilitation, convalescence and short breaks, in partnership with the Health Authority and Primary Care Trust. There are no long-stay residential places at Perth Green. There are currently 15 rehabilitation places, and the remaining bedrooms are being used for interim or short-break care. It is proposed that Perth Green will provide 30 places, which will include the 15 rehabilitation places, up to 8 convalescence 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 DS0000037978.V271828.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Before this announced inspection took place the Manager completed a PreInspection Questionnaire, and comment cards were made available for service users and their relatives. One comment card (from a service user) was received, and this indicated their satisfaction with the service. The inspection took place over 2 days in February 2006. Time was spent on both days with several of the 17 service users staying here and with visiting relatives, talking to them about the accommodation and the service they were receiving, and joining them for 2 meals. Some time was spent looking around parts of the building. The rest of the time was spent with the Manager and senior staff discussing the proposed changes to the service, examining care records, health & safety records and staff records. What the service does well: What has improved since the last inspection? Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 6 Since the last inspection the home now has the complaints procedure on cassette tape so people with poor sight, or who find it difficult to read, can listen to what to do if they are not happy with the service. Nearly three-quarters of the care staff have now achieved a care qualification, and more staff are doing this training. The home has got some new staff so it does not have use agency staff so much. This means the staff team can work together consistently. What they could do better: There should be more information for people who come to stay for a shortbreak, like there is for the rehabilitation unit service. Also the Statements of Purpose need to be changed to reflect the actual registration status of the service. Records about moving & assisting must give details of how people need support so that staff know what equipment to use and how to move people in the right way. Also records that check whether someone can look after their own medication should clearly show if they need some help with this. It might be better if some foods were brought to the small kitchenettes every day so that service users (with staff) could make some snacks or supper so they could keep their skills up in this area for when they go home. It would be useful if there were extra copies of the cassette that explains the complaints procedure, in case more than one person needed it during their stay. During these visits the temperature of hot water to all the baths was cold and so service users could not have a bath. An Immediate Requirement Notice was given to the Manager and a formal letter was sent to the Provider. (The hot water was fixed the next day.) Two of the baths are not right for the people who stay here. These should be replaced with better type of baths. It would be better if room keys were left in bedroom doors so that service users know that they can use them when they want. It might help to stop peoples laundry from getting lost if laundry bags were used. Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 7 The service should be reviewed by the Provider to make sure it is doing what it aims to do for people. The questionnaire given to people who stay here should be written out in a different way to encourage them to say what it was like for them, and to get any suggestions for making it 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 DS0000037978.V271828.R01.S.doc Version 5.1 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 Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 6. Prospective service users have some brief information about the 3 different services before they are admitted. 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 very brief Statements of Purpose for each of the 3 services it proposes to provide, that is rehabilitation, interim and shortbreak. These briefly outlines the aims and objectives of the differing services, however some of the information regarding the homes registration status is incorrect. 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 descriptions and photographs of the accommodation and types of therapy people might receive here. In this way potential service users of the rehabilitation service have good information about what to expect from the service before they arrive. This is particularly important for the people who use the Perth Green service, as they usually do not have the opportunity to visit Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 10 the service before their stay here. At this time there is no Service Users Guide for the short-break service or interim service. The Manager stated that new Service Users Guides for the other 2 services (short break and interim) will not be developed until the proposed changes are agreed. 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 DS0000037978.V271828.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9. Service users care needs are set out in an individual plan of care. Service users health care needs are fully met. Service users capability to manage their own medication is assessed. EVIDENCE: There is an individual plan of care for each of the service users that come to stay at Perth Green House. These are based on a range of assessments of needs, such as moving & assisting, nutrition, continence, falls risk and medication. For people receiving a rehabilitation service there are also therapy assessments and therapy plans that are put into place by the Occupational Therapists and Physiotherapists. Each service users care plans is reviewed weekly to show whether care goals have been met. Service users sign an agreement to information sharing with other agencies, but this does not refer at all to their care plan or goals so does not demonstrate their involvement in their own care planning. The moving & assisting assessments are not sufficiently detailed to guide staff in exactly what support a service user needs. For example, some moving & assisting assessments stated, needs assistance with bath, but this does not Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 12 describe what lifting equipment may be needed, nor number of staff to support, nor the moving techniques, nor which bathroom. This lack of detail and guidance presents a potential health & safety risk to the service users and to staff. The people staying here get excellent health care screening by all the relevant health care professionals. There is an Occupational Therapist and a Physiotherapist based at Perth Green House. There are twice-weekly GP visits for those receiving a rehabilitation service. All service users can retain their own GP input depending on the catchment area, or they can join the local GP practice as a temporary patient. There are Rapid Response nurses, Falls Lead Nurse, and Overnight Nursing Team on site at the home for advice or referral. The home also has good links with the Continence Advisor, Speech and Language Therapists, Stroke Unit and Community Psychiatric Nurse. All service users are assessed on admission for dental, ophthalmic and chiropody needs and visits arranged as necessary. In this way service users health care needs are fully met during their stay at Perth Green House. Following the last inspection there are now risk assessments in place regarding service users capabilities to manage their own medication. However there is no evidence that Perth Green House actively promotes independence in this area, and staff still describe this area as at the choice of service users, rather than accepted practice. At the time of this inspection, none of the 17 service users had retained responsibility for managing their own medication. One service users medication risk assessment indicated that this was an area they could manage themselves, but staff stated that the service user did not have the confidence to do so at this time. In this way the risk assessment was misleading and did not reflect the actual situation. There was no indication of the support actually required by this person, and no cross-reference to a care plan goal of support towards regaining this responsibility as part of their rehabilitation towards maximum independence. Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 & 14. Service users find that the lifestyle experienced whilst staying in the home meets their needs and expectations. Service users can maintain contact with relatives and friends during their stay. Service users exercise choice and control during their stay, but some opportunities for maximised independence are not promoted. EVIDENCE: The people staying here had many positive comments to make about the service they receive at Perth Green House. Service users were very clear about the rehabilitative (and short break) nature of the service and that improvements to their well-being were due to their stay here. One person said, I am so much better since I came here. Its given me the chance to get well enough to go back home. Other also described the help, support and time they had been given by therapists and care staff to regain their skills and confidence. Relatives also described the significant improvement in the service users well-being during their stay at Perth Green. They attributed this to the support of helpful, friendly staff and the good meals. Service users acknowledge that the service is designed to rehabilitate them, and is successfully achieving that. However some people said, it’s a long day Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 14 and I do get a bit bored. There are activities sessions on each day, such as quizzes and bingo, and these are advertised in the main dining room. There are TV lounges in each of the units where people can socialise. It was stated that service users are offered some opportunities to go out to local shops, but this tends to be part of rehabilitation plan and would depend on staffing levels. During their stay service users can maintain contact with their relatives. There is an enclosed pay phone in one corridor where people can make private phone calls. This area is large enough for wheelchair access. The home also has a portable phone that can be taken to bedrooms for incoming calls. Some service users also have their own mobile phones. There is a clear visitors policy in the Statement of Purpose that encourages visiting, but preferably not at mealtimes. There were a number of visiting relatives during these inspection visits. Relatives were very positive in their comments about the support service users have received at Perth Green House in order to get them back to their own homes. Some relatives said, its an excellent service, and we would recommend it to anyone who needed a bit of help to get fit enough to go home. During their stay service users are able to make their own choices about their daily lifestyles within this communal environment. Service users stated that they can get up and go to bed when they want, although they may be woken by others getting up early so that they tend to follow the majority routines. Service users can make choices about how they spend their day, although for some people this may be led by their therapy sessions. Several service users had chosen to spend time in the privacy of their own bedrooms during these visits. Some chose to join in social activities. Service users can also make choices from the menus and were very complimentary about the quality of meals. Following a recommendation at the last inspection, the small kitchenettes in every unit were stocked with some food so that service users (with staff support where necessary) could help themselves to snacks as part of their independent skills. The Manager stated that this had ceased as service users were not using the food and it had to be thrown away. Some rehabilitation service users do have therapy sessions involving cooking, but usually if this is assessed as an area of need. There are also occasional baking or cooking sessions as part of the activities programme. However peoples potential independence in this area is not maximised. The lack of use of the kitchenettes means that service users and staff miss daily opportunities to promote choice, autonomy, activity and continued living skills. Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16. Service users have information about how to make a complaint and are confident that their comments will be listened to. EVIDENCE: The Complaints Procedure is widely advertised around the home in easy-toread print. It is also in the Service Users Guide, which people using the rehabilitation service receive prior to admission. Since the last inspection it is now available on a cassette, and in Braille, for anyone with a significant visual impairment or other reading difficulties. There is a portable cassette player so that the tape could be listened to in the privacy of a bedroom. There have been a number of minor complaints and suggestions in the past year. In this way, it is clear that service users feel very comfortable about making their comments and complaints. In discussions, service users confirmed that they would feel confident about discussing any concerns with the Manager. All the complaints have been recorded and acted upon, and this shows that the home takes even very informal comments seriously. Three of these referred to service users not wanting to leave this short-term service. The remainder mainly related to missing clothes (which were subsequently found). The records do not currently demonstrate whether the complaint is resolved to the satisfaction of the complainant. Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23 & 26. Overall the home is homely and comfortable. None of the baths could be used at this time other than one shower. Service users bedrooms are satisfactory. The home is clean and hygienic. EVIDENCE: Perth Green House was built in the 1970s as a residential care home. Its radial design means that it falls into 5 units with a large central dining room. One unit corridor and the first floor accommodation is used wholly for offices for the many social and health professional that are based in this building. The accommodation for service users is on ground floor level only so it accessible for people with mobility needs. The sample of the building examined was warm, clean and generally comfortable. Overall service users were satisfied with the accommodation during their short stay here. However some service users commented that the plasticized chairs were uncomfortable and sticky to sit on for any length of time, unlike the material chairs that they have in their own homes. Some service users also Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 17 commented on the lumpy pillows, which were found in many bedrooms (although most rooms also had another pillow in, some did not). Most areas of the home have been redecorated, but due to the number of people using these short-term services there are some areas of decorative wear and tear, such as small areas of torn wallpaper. The service does not have on-site maintenance staff. Instead the Manager has to formally request the input of contracted maintenance services for every minor repair. This means there is no immediate attention to the building, so there are potential delays in repairs being addressed. A small number of minor premises issues were reported to the Manager for attention. These included: a bathroom window that does not lock (and could present a security risk); broken window handle in a bedroom; chipped Formica to vanity units in bedrooms (some of which present a safety hazard); poorly finished flooring around WC bowls; and no mirrors in any communal WC. Service users are still not automatically given a key to their bedroom door. Instead it is recorded on an agreement form whether a service user chooses to have a key to their bedroom during their stay. These forms are not necessary as service users have a right to a key, unless a risk assessment determines that having the key would present a risk to their well-being. In this way independence in this area is not actively promoted and encouraged by the service. Also a numbered key might support service users orientation around the complex layout of this large building. Of most concern during the examination of the building was the lack of hot water to the 6 baths. The safe temperature guidelines for baths is around 43°C. However tests at different time over 2 days showed that the hot water temperatures for 5 baths ranged from 31-35°C, which is very cool. One bath had water at 41°C, but the very low pressure meant that by the time the bath filled the water would be too cool. Records of bath water temperatures over the past 18 months indicated that the water has been issued too cold at between 29-35°C. Although periodically reported by the Manager for attention, this unacceptable situation has continued. One service user commented that they had been supported to use a medi-bath (sit-in bath), which was filled with cold water and that cold water had been poured over their head to wash their hair which had left them shivering. This is unacceptable, and staff should have recognised that the water temperature was not satisfactory. At the time of this inspection only one shower was available at the right temperature for use by 17 service users, and potentially by the 30 places at this service. An Immediate Requirement Notice was issued to the service for Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 18 this matter to be addressed urgently. This was addressed the next day and will continue to be monitored by the Manager and at future inspections. The home provides 6 baths and one shower. Two baths are medi-baths, which are box-style baths where a service user has to sit up so they cannot have full body immersion. These are unacceptable and inappropriate for the rehabilitation or short-break of people who use this service. All areas of the home were clean, and there is very good odour control in the home. Several service users have their laundry managed by relatives during their stay. The Manager commented on the difficulties in identifying different service users clothes as they are only here for a short time. This may have led to some complaints about missing clothes. Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 29. Service users needs are met by the number and skill mix of staff. Service users are protected by the homes recruitment practices. EVIDENCE: At the time of this inspection there were 14 service users using the rehabilitation service, and 3 people receiving an interim service. There were 3 care staff on duty in the rehabilitation unit. There were 2 care staff on duty in the interim/short break units. There is also a senior staff on duty throughout the day and evening. 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. Since the last inspection a number of care staff have completed NVQ training and now 70 of the care staff team has an NVQ care qualification. There is a good mix of age and experience amongst the staff team and there are 3 male care staff. For several months some vacant posts at Perth Green House have been held for possible redeployment of staff from other services. In the meantime the home had to use several agency staff to cover those duties until those appointments were made. Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 20 Most of these posts have now been filled and 7 new staff have commenced work at the service. The appointments are made in line with the South Tyneside Social Services Department robust recruitment and selection procedures. These includes shortlisting, interview, CRB disclosures, health declaration, and references. The HR department holds personnel files. Individual staff files held confidentially at the service includes copies of the information required by the Manager. In this way, the Manager is assured that the staff providing care for service users are suitable to do so. Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 35. Service users views are sought but there is no formal review system of the service. Service users are encouraged to manage their own monies and this is appropriate EVIDENCE: A specific quality assurance system has yet to be designed for this service. In the meantime service users views are sought via postal questionnaires. However these have only yielded a 25 response so far. Consideration is now being given to promoting the questionnaire to service users on discharge. Also the questionnaire is a tick-list and its design does not encourage individualised comments of a service users experience during their stay. Most people continue to manage their own financial affairs (or have representatives to do this for them) during their stay at Perth Green House. However the home can provide secure storage for small amounts of personal Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 22 monies if requested to do so by service users. There were 2 people who had deposited small amounts of money in the office for safekeeping. An appropriate record is kept of the management of this money and this was signed by the service user and the Manager. Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 23 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 2 X X X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X 1 X 2 X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X X Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 24 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 OP1 Regulation 4(1)b Requirement The Statements of Purpose for each of the services (rehabilitation, interim and short-break) must reflect the correct registration status of Perth Green. There must be a Service User Guide in respect of the other services the house provides, i.e. short-breaks and, if agreed, a convalescence service. (Previous timescale of 01/01/06 not met.) Care plans must demonstrate how a service user has been involved in the drawing up of their own care plan. Moving & assisting assessments must instruct staff in the specific methods of supporting a service user with their individual moving & assisting needs. The risk assessments regarding self-administration of medication must identify the actual support required by each service user, or be cross-referenced with a care plan goal regarding medication. Hot water to baths must achieve a satisfactory, safe temperature DS0000037978.V271828.R01.S.doc Timescale for action 01/05/06 2. OP1 5 01/05/06 3 OP7 15(1) 01/05/06 4. OP7 13(5) 01/05/06 5. OP9 12(2)b 13(4)b 01/10/05 6. OP21 13(4) & 23(2)c 11/02/06 Perth Green House Version 5.1 Page 25 7. OP21 8. OP33 10. OP38 of around 43°C. An Immediate Requirement Notice is issued. 12(1)a & The 2 inappropriate medi-baths 23(2)j n must be replaced with suitable bathing facilities for use by people using a rehabilitation and short-break service. 24 An effective quality and monitoring system must be put into place. (Previous timescales of 30/11/04 and 1/11/05 not met.) 13(4)c 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. (Previous timescale of 01/11/05 not met.) j. 01/07/06 01/05/06 01/05/06 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. Refer to Standard OP1 OP2 OP15 Good Practice Recommendations The Service User Guide should be amended to reflect that a risk assessment is used to determine whether a service user can manage their own medication during their stay. The contract should be amended to reflect the short term nature of the services provided here, and references to long stay conditions be removed. The kitchenettes should be stocked with items on a daily basis for service users, with staff support, to be encouraged and enabled to retain their independent living skills in this area. The Complaints Records should demonstrate whether a complaint has been resolved to the satisfaction of the complainant. More copies should be made of the Complaints Procedure on cassette tape, so that each service users with a visual impairment or reading difficulty staying at the same time could have their own copy in their bedroom to refer to. DS0000037978.V271828.R01.S.doc Version 5.1 Page 26 4. 5. OP16 OP16 Perth Green House 6. 7. OP19 OP23 8. 9. OP26 OP31 Consideration should be given to the provision of dedicated on-site maintenance/handyperson staff to address minor repairs and redecoration. All service users should be given a key to their bedroom door on admission, unless a risk assessment determines otherwise. The Agreement form for service users to choose to have a key is not necessary, and numbered keys should be already available to service users. Consideration should be given to the use of individual laundry bags so that service users clothes can be kept separately during washing. There should be dedicated administrative support for the intermediate services provided at Perth Green House. Perth Green House DS0000037978.V271828.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields 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. 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