Inspection on 19/06/08 for Brendoncare Ronald Gibson House

This inspection was carried out on 19th June 2008.

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

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

Other inspections for this house

Brendoncare Ronald Gibson House 24/05/07

Brendoncare Ronald Gibson House 29/08/06

Brendoncare Ronald Gibson House 17/01/06

Brendoncare Ronald Gibson House 19/04/05

Brendoncare Ronald Gibson House 23/11/04

Brendoncare Ronald Gibson House 15/06/04

Similar services:

Ashlong House

Norbury Crescent (30)

Henry Nihill House

Birchwood

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

The Infirmary

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Ronald Gibson House 236 Burntwood Lane Tooting London SW17 0AN Lead Inspector Louise Phillips Key Unannounced Inspection 11:00a 19th June 2008 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 Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ronald Gibson House Address 236 Burntwood Lane Tooting London SW17 0AN Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8877 9998 020 8877 3860 mbird@brendoncare.org.uk www.brendoncare.org.uk The Brendoncare Foundation Ms Heather Butler-Gallie Care Home 56 Category(ies) of Dementia (4), Dementia - over 65 years of age registration, with number (16), Learning disability (2), Old age, not falling of places within any other category (56) Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Management of the home There will be a total of 56 management hours per week available within the Home. The Manager of the Home will remain supernumerary and work full-time. The balance of the 56 hours will be provided by designated staff. Care Staff and Dementia Unit Care staff must be provided in sufficient numbers, and with the necessary qualifications and experience, to meet the assessed needs and dependency levels of all low, medium, high, and continuing care band service users accommodated in the Home at any one time. As a minimum care staff shall be provided as follows : 8am to 2pm : 2 Registered Nurses 8 Care Assistants 2pm to 8pm : 2 Registered Nurses 7 Care Assistants 8pm to 8am : 2 Registered Nurses 3 Care Assistants The specified registered nurse numbers are additional to the supernumerary management hours set out above. the low, medium and high bands refer to assessments for Registered Nursing Care Contributions (RNCCs). The continuing care band applies to service users whose needs are predominantly for health care, and who are therefore wholly funded by the NHS Ancillary staff for all units There will be adequate and sufficient staff and/ or contract arrangements in place at all times to ensure a good quality catering, domestic, cleaning, laundry, maintenance, and administrative service for all users. Respite Care Respire Care agreed for one specified female service user who is under 55 years of age. One male service user aged 48-55 requiring general nursing care 0ne Service user aged 53-65, with Dementia, can be accommodated within the home Two Service users aged 53-65, with Learning disabilities, can be accommodated within the home 2. 3. 4. 5. 6. 7. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 5 Date of last inspection 20th November 2007 Brief Description of the Service: Ronald Gibson House provides nursing care and accommodation for 56 residents, 16 of whom may have dementia. The service is part of the Brendoncare group of homes. The service is organised on two floors with one unit providing dementia care being located on the ground floor. The home is operated by the Brendoncare Foundation and is situated near Springfield Hospital in Tooting. There is sufficient parking on site for visitors and the home has access to local bus routes. The range of fees at the time of inspection range from £752.50-£845.00 per week, depending on care needs. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This inspection took place over one day by one inspector. Time was spent talking to seven staff, four residents and viewing paperwork. A tour of the premises was carried out and care records were inspected. Information has also been gained from the inspection record for the home and the Annual Quality Assurance Assessment (AQAA) that the manager completed. Surveys were sent to 30 staff, 4 health/ social care professionals, 14 residents and 13 relatives/ advocates. They were received back from 2 staff, 1 professional, 6 residents and 8 relatives/ advocates. What the service does well: What has improved since the last inspection? What they could do better: Areas where the home could be doing better are highlighted in the report and were discussed with the manager during the inspection. These include improvements to the environment, confidentiality and improving records kept about residents. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 and 6 Quality in this outcome area is good. The residents are appropriately assessed prior to moving to the home, to ensure that the service can meet their needs. Intermediate care is now provided at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: “…I knew as soon as I walked in…I was made to feel very welcome…all of the family agreed it was the right place…”. This was a comment received from a relative who said that they particularly like the atmosphere and friendliness of the staff at Ronald Gibson House. Residents also spoke about their positive experiences of deciding to move to the home, saying that they were given enough information and liked that they Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 10 and their family were able to visit the home prior to making a decision about where to live. Prior to residents moving to the service, a thorough assessment is carried out by the manager and a team leader. This includes looking at the residents needs in all activities of daily living, such as personal care, assistance needed with dressing, mobility, independence in using the toilet, oral health and foot care needs can all be met by the service. The assessment also involves looking at the emotional needs of the resident, as well as their preferences about how they like to spend their time. Communication needs are also identified, and where relevant the input of Speech and Language Therapy is sought during the assessment, to help develop appropriate communication techniques with residents who are unable to verbalise their wants. Personal safety is also looked at in the risk assessment. These are initially carried out at the time of assessment, with areas such as mobility, falls, eating and drinking and social activities all assessed, in light of the service facilities, so that any risks can be minimised. Appropriate information is also gained from the care manager who has referred the resident to the service, along with information about the resident’s history, previous occupation and important family members, etc. Since the last inspection the home has developed its service to enable it to provide intermediate care for a number of patients coming directly from hospital, for a period of no more than six weeks, prior to their returning home. Whilst, at the time of inspection, their were no residents at the home for intermediate care, the manager said that they have had three residents who have all moved home successfully within the their six week stay at the home. The service has identified specific rooms for residents receiving intermediate care, and there are named nursing and care staff who work specifically with these residents. Occupational Therapy and physiotherapy input is provided by the hospital. A medication policy has been introduced, specifically for residents receiving intermediate care, along with an assessment form and placement agreement, and completed examples of these were seen for the previous residents who had received intermediate care at the service. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is good. The residents’ needs are met through good care planning that takes into account individual needs and preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents living at Ronald Gibson House say that they feel they get good care and that they get appropriate medical support. Relatives also say this, adding that they believe the home is able to meet the differing needs of the residents and that staff keep them informed of important issues affecting their relative, with one saying that: “…I am informed straight away…” regarding any issues. One relative said that sometimes their relative is not always appropriately dressed, giving the example of them wearing a vest under their clothes on a hot day. Survey responses from relatives indicates that they are all generally very happy with the care their relative receives, with one saying that: “…the care of my (relative) comes first…this what they do…”, and another stating: Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 12 “…I do not think they can improve…”. One relative did say that their relative “…needs physiotherapy and speech therapy to support and encourage ability to talk and be mobile…”. During the inspection one resident discussed openly with us the help they receive with personal care. They said that this is carried out with respect to their privacy and in a way they like. However, they did say that sometimes the care they get can depend on the staff on duty, with some seeming more rushed than others. During the inspection staff were seen to knock at bedroom and bathroom doors before entering. The care plan files for each resident are kept in their own bedroom in a file holder attached to the wall. It is not clear if residents were given a choice to having the care plans stored in this way, and whether they consent to this. It is also unclear how confidentiality is maintained for the resident, in light of their visitors having access to these files, and other residents who visit them in their room. The service should find a different way of keeping the care plans to ensure that residents’ confidentiality and privacy is maintained regarding their personal care information. Information in the care files is very detailed, including information about who the residents’ named nurse and keyworker are, plus a description of the role of the keyworker, so that the resident knows what to expect. The section titled ‘resident profile and biography’ provides individualised information about the residents’ medical history and their abilities in relation to physical, cognitive and sensory needs. There is also summarised information about the residents personal history, their previous occupations and relevant family members, as well as their interests and any particular communication needs. Following the resident being admitted to the home, the initial care plans are reviewed regularly and amendments made where necessary. The care plans are in a clear, simple format, with headings to enable easy identification of the ‘problem/ risk identified’, the ‘expected outcomes/ goals’ and the ‘interventions/ actions’ to meet the needs of the resident. The service has made good progress in the care plans to make them more person-centred around the individual needs of the resident. Examples of this are that the ‘personal care’ care plan for one resident details that they ‘prefer to have a full wash daily, after breakfast’, and a ‘bath/shower once a week, any day of the week’. The care plan states what the resident is able to do for themselves, the particular body wash, shampoo and toothpaste they like to use and how many staff are needed to assist with this. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 13 There are care plans around the mobility needs of the resident, as well as their preferences regarding eating and drinking and the specific assistance they need with this For one resident, the care plan around their communication needs has been progressed from advice gained from the Speech and Language Therapy services, with this developed into a care plan for staff to refer to at the home. Continence assessments are carried out six monthly on residents who have a need in this area, and evidence was seen of the involvement of the continence care nurse in this process. Feedback from health and social care professionals involved with the service is that staff at the home contact them when necessary, and that they utilise the advice that they give. The care files are well-maintained, with records to demonstrate that appropriate assessments are carried out around the risks of pressure sores, nutrition, moving and handling, bedrails, falls and the use of wheelchair straps. The risk assessments are carried out either by a staff nurse or the physiotherapist employed at the home. Consent is also sought from relatives for the use of bedrails and wheelchair straps. Daily records are maintained by nurses and carers who support the resident. These contain information predominantly about the personal and physical care provided to the residents, and there should be more information about how they have supported the resident with their social/ emotional needs and attending activities. This will demonstrate how the staff support the resident on a more holistic level, whilst providing a picture of how the resident spends their day, other than when their personal and physical care needs are being attended to. The medication system at the service is audited monthly by a Team Leader who ensures the appropriate storage, supply and labelling of medication. Spot-checks are also carried out by the local pharmacy to assist the home with this. Since the last inspection the manager has implemented a ‘care of the dying’ pathway, which has been developed from the Liverpool Care Pathways and amalgamated into Brendoncare’s own pathways. The document covers all areas such as assessment and planning of specific religious and spiritual needs, relative’s awareness of condition and caring for the resident if resident is or becomes unable to communicate their needs in relation to personal care and treatment. Completed documents were seen to include input from all relevant professionals and persons involved in the residents care, such as relatives, palliative care nurses and dietician. The manager said that he is oncology trained and that ongoing training is planned for staff in end of life care. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. Residents have the opportunity to be involved in a variety of activities that are planned around needs, interests and community living. Meals are good and offered at flexible times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At Ronald Gibson House there is a team of three staff, headed up by the physiotherapist who provide a number of activities for the residents. The physiotherapist explained that the home provides three types of therapy physiotherapy, aromatherapy and sensory, of which all residents are assessed for and care plans developed. The service has is own sensory room and is in the process of landscaping a sensory garden for the residents, in the garden area of the home. In addition to this, activities such as flower arranging, cooking, music, church services, films and theme days – (eg valentines day, Easter) are arranged on a weekly basis. The physiotherapist also said that the service does plan outings for the residents, such as day trips to the zoo, river trips, or to the seaside. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 15 The physiotherapist said that they hope to increase these since their recent registration with ‘Dial-a-ride’. Throughout the home there are boards that display the activities planned for the week that residents can get involved in if they wish. One resident said that since the return of the manager “…there is now more to do…always something I can go to in the day room…”. Residents who responded to the surveys said that there is usually an activity they can get involved in, with one also saying that “…things have improved a great deal over the last few months with more things to do for the able-bodied…”. Relatives said that they feel the service is good at meeting the different needs of the residents, with one saying that: “…they try very hard to cater for all ethnicity…”. During the inspection an exercise group was observed taking place in the day room. After lunch some residents attended the flower arranging group, whilst some residents were seen enjoying the sensory room, with the support of staff. The physiotherapist also manages some volunteers who visit the service to read with residents and take them out for walks. All relatives comment that they are able to visit their relative at any time and that they always receive a warm welcome from the staff. They say that they are offered refreshments on arrival and that there is also a ‘relatives room’ where they are able to make their own drinks. Relatives also say that where able, their relative is supported by staff to keep in contact with them by telephone. Some relatives said that they would like to see staff encouraging their relative more to engage in activities, whereas others felt the home could improve by having staff spend more time with residents who are unable to attend the activities or the day centre. Feedback from residents is that they like the meals at the home, where one commented that “…the food is always good…”, and a relative said that the “…food is excellent…”. During the inspection we saw lunch being served, which was of good portion size and nutritionally well-balanced. Residents said they enjoyed the meals, and that they did not feel hurried by the staff to eat these. Where necessary, residents were seen being supported by staff and using special knives and forks to enable them to eat more independently. The lunch meal is served over two sittings, to allow the residents to eat anytime between 12pm and 2pm. Suggestions that residents gave for improving the food were that they would like more green vegetables and pasta. One resident commented that there can be some cultural issues concerning the food, where the staff description of food can be confusing in what they can Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 16 expect. They gave the example of the staff saying that the pudding was ‘jam cake’, when in fact it was jam roly-poly; and another time when they were offered ‘baked egg with custard’, which was actually baked egg custard. It is recommended that all staff familiarise themselves with the correct names for foods offered, to avoid confusion for the residents and so that they actually know what food to expect. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. There are systems in place to minimise risks to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a complaints procedure that is provided in the Service Users Guide and the resident’s care files at the home. The complaint procedure in the files was seen to need updating to include the new contact information for the CSCI. There is a system for the logging of complaints, along with records of actions taken and any correspondence relating to these. There have been no complaints received by the service since the last inspection. Feedback from residents is that they know how to make a complaint if there was something they were not happy about. One resident said that “…the manager is a very good. When I speak to him I know I am listened to and action will be taken…”. Relatives are similarly positive, saying that they get an appropriate response if they raise concerns, that “…the manager is always willing to listen to and sort out any problems that arise…”, and that that the “…staff respond very quickly to our concerns…”. In each residents bedroom there is a ‘communication book’ for relatives and staff to write in and inform each other of significant events or needs. These Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 18 were seen to detail particular dietary requests and information about a visit by a doctor. One relative said that this is good for ensuring that communication is maintained between them and their relatives named nurse, particularly where they might not see them when they visiting the home. Training records indicate that the staff have received recent training in abuse awareness and safeguarding adults, so to minimise risks to residents. One staff member spoke about how they are encouraged by the team leaders and manager to report any safeguarding issues immediately. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 and 26 Quality in this outcome area is good. The home is spacious, clean, homely and well-maintained for the residents comfort. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Ronald Gibson House has a warm, comfortable atmosphere that is enhanced by the homely décor and spacious communal areas. Relatives say that the staff are always welcoming and that they feel able to visit at anytime. One relative also said that the home is well decorated. Residents say that the home is always fresh and clean, with one saying that “…it is refreshing to find a home so bright and clean and free of smells…”. During the inspection residents were happy to show us their bedrooms, saying that they liked that they were able to bring some of their own furniture, pictures and possessions to make it feel more homely. Residents were seen Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 20 enjoying sitting out in the gardens at Ronald Gibson House, and were enthusiastic about the new sensory garden that is being developed in an area of the garden. Some areas that were seen to need addressing were that the carpets in the hallways were stained and in need of replacing, and the extractor fans in the en-suite bathrooms were dusty and in need of cleaning regularly. In addition, one resident did say that: “…I would love to have a bath-chair in my bathroom so I can wash myself…”. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. The service provides training so that residents receive a good level of care, and recruitment procedures protect the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Ronald Gibson House has a consistent staff team, most who have worked at the home for a number of years and have a good understanding of the needs of the residents. Staff feedback that they are confident that the service they provide promotes the well-being of the residents. Relatives comment that they feel the staff have the right skills and experience for their role, with one saying that “…90 do…”, and another commenting that the “…staff are excellent…”, further adding that “…they offer support, very friendly and approachable…”. Residents who responded to the survey say that the staff listen to and act upon what they say, with one saying that “…sometimes they have to be told more than once…”. Residents also say that staff are generally always available when they need them. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 22 The home holds recruitment information on each member of staff. The staff files are well organised and contain relevant information such as proof of identification, correspondence relating to offer of job, Criminal Records Bureau (CRB) check, two references and record of the interview of staff. The manager said that the organisation is in the process of centralising the staff recruitment information, CRB’s and training records, whereby when these are due to be refreshed the system will flag this up. All new staff receive an induction to the service which is in line with Skills for Care, with new staff also having to complete a workbook to demonstrate their understanding of their role. The induction covers areas such as confidentiality, medication, abuse awareness and person-centred planning. Staff who responded to the survey say that they received a very good induction that covered everything they need to know. Staff also said that they get enough training to support them in their role. With one commenting that there is: “…training given and support to help care for our clients…”. Training records indicate that staff receive training in health and safety, infection control, moving and handling, first aid and death and dying. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 37 and 38 Quality in this outcome area is good. There is a committed manager at the home who is progressing the service for the benefit of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: “…the manager is very good, always asking if things needed…”, “…a lot has improved since he has been here…”, “…overall the home is run well…”. These are comments received from residents and relatives regarding the manager of Ronald Gibson House. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 24 Since February 2008 the permanent manager has returned to the service following an extended period of leave. The comments above reflect that this is viewed as positive by residents and relatives alike. Staff also comment that they are happy the manager is back in post, and that they feel well supported by him. The staff further say that there is good communication, and that they are informed of relevant issues that affect them and the residents. The manager said he has a number of years experience in nursing in senior roles and is trained in a number of relevant nursing specialties such as oncology and neurology. He needs to register with the CSCI to become the Registered Manager of Ronald Gibson House. Consideration should be given to ensuring that the manager undertakes the Registered Managers Award in the near future. Quality assurance is carried out by the service through annual questionnaires sent to relatives for feedback on various aspects of the care, service, activities and accommodation. The last survey was carried out in November 2007 and the statistical results for this, and a summary of the comments were seen. It would be beneficial to have seen a written action plan of what the service has planned and done to address the feedback. The response rate from residents to this survey was 27 , which was an improvement on the previous year, though the service needs to look at alternative ways of gaining feedback to ensure the views of all residents are received. Meetings with residents and relatives occurs approximately 2-3 times a year, and staff meetings approximately every two months, for each grade of staff, with a whole staff meeting every three months. The home holds a personal allowance for each resident that is funded by themselves or their family. All residents’ money is held in one account, which the accountant says is a non-interest bearing account. Records for the amount held by each resident is held on the homes accounting system. The accountant said that should one residents’ money run out then money is not drawn from the existing money in the account, and that they contact the family for some more money to ‘top-up’ the residents’ account. Record-keeping at the service is generally of a good standard, however in some care files entries were seen to be crossed out, yet not appropriately initialled by who had done this, nor dated as to when they had done it. As stated earlier in the report, the service must ensure that all records relating to residents are stored securely at the home. The service maintains records to demonstrate that appropriate health and safety checks are carried out on the fire system and equipment, electrical installation, gas safety and Portable Appliance Testing, etc. Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X 3 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 2 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 3 2 X 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 X 3 3 Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP16 Regulation 22(7) Requirement The complaint procedure must include up-to-date contact information for the CSCI. The Registered Person must ensure that the carpets in the hallways are replaced. The Registered Person must ensure that the extractor fans in the en-suite bathrooms are cleaned at a minimum of six monthly. The manager must register with the Commission for Social Care Inspection. (Previous timescale not met) Timescale for action 31/07/08 2. OP19 23(2)(d) 31/03/09 3. OP25 23(2)(p) 30/06/08 4. OP31 8 31/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000019116.V364731.R01.S.doc Version 5.2 Page 27 Ronald Gibson House 1. Standard OP8 The daily records maintained by nurses and carers should contain information about how they have supported the resident with their social/ emotional needs and attending activities. The service should ensure that residents care plans are kept securely so that privacy and confidentiality is maintained regarding their personal care information. All staff need to familiarise themselves with the correct names for foods offered, so that residents know what food they can choose and expect. Consideration should be given to supplying residents with a chair in their en-suite to enable them to address their personal care needs independently. The manager should undertake the Registered Managers Award. The manager should ensure that appropriate recordkeeping techniques are used at the service. 2. OP10 3. OP15 4. OP21 5. 6. OP31 OP37 Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ronald Gibson House DS0000019116.V364731.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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!