CARE HOMES FOR OLDER PEOPLE
South Garth 1 Elwyn Road Exmouth Devon EX8 2EL Lead Inspector
Michelle Oliver Unannounced Inspection 7th November 2005 14:45h 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 South Garth DS0000022033.V262096.R01.S.doc Version 5.0 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. South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service South Garth Address 1 Elwyn Road Exmouth Devon EX8 2EL 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) 01395 265422 01395 227474 Mrs Christa Elizabeth Greaves Woodland Health Care Limited Mrs Sharon Lesley Beech Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25), Physical disability over 65 years of age of places (25) South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 3rd May 2005 Brief Description of the Service: South Garth provides personal care for up to 25 older people who may also have physical disabilities. The property is a detached converted house with a modern extension in a suburb of Exmouth. Accommodation is arranged over the ground and first floors. There is a passenger lift. There are two lounge areas plus a large conservatory that is used as a dining room. There is a small car parking area, but in practice people tend to park on the road. There are pleasant level gardens that are sunny and sheltered. South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place on Monday 7th October 2005 from 3pm to 6pm. Ten residents were spoken to and all residents seen during the inspection. All members of staff on duty also took part in the inspection. The atmosphere in the home was warm, welcoming and friendly. Residents were relaxed, content and spoke highly of the care they received in the home. The inspector looked around the home, a number of records were inspected, which included residents care plans and fire log book. The home does not currently have a registered manager. Staff were very helpful on the day of the inspection and a lot of positive discussions, advice and suggestions took place throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better:
Assessment of the risk to residents from scalding from basin hot water taps must be undertaken and the risk, so far as possible eliminated. Residents care plans must be reviewed regularly and any changes recorded to provide staff with up to date relevant information to ensure that residents current needs are met. South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 6 A safe system of reviewing and testing fire precautions must be undertaken to ensure the safety of residents at the home. Although residents spoken to during the visit had no complaints about care given throughout the night, staff said that the current staffing level is not sufficient to meet residents current needs. It is recommended that an assessment of staffing at night is undertaken to establish whether this is the case. 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. South Garth DS0000022033.V262096.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection South Garth DS0000022033.V262096.R01.S.doc Version 5.0 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 the following standard(s): None of these standards were assessed at this visit. EVIDENCE: South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 & 8. Not all aspects of residents’ health social and personal care needs are identified and planned for. Care plans do not always reflect the high quality of the care that residents receive at South Garth. EVIDENCE: All residents have individual plans of care based on an assessment undertaken before a resident decides to make South Garth their home. The purpose of the plans are to identify residents’ needs and risks and to give staff the information to enable them to meet care needs. Three care plans were looked at during this visit. Assessment of the risk to residents of scalding from basin hot taps had not been undertaken. One care plan was not up to date. Information recorded in the care plan referred to the resident being given assistance to undertake a procedure to monitor their medical condition. A member of staff said that they were unaware of the information and that the resident would not be capable of carrying out this procedure. Staff were aware of individual care needs and were able to speak about how they are met on a daily basis. Longer term needs were not reviewed. A resident is currently receiving treatment for a medical condition. Their behaviour at the time of the visit, information included in daily reports and
South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 10 remarks made by other residents indicated that this treatment may not currently be effective. Day reports included details of the residents symptoms but no evidence of the involvement of specialist health services. South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 & 15. A varied balanced diet is provided, served in a pleasant atmosphere, with individual support given discreetly as needed. Residents are encouraged to maintain contact with family and friends. EVIDENCE: Ten residents living at the home were spoken to. All said “the food is good”. For example one resident said ’if you don’t like something they’ll change it’. A menu is available to residents but most residents said that they didn’t want to see it. Menus showed a varied, balanced and nutritious diet. At the time of this visit staff asked residents what they would like for their evening meal. Residents said that their visitors are made to feel welcome when visiting at any reasonable time and that they visit without prior appointment. South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 12 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): None of these standards were assessed at this visit. EVIDENCE: South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 13 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): 24 Residents are provided with comfortable, homely surroundings. EVIDENCE: The living accommodation is well decorated and homely. Residents’ rooms were personalised with sentimental items, photographs and small pieces of furniture and all expressed their satisfaction with the accommodation provided. South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 14 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 The numbers and skill mix of competent staff are sufficient to meet current residents’ needs throughout the day but may not always during the night. EVIDENCE: The home aims to provide 4 cares between 8am-2pm, 3 between 2pm –8pm and 2 night carers one of which is a sleeping carer. Staff said that residents needs had increased during the night and that I waking staff was not always sufficient to meet their needs. This was not confirmed by comments made by residents. Residents said that the staff were kind and caring and always there to help. During the visit staff were observed spending time with residents and responding to their needs promptly. South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 15 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): 31, 35, & 38. The home is currently well run and improvements are ongoing. EVIDENCE: The home is recruiting a manager at the time of this visit. The management company, Woodland Healthcare Company, has provided the home with management cover and support in the absence of a permanent manager. Staff know about the structure in place, who to contact and a list of contact telephone numbers was prominently displayed. A manager within the Company has been working at the home during this recent period. Staff said they felt safe with this arrangement. Residents said that the home was well run. Financial records were not available at the time of this visit. They will be looked at during the next inspection. It was noted that window restrictors that had been fitted to two first floor windows were broken. This represents a hazard to residents. The home’s
South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 16 maintenance person has not been available recently. Staff said that they would make sure that this was attended to urgently. Routine, regular testing of fire alarms and equipment had not been undertaken since September 2005. Once again staff said that the maintenance person had not been available recently. Arrangements must be made testing to be carried out as required. A corridor leading to a fire exit was partially blocked by a desk, chair and wheelchair. Residents are potentially at risk in the event of a fire at the home. An immediate requirement was made at the time of this visit. It has been confirmed that the corridor has been cleared and that arrangements for the regular testing of fire equipment have been made. South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 17 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x x x x 3 x x STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x x x x 1 South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 18 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 OP7 Regulation 13 Requirement Unnecessary risks to the safety of service users are identified and so far as possible eliminated.[ this relates to risk assessments of risks of scalding] This is the 2nd time this requirement has been made. The 07/12/05 timescale of 03/05/05 has not been met. The registered person shall keep the service user’s plan under review. [ this relates to information in a 07/12/05 care plan not being up to date having not been reviewed] The registered person shall make adequate arrangements for the 06/12/05 evacuation, in the event of fire, of all persons in the care home, and for reviewing fire precautions and testing fire equipment at suitable intervals. [ this relates to fire alarms and emergency lighting not being tested regularly and the corridor leading to fire exit being partially blocked] Timescale for action 2 OP7 15[2][b] 3 OP38 23[4][c] [iii] [v] South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP27 Good Practice Recommendations An assessment of residents needs and tasks undertaken by night staff to be assessed and staffing levels adjusted accordingly. South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 South Garth DS0000022033.V262096.R01.S.doc Version 5.0 Page 21 - 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!
