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Inspection on 14/06/06 for The Georgians Nursing Home

Also see our care home review for The Georgians Nursing Home for more information

This inspection was carried out on 14th June 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a committed manager and team who provide care to residents in a caring and sensitive way. The senior staff team have worked in the home for a number of years and are knowledgeable about residents social and personal care needs in a way, which supports the whole staff team in providing a consistent service, which residents said meets their needs in the way they wish.

What has improved since the last inspection?

The Manager has undertaken a review of policies and procedures, which are used to ensure resident`s needs are met in the right way and is considering ways of increasing communication with residents, family carers and staff in order to further involve them in the development of the service.

CARE HOMES FOR OLDER PEOPLE The Georgians Nursing Home 50 Wide Bargate Boston Lincs PE21 6RY Lead Inspector Roger Harrison Key Unannounced Inspection 14th June 2006 09:30 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 The Georgians Nursing Home DS0000002556.V288609.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. The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Georgians Nursing Home Address 50 Wide Bargate Boston Lincs PE21 6RY 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) 01205 364111 01205 311417 The Georgians (Boston) Limited Mrs Patricia Cope Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48), Physical disability (1) of places The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide nursing and personal care for service users of both sexes whose primary needs fall within the following cat egories:Old age, not falling within any other category (OP) (48) Physical Disability - under the age of 65 years (PD) (1) for one named service user. The maximum number of people to be accommodated is 48. 2. Date of last inspection 1st November 2005 Brief Description of the Service: The Georgians Care Home is a listed building situated in the centre of the market town of Boston and a short walk from the shops and local facilities. There is a small car park to the side of the home and a patio area to the rear. There is ample public parking to the front of the building. The home provides both personal and nursing care. Accommodation for residents is available on both the ground and first floor. Rooms on the first floor are served by a shaft lift and stair lift. The home has twenty-four single rooms and twelve double rooms. There is a regular bus and train service in Boston. Charges made at the home on 14/06/2006 range from: £335.00 £548.00 p.w. The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key inspection was undertaken using a review of all the information available to the Inspector about The Georgians, and through undertaking a visit to the home, with the inspector using a method of inspection called “case tracking”. This involved identifying five residents who currently live at the home and tracking the experience of the care and support they have received during the time they have lived at The Georgians. The inspection visit was achieved by the inspector talking to the manager, touring the home, looking at information on care plans and files, talking to residents and care staff, and observing day-to-day care practice within the home. What the service does well: What has improved since the last inspection? What they could do better: The manager should maintain a review of the numbers of care staff to service users to ensure the staffing numbers available are appropriate to meet the assessed needs of all residents. The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 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 The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 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): 3 Standard 6 N/A. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager provides information for new residents and carries out assessments of need, which are used to support individuals in their decision to move to the home, and to ensure long term needs can be met. The Georgians does not provide an Intermediate care service. EVIDENCE: Information provided before the Inspection visit to the home shows that the Manager has produced a statement of purpose and a service users’ guide alongside terms and conditions, which residents said are provided on admission to the home. The Manager confirmed that pre-admission assessments are undertaken to ensure any new need matches that of existing residents. Two visitors arrived during the Inspection visit to view rooms available in order to make a choice for a relative and said, We have heard good things about this home. The Manager provided a colour brochure and discussed the assessment process with the visitors whilst advising on room availability and giving a brief tour. The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 9 One new resident told the Inspector he had come to the home from hospital and that he knew about where he was coming and had an assessment of his needs by the home and other professionals. During the visit an Occupational therapist and nurse visited the resident as part of the assessment and review of the placement. The manager also showed the Inspector a copy of a form used by the senior care team when undertaking pre admission assessments and the Manager was observed arranging to visit a potential resident in hospital in order to assess needs in advance of any move to the Georgians. The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive care and nursing plans are provided for residents ensuring that residents’ health, personal and social care needs are met. Systems are in place to ensure the safe storage, recording and administration of medications. EVIDENCE: The Manager and senior nurse confirmed that they feel it is important to involve residents in the planning of their care. All residents have a care plan in their rooms showing how medical and personal needs are met. Residents and family carers said they know about information contained in their plans, which included all physical, medical, nursing and social needs. Private and confidential information is stored for each resident in the Managers office. Care staff said that they use care plans to support residents in the way they wished and residents said they felt supported and respected by the staff team. Family carers who were visiting the home said that staff provide a good standard of care for individuals. The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 11 Care plans showed reviews that had been undertaken monthly and that residents are involved in these. A family carer said; “I was invited to, and fully involved in Mums review”. The nurse in charge provided medicine records and showed the Inspector procedures which the care team follow. Medication charts for residents contained identification photographs and residents said they felt their medicine needs are met by the senior care team. During the Inspection visit staff were observed providing support with medication as it is prescribed, and in a way which residents said made them feel safe. The Manager has produced a “Bereavement Information” leaflet for residents and their carers to inform them about local services, contacts and to offer support direct. The manager described the positive support given to residents and relatives during the process of bereavement. The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by staff to take part in a range of activities, maintain control over their lives and receive a balanced and varied diet which is provided in the way residents wish. EVIDENCE: During the visit to the home family members and professionals were observed coming and going throughout the day. Three family visitors said they always felt welcome when visiting the home and residents said they have access to a range of activities, which meet their needs. The Manager confirmed that an activities Co-ordinator is employed by the home, who produces a list of weekly activities, which is on display in the reception area of the home. Residents said the activity list is changed every week. Communal areas of the home also have activities displayed on the wall, which residents said they take an active part in. Activities listed include; Community shopping visits, musical exercises, craft sessions, gardening and general games. Communal areas have a range of books, music facilities and private space, which residents were using during the home visit. The home has a separate hair salon, which residents said they make good use of and two external craft instructors were observed arriving to undertake an activity with a group of The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 13 residents. The Manager said she supports the production of a monthly magazine, which highlights events and activities offered by the home and is given to all residents. Menus at the home are produced through the use of care plans and feedback from residents. Display boards on both floors of the home show two meal alternatives for each day and menu plans show a wide variety of meals are provided. Residents said the food at the home is very good and carers visiting the home said that they felt the food is excellent. Residents were observed taking lunch in communal areas and in their own rooms as they said they wished. The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager and care team take complaints seriously and wherever possible involves residents and carers in resolving issues as soon as they arise. The Care team know how to act in order to protect residents from abuse. EVIDENCE: Information provided by the Manager before the Inspection visit showed that their is a complaints policy and procedure in place which is on display in the home and reviewed regularly. The Manager confirmed during the Inspection visit that there has been one formal concern raised with the Manager during the last year which was about general care issues. A record has been kept of the concerns raised, and the Manager said the issues raised had been fully resolved informally by the home through a review. Three staff members separatley confirmed that any concerns are directed to the Manager and that they are clear about their responsibilities in relation to protecting all residents from abuse of any kind. All staff felt they had sufficient training to enable them to respond to residents in a way which encouraged good two way communication and residents said they felt happy to raise any complaints direct with the Manager or staff team. The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents needs are met within a clean, safe and well maintained environment. EVIDENCE: Information provided by the home owner before the Inspection visit was made show that some internal decoration has been carried out and new carpets have been fitted on the first floor of the home. All residents rooms have names and numbers and are well personalised in the way each resident said they wished them to be. Fire exits are all clear and staff confirmed fire bells are tested every week. Fire instructions are available on message boards on both floors of the home and staff members described the fire drill in place and how to evacuate residents. The sluice is well maintained and corridors had temperature gauges to ensure residents do not get too hot or cold. All bathrooms contained a range of equipment to support residents wider phyiscal needs and residents said thay felt the home is always kept clean and well The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 16 maintained. Comment cards completed by residents before the Inspection visit said the home is always clean and family carers commented on how consistently clean the home is. One family carer said; “Its the only home I would recommend with nursing care because it always smells so nice. Call bells are available for all residents and one bell tested was responded to quickly. Residents have the opportunity to have a telephone in their rooms and one resident said she found this really useful. During the Inspection visit the Inspector spoke to residents about how they felt regarding sharing rooms who said they are happy with the shared arrangements in place. The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are currently sufficient numbers of care staff available at the home with appropriate training and skills to meet the needs of residents safely. EVIDENCE: Residents said that they felt they receive good support from staff and that they felt safe when receiving care and support. During the Inspection visit the Manager said that there are sufficient staff levels in place to meet the current needs of residents but does recognise that some residents feel there are sometimes not enough staff available to provide quick responses to all calls for support. Comment cards provided by the Manager at the Inspection visit said that residents felt there are usually enough staff available to meet their needs. The Manager said she will use comments made by residents to continue to keep staffing under review and is looking to increase afternoon or night staff in the near future. Staff members told the Inspector about training and NVQ qualifications that they had either achieved or were being encouraged to undertake. One staff member said that staff meetings are held every three months and that pratice supervision is provided by the Manager in a structured way. Training and supervision information is available on staff files and Training undertaken by The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 18 staff includes first aid, Fire safety, moving and handling, record keeping, Infection control, adult protection and distance learning. Staff members all said their training needs are identified through support from the Manager and that there are a range of opportunities avalailable to ensure training needs are met. Staff files provided information to confirm that safe recruitment checks are in place and available. The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 31,33,35,36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well Managed and run in the best interests of residents. Residents health and safety needs are promoted and protected by the Manager and staff team. EVIDENCE: The home-owners continue to employ a well established registered Manager. The home proprieter also has an office at the home and is regularly available to talk to if needed. The Manager confirmed staff have access to supervision and team meetings and that she encourages all staff to undertake training in order to develop skills and contninue meeting residents changing needs. The Manager has a range of policies and procedures in place which are reviewed as needed and issues raised during previous Inspections have been addressed by the Manager. The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 20 The Manager provided details before the Inspection visit to confirm that all residents are encouraged to manage their own finances wherever possible. The Manager said “Relatives and residents handle all this and we are not privy to their arrangements”. Residents said they felt the Manager offered a good service and the Senior nurse described the staff arrangements in place to support the Manager in her role. Staff said the Manager is respected and family carers felt the home is managed well with residents best interests at the centre of its philosophy. The Manager said she regards residents and carers comments and contributions to the development of services as important and said she would be taking further action to encourage views to be expressed through the use of a regular questionairre to be incorporated within the homes monthly magazine. The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 3 X X X X X X 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 3 X 3 X 3 3 X 3 The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? NO. 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. Standard Regulation Requirement Timescale for action 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 It is recommended that the Manager regularly reviews the ratio of care staff to service users to ensure the staffing numbers available are appropriate to meet the assessed needs of all residents. The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 The Georgians Nursing Home DS0000002556.V288609.R01.S.doc Version 5.1 Page 24 - 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. 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