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Inspection on 06/05/05 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 6th May 2005.

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 is well run and staff are supported by a range of policies and procedures to follow. Staff receive regular training and supervision which enables them to offer a service of a high standard. The home offers a homely environment, with a relative commenting that the home was `scrupulously clean` with `superb, considerate and caring staff`. The social and individual needs of residents are seen as important and a range of activities, both individual and group is provided.

What has improved since the last inspection?

Care plans are now reviewed on a regular basis. A new walk in bathroom has been provided on the ground floor for the benefit of residents who prefer a shower. Locks are provided on doors to residents` rooms with a key when requested.

What the care home could do better:

Fire bells must be tested on a weekly basis as recommended by the fire authority and regular checks must be made on the nurse call bell system to ensure that residents calling for assistance receive a response from staff on duty.

CARE HOMES FOR OLDER PEOPLE The Georgians Nursing Home 50 Wide Bargate Boston Lincolnshire PE21 6RY Lead Inspector Jean Cope Unannounced 6 May 2005 09.00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Georgians Nursing Home Address 50 Wide Bargate Boston Lincolnshire PE21 6RY 01205 364111 01205 311417 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Georgians (Boston) Limited Mrs Patricia Cope Care Home 48 Category(ies) of OP (Older Person) - 47 registration, with number PD (Physical Disability) - 1 of places The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered to provide nursing and personal care for service users of both sexes whose primary needs fall within the following categories: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. Date of last inspection 24.01.05 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 service users is available on both the ground and first floor. Rooms on the first floor are served by a shaft lift and a stair lift. The home has 24 single rooms and 12 double rooms. There is a regular bus and train service in Boston. The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a three day period and the inspector was assisted by a fire officer on the second day. The inspector toured the building and spoke with residents, relatives and staff. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care that they receive through observation of care practices, checking of their records and discussion with them. What the service does well: What has improved since the last inspection? Care plans are now reviewed on a regular basis. A new walk in bathroom has been provided on the ground floor for the benefit of residents who prefer a shower. Locks are provided on doors to residents’ rooms with a key when requested. The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4, and 5. Written information is available for new residents and their relatives to advise them what services and facilities are available in the home with residents being clear about what services they are paying for. Residents’ are only admitted if the manager and senior staff are sure that their needs can be met. EVIDENCE: The home has a statement of purpose and a service users’ guide which is provided in each of the resident’s rooms. Terms and conditions are provided for residents on admission to the home with visiting relatives confirming that their parents had received terms and conditions and signed them. They also said that the manager of the home had visited their relative in another home to undertake an assessment and had confirmed that The Georgians was able to meet their needs. New residents and their relatives are encouraged to look around the home before deciding to move into the home. One visitor commented that her relative’s needs were met and that she was ‘treated as a individual person and not as a child’. The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9, 10 and 11 The staff team have a caring and gentle attitude towards residents and their privacy and dignity is respected in a variety of ways especially at the end of their lives. Comprehensive care and nursing plans are provided for residents ensuring that residents’ health, personal and social care needs are attended to. Systems are in place to ensure the safe storage, recording and administration of medications. EVIDENCE: Each resident has a care plan which is regularly reviewed. Care plans were found to be accurate and included the health, social and personal preferences of individuals. Visitors confirmed that they had been involved with their relatives in compiling care plans which are kept in the resident’s own room. Medicines are kept locked and only staff who have been trained to give medicines do so. One relative said that the staff had asked for a review of her relative’s medication when moving into the home from another home. She said that she was ‘so pleased that this was done and she got her personality back’. Staff were seen to be talking to residents in a gentle and caring way and ensured that the resident’s privacy was respected. Two relatives confirmed that their relative’s dignity had always been promoted through ensuring that The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 Page 10 their relative was always nicely dressed and that the bed linen always looking ‘beautiful and pretty’. They also confirmed that the care given to their relative at the end of her life, was, ‘superb, kind, caring and considerate’, and that they were always well informed and supported themselves by the staff. The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 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 standard(s) 12, 13 and 15 The importance of providing activities for residents in the home is taken seriously and residents are able to make a choice about activities they become involved in. Residents are still able to have control over their lives. EVIDENCE: Friends and relatives were visiting the home and said that they were made to feel welcome and well informed. An activities co-ordinator is employed to work with residents on a daily basis to assist them with their social activities. A record is kept on residents’ individual choices on how they like to spend their time and what they prefer to do. A small mobile shopping trolley has been introduced where residents can purchase their own toiletries, personal items and sweets and biscuits, which has proved to be very popular. There are regular church services held in the home with a relative saying that she felt her mother’s spiritual needs were also met by the ‘human kindness showed by the staff’. The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 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 standard(s) 16, 17 and 18 Complaints are recorded and responded to appropriately and residents are cared for by staff who are able to respond if they believe that residents may be put at risk of abuse or harm. EVIDENCE: The home has received one complaint since the last inspection, which was dealt with within 28 days. Residents were able to use a postal vote at the recent election and staff receive training on how to recognise and prevent adult abuse; two staff on duty confirmed this. The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 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 standard(s) 19, 20, 22, 23, 24, 25 and 26. The home provides a welcoming, comfortable, clean and homely environment with an on going maintenance programme, but residents’ safety could be put at risk if the call bell system is not maintained. There are sufficient aids and adaptations to maintain residents’ independence. EVIDENCE: The home was cleaned to a high standard throughout and was odour free. It is well maintained with an on going programme of decorating and refurbishing. Relatives described the home as always being ‘scrupulously clean’. Residents are able to bring into their own room, their own personal belongings, including small items of furniture. The home provides a range of aids to assist the more frail residents when necessary; these include specialist beds, hoists and specialist baths. A new walk in shower has been installed which staff said was popular with the residents. On the first day of the inspection on two occasions the bleepers held by the staff did not pick up two different call bells requesting assistance. On the third The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 Page 14 day of the inspection, the manager said that all batteries had been replaced in the bleepers. The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 29 and 30 Residents and their relatives feel that competent, caring and considerate and well trained staff are meeting their needs. The manager ensures that staff are recruited safely and that all staff have been checked by the Criminal Records Bureau in order to protect residents. EVIDENCE: A trained nurse is always on duty in home on a 24 hour basis. There are usually two trained nurses on duty in the morning assisted by eight carers which reduces to one trained nurse and six carers in the afternoon and evening. Many positive comments were received about the ‘lovely’, ‘very, very kind staff’, ‘superb, kind, caring and considerate staff’. Staff are recruited safely and are provided with an induction training. Eight training courses have been organised for staff in the forthcoming year, and opportunities are offered, when available, for care staff to enrol on a National Vocational Course (2) in caring. The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35, 36, 37 and 38. The home is well managed and run in the best interests of residents living in the home, however there is potential risk to residents and staff if fire systems are not checked as recommended by the fire authority. EVIDENCE: The home has a registered manager who continues to update her skills and knowledge in relation to caring for older people. Staff are regularly supervised and their views sought on how to improve the services provided in the home. An internationally accepted quality assurance method has been adopted by the manager, which is reviewed annually. There are arrangements for the safe keeping of residents’ monies and when money changes hands, receipts are kept and recorded. It was evident that staff on duty on the first day of the inspection had not heard the fire alarm being sounded on a weekly basis recently. A fire officer The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 Page 17 also visited the home on the second day of the inspection and made some recommendations, which had been followed up on the third day of the inspection. The home has a range of policies and procedures for staff to follow which are kept in the nursing office and the manager’s office. The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 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 x 15 3 COMPLAINTS AND PROTECTION 3 3 x 2 3 3 3 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 Standard No 16 17 18 Score 3 3 3 3 x 3 x 3 3 3 2 The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 Page 19 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 OP22 Regulation 23(2) Requirement Equipment provided at the care care home must be kept in good order. Regular checks or a mainentance check must be made to ensure that staff are able to respond to all call bells when residents need assistance. The fire bells must be checked on a weekly basis from different call points and fire panels must be serviced annually by an approved contractor Timescale for action Immediate 2. OP38 23(4) Immediate 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 OP28 Good Practice Recommendations 50 of care staff working in the home must achieve National Vocational Qualification Level 2 by 2005. The Georgians Nursing Home C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Unity House, The Point Weaver 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 C53 C04 S2556 The Georgians V225578 Stage 4.doc Version 1.30 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. 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