Inspection on 23/01/06 for Viera Gray House

This inspection was carried out on 23rd January 2006.

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

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

Other inspections for this house

Viera Gray House 08/10/08

Viera Gray House 09/07/07

Viera Gray House 12/07/06

Viera Gray House 26/07/05

Viera Gray House 24/02/05

Viera Gray House 25/08/04

Viera Gray House 17/02/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Viera Gray House 27 Ferry Road Barnes London SW13 9PP Lead Inspector Sandy Patrick Unannounced Inspection 23rd January 2006 10:30 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 Viera Gray House DS0000017396.V261197.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. Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Viera Gray House Address 27 Ferry Road Barnes London SW13 9PP 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 8748 4563 02087484560 Richmond upon Thames Churches Housing Trust Ms Elizabeth Wright Care Home 38 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (20), of places Physical disability over 65 years of age (20) Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th July 2005 Brief Description of the Service: Viera Gray is a purpose built care home accommodating up thirty-eight older people, including up to eighteen service users with dementia. The home opened in 1992. The home is owned and managed by Richmond upon Thames Churches Housing Trust. The home is divided into four units, each with a sitting and dining area and a small kitchenette. All bedrooms are for single occupancy and have en suite facilities. Each unit has their own bathroom, equipped with specialist mobility baths. There is an attractive and well maintained garden. The home is situated close to local shops and transport links. The Registered Persons have produced a Service User Guide, which includes information on the aims and objectives of the service. Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two days, the 23rd and 25th January 2006. The inspection was unannounced. The second visit was conducted by a Pharmacy Inspector. The report of their findings is detailed within Section 2 (Standard 9) of this report. The Inspection Team included one of the Commission for Social Care Inspection’s Directors. The Inspection Team met with the Registered Manager, other staff on duty, service users and some of their visitors. They were made welcome by all and were invited to join service users for their midday meal. Service users who spoke with the Inspection Team said that they were happy and well cared for at the home. At the last inspection of July 2005, comment cards were left with the Manager to be distributed to service users and their visitors. Three of these comment cards were returned after the completion of the last inspection report. Two were from service users and one was from a visitor. Both service users wrote that they liked living at the home, were well cared for and that their privacy was respected. They stated that they knew who to speak with if they were unhappy with any aspect of their care. The visitor said that they were made welcome at the home and that they were appropriately consulted about their relative’s care. They commented that they felt the service users would benefit from more outings and entertainment. Thirty-five service users were living at the home at the time of the inspection. What the service does well: Service users say that they are happy living at the home. Service users can remain as independent as they are able to, organising their own time and social activities. Visitors and family members are welcome at the home and are supported to continue with the care for service users if they wish. The home makes good use of a local advocacy organisation to consult with service users about their views of the service. Many of the staff have worked at the home for a long time and are familiar with service users’ needs. Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Viera Gray House DS0000017396.V261197.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 Viera Gray House DS0000017396.V261197.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): 1, 2, 3, 4 & 5 There is a range of information available to potential and new service users to inform them about services and facilities at the home. There is an appropriate procedure for assessment which aims to identify individual needs. Potential service users are able to visit the home and are admitted on a trial stay so that they can make an informed decision about whether they wish to live at the home. The home does not provide intermediate care. EVIDENCE: There is an appropriate Service User Guide and Statement of Purpose which have not changed since the last inspection. These are available to service users. The Manager reported that photographs of all staff had been taken and were being displayed in frames within individual units to help service users identify the staff who work with them. Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 9 All prospective service users are invited to visit the home and to join service users for a meal if they wish. Senior staff conduct assessments of need. Information from social workers and health care professionals are included as part of the assessment. The service user and their representatives give their views and information. Copies of assessments were seen. All service users are admitted on a six week trial stay period. At the end of this, service users, their representatives and representatives of the home meet to decide whether the placement is appropriate. Evidence of these review meetings were seen to be in place within service user records examined. Licence agreements include a description of the room and room number, the procedure for changes to fee arrangement and the procedure for termination of the agreement. Viera Gray House DS0000017396.V261197.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 Individual needs are recorded within care plans. Health care needs are appropriately recorded and monitored. Personal care needs of service users are either not being met or not being appropriately recorded in some cases. Arrangements for the ordering, recording, administration and selfadministration of medication by service users are in place to protect the health of service users. Staff have access to a pharmacist for advice. Omissions in recording were found that might have an impact on the health and welfare of the service users. EVIDENCE: Individual care plans are in place for all service users and include information on meeting a range of needs, including personal and health care needs. A sample of these were examined by the Inspection Team. Risk assessments are in place regarding manual handling, mobility and some other risks. Some of these were very basic and were really just a statement Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 11 rather than as assessment of risk. The Manager should make sure that there is a full assessment of each risk and that this is recorded. The records of baths in some service user plans were periodic. In one case as service user had not had a recorded bath since November 2005, and had only had two baths recorded in October. In another plan, a service user had last had a bath in December 2005. They had only two recorded baths for November and December. In one service user plan, there was a record to indicate that this person had consistently refused a bath. There was no indication that staff had taken action to find out why this was the case and how they could make the bath time experience more appealing for this person. Records indicated that some female service users had been given baths by male carers. All service users must be offered the opportunity to choose same gender carers. These choices must be recorded in all service user plans and must be respected. Health needs are recorded and monitored within care plans. All service users are registered with local GPs and see other health care professionals as required. All medications in the office, and records relating to receipt, storage, administration and disposal of medication were examined. The deputy manager and the person in charge of each unit were interviewed. All medication not supplied in the monitored dosage system was counted and compared to the receipt and administration records and the communication book checked to ensure service users were receiving medication as prescribed. From these observations and discussions service users are encouraged to maintain control of their medication in a safe manner. From the records and medication currently in stock one resident had been signed as being given medication when the medication had not been given. There had been concerns about the health of the resident that could be due to omission of the medication. It was not clear whether the medication had been given or not. The refusal and non-administration of all medication had been recorded clearly. The date of change of dose of medication had not been recorded clearly for one resident. Information was available in the office detailing the change. All other alterations and discontinuations had been recorded clearly in accordance with prescribers’ directions. Written guidelines for the use of one sedative medication prescribed when needed were not seen. The issue with the client’s behaviour had been identified in the care plan and the staff on duty demonstrated knowledge of when and how to give the medication. Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 12 Regular audits of medication and records are not currently preformed in the home. The allergy section on the administration record was not completed for any residents. The date of receipt and signature of the person checking in the medication was not recorded for all medication ordered on a monthly basis. All other records indicated that medication had been administered as prescribed unless other wise directed and arrangements are in place to ensure service users are administered their medication in a safe and appropriate manner by trained care staff. Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 & 15 A small amount of planned activities take place at the home, however there needs to be improvements to the way in which activities are planned and facilitated and individual needs are identified and met. The home should look at ways to work towards a more person centred approach. There have been improvements to consultation, food preparation and choice since the employment of a new cook. Further work to make sure that staff support service users appropriately during mealtimes needs to take place. EVIDENCE: There is a programme of one planned activity each day, which is facilitated by staff on duty. Attendance and participation of these can be low. There is no Activities Officer employed to oversee and plan activities. The home caters for a range of needs and this diversity means that organising activities to suit all may not be possible or appropriate. Quality monitoring at the home has identified that some service users are dissatisfied with activities. The Manager organised for all service users and their families to provide information on their life histories and preferred social activities. The home has received information from most families. This information should be used to Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 14 support staff to have a better understanding of individual needs and wishes and should supported planning of activities to meet these needs. Some service users who reported that they generally organised their own activities, were happy that they could access the local community and participate in social groups of their choosing. Monthly visits from entertainers and musicians are organised and are open to all service users. Further work to promote meaningful activities which meet the needs of the service users needs to take place. The Manager should organise for the information supplied by service users and their families to be used to help develop activities which suit individual needs and wishes. A seasonal news letter is offered to all service users and displayed on notice boards. This fives information on activities and staff and service user ‘news’. Service user meetings are held regularly. The Inspector saw that the cook had attended the most recent meeting to discuss menus. Service users were also given information on health and safety, activities, staffing and the building. Service users were able to contribute. The list of organised activities was on display on the staff notice board within units but not advertised to service users. Neither was a menu, indicating the days choices, available for service users to see. The Manager reported that all service users were given a copy of the 4 weekly menu and activity programme within the newsletter. However, some service users may not have kept this and it may be difficult for service users to understand what the choices for each particular day are. The Manager should consider how best service users can be given information on menu choices and activities in a useful and meaningful way. Staff on duty told the Inspection Team that they keyworked service users from different units. They said that they did not regularly work in some of these units. They described some of their keywork responsibilities as buying toiletries and checking clothes. They felt that the system had advantages, but the Inspection Team saw some disadvantages to this way of working. For example one service user file indicated that they had consistently refused a bath or shower. However, there had been no reassessment of their need, change to their care plan or any indication that action had been taken to look at why this was the case and how best the service user could be supported to meet their personal hygiene needs. The keyworker who did not work on the unit may not have been aware of this information. As they did not work directly with the service user, they may not have the skills and knowledge to offer the best support for finding a solution to this problem. If keyworkers do not regularly work with service users, they cannot know their needs well. The keyworking system should be useful for service users and their families. Service users should feel able to trust and be familiar with their keyworker. Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 15 The Inspection Team spent some time on each of the different units. On one unit, six service users spent time sitting in silence. The television was on, but none of the service users showed any interest in this. Staff on duty did not speak to the service users or offer them any alternative activities. In another unit the radio was on a pop music station and service users within the unit did not appear to have chosen this. One service user spoke to the Inspector about their love of music and they were clearly very knowledgeable about this. As they spoke it became clear that they had some experience of playing a musical instrument or singing in a choir. However, their service user plan made no mention of this. The Inspector is concerned that if staff do not take time to find out this level of detail about individual lives and look at ways in which individual skills, interests and experiences can be valued in the home, then service users are not having their needs met. Where television and radio stations are turned on but service users are not interested then staff are not thinking about the needs of service users. The life histories given by service users and families could be a useful tool to help staff to understand individual needs but there needs to be a committed person centred approach. At one point a service user who was walking about the unit went into a kitchenette to look out of a window. Staff told the service user to leave and to sit down. The service user questioned this and said that they were not doing anything wrong. There were no obvious dangers in the kitchen and the several staff were available in the unit. The Inspector could not understand why the service user was being asked to leave the kitchen area. When they did leave, the staff continued to insist the service users sat down. There was no reason for this and the service user made it clear that they did not wish to. The Inspector is concerned about this. Although the staff did not feel they were being unkind and clearly felt that they were doing the right thing, it is concerning that they took this approach and did not see that they were unfairly and unnecessarily restricting the rights of a service user. Service users have the right to wander through the home and they also have the right to take risks, as long as these have been appropriately assessed. Telling a service user to sit down, when they do not wish to, is not acceptable. Since the last inspection, a new cook has been employed. The Manager said that the new cook had been very good at consulting with service users about the menu and their enjoyment of the food. The cook visits each unit after lunchtime meals to speak with service users and check the contents of the kitchenettes on the units. The cook is training all staff on table laying and the presentation of meals in February. On the day of the inspection the cook was not on duty. The Inspection Team was invited to join service users for their midday meal. This was tasty and was enjoyed by all. During the mealtime, staff were attentive to service users and clearly wanted to do their best to support them. However, the Inspector saw examples of bad practice and was concerned that staff were unaware that what they were doing Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 16 was not appropriate. For some of the meal, staff stood over service users and tried to feed them. Their approach was not consistent and they walked away and returned several times. In one instance they did not listen to a service user who told them that they had a mouthful and were still eating. The staff member continued to hold a fork of food close to the service user’s mouth waiting for them to take it. One service user appeared able to feed themselves, although this took time. A staff member did not ask them whether they wanted help, but started to try to feed them. The service user did not appear to want this help and commented that they were managing. This was ignored. The Inspector saw staff members reach across service users’ plates. Staff members also drew attention to food that had been dropped by a service user, telling them and the Inspector that they were very messy. All service users were offered the same drink and there was no alternative. The Inspector noted that at least two different types of squash were available on the unit, although service users were not made aware of this. One service user was clearly finding their meal difficult to eat using a regular fork and plate. The Manager must arrange for assessments to be carried out to make sure that all service users are offered necessary equipment to maintain independence and to make it easier for them. Some service users were dressed in plastic aprons. This is inappropriate and service users should be offered a choice. If they do not wish to wear aprons they must not be made to. Alternative aprons/protection must be used where service users have expressed a wish for this. Service users’ opinions, or the wishes of their families if they cannot give their own consent, must be recorded. Following the midday meal, service users were not offered a hot drink. Although service users are able to request hot drinks, it would be good practice to make sure all service users were offered this following meals. Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18 There is an appropriate complaints procedure, which is accessible to service users. All service users have a representative external to the home. Procedures designed to protect service users are in place. EVIDENCE: There is an appropriate complaints procedure, including time scales and reference to the Commission for Social Care Inspection. Copies of the procedure are available within the Service User Guide and on communal notice boards. There is a record of complaints and how these have been dealt with appropriately. The Manager is good at keeping the CSCI informed of complaints and action taken. There is a record of compliments and thank you cards from service users and their relatives. All service users have representatives external to the home. There is a range of information on advocacy services available to service users. A local advocacy group visit the home annually and consult with service users about their experiences of living at the home. The home has adopted the London Borough of Richmond Protection of Vulnerable Adults Procedure. Richmond Upon Thames Churches Housing Trust have their own procedures on abuse and whistle blowing. The Inspector saw evidence that all staff had attended or were due to attend training in protection of vulnerable adults. Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 18 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, 20, 21, 22, 23, 24, 25 & 26 The environment is suitable and appropriately maintained. Individual and communal space are adequate and are appropriately decorated, furnished and equipped. EVIDENCE: The home is a purpose built, two storey building in a residential road. The home is set in attractive grounds. The building is well maintained and decorated and is appropriately furnished throughout. The home is divided into four units, each with their own facilities. The building remains in a good state of repair. The Manager reported that the Maintenance worker attends to all minor repairs. Stained and worn carpets would benefit from replacement. There is a bathroom, with a specialist mobility bath, available in each unit at the home. There are no shower facilities allocated to service users. The Manager reported that service users are able to access the staff shower upon Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 19 request. The Registered Person should consider whether shower facilities can be provided so that service users do not have to request use of the staff shower. The premises are suitably equipped with adaptations and equipment throughout. A passenger lift accesses all floors. All rooms are equipped with call alarm systems. Corridors and bathrooms are equipped with grab rails. The home was appropriately heated and ventilated throughout. All hot water outlets had been appropriately equipped with temperature control valves. Water temperatures are checked and recorded weekly. Appropriate checks have been made on gas and electrical equipment and wiring. The home was clean throughout on the day of the inspection. Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 20 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 & 30 There are appropriate procedures for the recruitment, induction and support of staff. Staff attend a range of training opportunities, but need further training and information in order to provide a specialist service for those who have dementia and meaningful activities. EVIDENCE: There is a good range of information for staff on their roles and responsibilities and the day-to-day running of the home. All staff have job descriptions. There is a clear management structure. Staff who spoke with the Inspectors said that they were well supported. There was one senior and five other staff vacancies at the time of the inspection. Three members of staff had been recruited and the Manager was awaiting the return of checks before they commenced work. The Inspector saw the information relating to the recruitment of these staff, including interview records. Appropriate checks had been, or were being, made on these staff. The Manager same regular feels staffing placement at Viera Gray House reported that some of the vacancies had been covered by the agency staff and staff overtime. The Manager reported that she levels at the home are suitable. A Social Work student was on the home at the time of the inspection and had assisted senior DS0000017396.V261197.R01.S.doc Version 5.1 Page 21 staff. Staffing levels must be kept under review, giving particular attention to the provision of activities. The staff files which were seen were complete. They contained recruitment records and also evidence of induction, supervision and appraisal. The organisation experienced problems with NVQ training providers in the past. The home now use a new provider and staff who are undertaking the qualification seem happy with the support that they receive. The Manager reported that all keyworkers and the majority of general care assistants have NVQ Level 2. Staff who do not have the qualification will be commencing this during the year. There is a good range of training opportunities for staff and evidence that staff have undertaken different courses. Most staff have attended a one day training session in dementia. Four staff have additionally attended a training in activity provision. These are areas where staff need further training and information. The Manager should also consider person centred training for staff. Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 22 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, 32, 36 & 38 The home is appropriately managed and the management approach is open and inclusive. Checks on health and safety are made and recorded. EVIDENCE: The Manager has worked at the home for seven years and worked at other Richmond Upon Thames Churches Housing Trust services before this. She is qualified to NVQ Level 4 and is an NVQ Assessor. The staff reported that they are well supported and that the Manager is accessible. There is evidence that staff receive regular supervision from their line managers. Team and general staff meetings are organised. There is a handover of information between each shift. Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 23 There is evidence of regular checks on health and safety of equipment and the environment, including fire checks. Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 24 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 3 X 3 Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 25 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 OP9 Regulation 13(2) The Requirement Registered Person Timescale for action must: 01/03/06 1. Investigate whether the resident had been given their medication as prescribed or not and take appropriate action. Send a report of the investigation to the CSCI office. 3rd February 2006. 1. Make sure that the receipt of all medication is recorded appropriately. 1st March 2006. 2. Make sure that the allergy section on the administration record is completed for all residents. 1st March 2006. 3. Make sure that changes of dosage are clearly recorded on the administration record for all medication. 1st March 2006. 4. Make sure that there are clear written guidelines for the use of sedative medication prescribed when needed. 1st March 2006. Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 26 2. OP10 12(1) The Registered Person must 31/03/06 make sure that service users are able to bathe whenever they wish and that this is recorded. Previous Requirement 31/08/05 The Registered Person must make sure all service users are offered the choice for same gender carers for personal care. This choice must be recorded within service user plans. 3. OP12 16(2)m&n The Registered Person must 31/05/06 make sure that the activity programme offers a choice of stimulating activities meeting individual and group needs. Activity participation and enjoyment should be recorded, to support continued development of this service. Previous requirement 30/09/05 4. OP14 12 The Registered Person must 31/08/06 consider ways in which a more person centred approach can be introduced to the home so that different individual needs can be identified and met. The Registered Person must 31/03/06 make sure staff do not restrict the rights of service users. The Registered Person must: 1. Make sure service users are offered a choice of drinks during and following DS0000017396.V261197.R01.S.doc Version 5.1 Page 27 5. OP14 12 6. OP15 12 16(2)i 31/03/06 Viera Gray House meals. 2. Make sure there are assessments for service users who need specialist equipment to help them to eat. 3. Make sure staff support service users appropriately during mealtimes. 4. Consult with service users or their representatives) to ask whether they wish to wear aprons during meal times. Their choices should be recorded. Plastic aprons must not be used. 7. OP30 18(1)(c) The Registered Person must 31/08/06 make sure that staff a range of training opportunities so that they can better understand the needs of people with dementia and in relation to activity provision. Previous requirement 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations It is strongly recommended that a formal system of audit be introduced to monitor the safe handling and administration of medication. Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 28 2. OP12 The Registered Person should consider employing an Activities Officer to oversee and co-ordinate activity provision at the home. The Registered Person should consider how best to inform service users of their menu and activity choices on a daily basis. The Registered Person should consider whether it is appropriate for service users to have allocated keyworkers who do not work directly with them. The Registered Person should consider the replacement of badly stained and worn carpets. The Registered Person should consider whether shower facilities can be provided for service users. The Registered Person should consider organising for person centred training for staff. 3. OP14 4. OP14 5. OP19 6. OP21 7. OP30 Viera Gray House DS0000017396.V261197.R01.S.doc Version 5.1 Page 29 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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