Care Home: George Potter House

What the care home does well One health care professional who visits the service commented that: "...I am confident that care staff at George Potter House have a genuine passion for helping others...". Two relatives of people who use the service said: "...my mother is taken very good care of..." and "..we are very happy with the care Mum gets...". One person who uses the service told us that: "...the home is nicely run, staff are very good and do their best to keep everyone happy...". This demonstrates that the service benefits from a committed staff team who demonstrate a genuine caring approach towards the people who use the service. What has improved since the last inspection? At the previous inspection there had been seven areas where the home had to improve. The home has taken action on all of these areas, which represents a positive response to the findings of previous inspection, and good developments to the service. In particular, the home has improved record-keeping and made improvements to the environment and staff training. What the care home could do better: Areas where the home could be doing better are highlighted in the report and were discussed with the manager during the inspection. These include improvements to the handling of monies that people who use the service hold at the home, and ensuring that full recruitment information is obtained prior to staff starting work at the home. Some improvements are also needed in the decor around the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: George Potter House 130 Battersea High Street Battersea London SW11 3JR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Louise Phillips     Date: 1 4 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: George Potter House 130 Battersea High Street Battersea London SW11 3JR 02072233224 02072236984 georgepottercare@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Sovereign (George Potter) Ltd care home 69 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Distribution of Staff The number and distribution of nurses care staff and ancillary staff must be reviewed at regular intervals. If at any time the evidence indicates that there is insufficient staff of any categories available to meet the assessed needs of service users, the NCSC will require additional; staffing as appropriate. Exception to age of one service user Agreement is given for the home to continue caring for the service user currently resident in the home who is aged 39. However, an urgent review must take place by the 30/09/03 to look at her needs, as this home is not suitable for this service user long term. The service user has a mental health problem as well as a mild learning difficulty. From the assessment made at the time of placement it is not clear why this home was deemed suitable for her. Reviews The organisation must ensure that the above minimum staffing levels remain under review and that at all times suitably qualified, competent and experienced persons are working in the home in such numbers as are appropriate for the health and Care Homes for Older People Page 4 of 25 Over 65 0 36 33 0 welfare of service users. Staffing Levels No of Service Users 8am ? 2pm 2-8pm 8pm-8am TN CA TN CA TN CA 51-55 3 8 3 7 2 3 56-60 3 9 3 8 2 4 61-65 3 10 3 9 2 5 66-69 4 10 4 9 2 5 Date of last inspection Brief description of the care home George Potter House is registered to provide accommodation and nursing care for sixty-nine older people. This may include thirty-three individuals with dementia. The home is privately owned by Sovereign (George Potter Ltd) and is situated in Battersea, within easy reach of local shops and Clapham Junction train station. Accommodation is provided over two floors serviced by a lift. The first floor unit is for residents with dementia. Information about the home is provided to residents in a written guide. The current range of fees are between #700 and #800 per week. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place over one day by one Regulatory Inspector. We spent time viewing care records and relevant paperwork held at the service. A tour of the premises was carried out on the ground floor only. Information has been gained from the inspection record for the home and the Annual Quality Assurance Assessment (AQAA), that the manager completed prior to our visit. We also received surveys from four people who use the service, two staff and three health and social care professionals involved with the service. In addition, we received a letter from a relative of a person who uses the service. The responses received are referred to in the report. During the inspection we met with the new manager of the service and the Director of Nursing for the organisation. In the report, where it refers to the manager, this also includes responses from the Director of Nursing. Time was spent talking to five staff and two people who use the service. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are appropriately assessed prior to moving to the home. Evidence: Prospective residents to George Potter House are appropriately assessed to ensure that the service is able to meet their needs. The manager and deputy manager are involved in assessing them, using the homes own assessment format that provides good information about the persons social and medical history, personal care issues, and any mobilising needs. At the start of the assessment process the service receives needs assessments and care plans from the local authority and this is used to inform the homes own assessment. As part of the assessment process potential users of the service are invited to visit the home to meet staff, people who use the service and look at the environment. People move in for an initial trial period of six weeks. Prior to the end of the six weeks Care Homes for Older People Page 9 of 25 Evidence: a review meeting is held between the person using the service, their relative, social worker and manager of the home to review their stay and for the person to decide if they want to stay. Intermediate care is not provided at the service. Care Homes for Older People Page 10 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use service feel they get good care, and the care planning ensures that their needs are met. Positive improvements have been made to audit the medication system at the service. Evidence: The responses to the surveys provide a valuable insight into the experience of people who use the service at George Potter House, along with the observations of their relatives. Responses from people who use the service are that they feel they get good care and support from the staff, that this is delivered with kindness and respect to their privacy and dignity. One person who uses the service said that they do not like that some staff do not speak English when they are around. Two staff also said that some staff speak in their native language where other staff, and people who use the service do not understand what they are saying. Relatives told us that they are kept informed about relevant events affecting their relative, and are encouraged by the service to be involved in their relatives care Care Homes for Older People Page 11 of 25 Evidence: Survey responses from staff reflect that they care about the people who use the service and are kept up-to-date about any changes to their needs. Feedback from health and social care professionals is that they feel the staff work hard and treat people who use the service with respect. One professional commented about the ...geninue care...the staff team are very gentle and do their best to provide caring environment..., whilst another said ...they have great respect for older people.... All the health and social care professionals who responded to our survey said that the staff have a good understanding of the history and needs of each person who uses the service. When we asked the health and social care professionals what could be improved about the home, one commented that although staff have received training in dementia care, they observed that some use inappropriate language when dealing with people who use the service, where they gave the examples of staff saying dont be naughty or thats silly. The care plans for a number of people who use the service were looked at during the inspection. They contain individualised information around areas such as communication needs, specific preferences around personal care, likes and dislikes, mobilising, and preferred times of sleeping. The care files are well-maintained, with records to demonstrate that appropriate assessment and reviews are carried out around risks such as moving and handling, continence and environmental hazards. Relatives and people who use the service have signed consent forms for the use of bed rails, where necessary. The manager said that all staff have had received training in care planning and that this had helped to improve the record-keeping at the service. We observed that the content of the daily records about each person has improved, and creates a better picture as to how each person has spent their day. People who use the service said that they are able to access the chiropodist, doctor or dentist when they need to, and that they feel their medical needs are met. Records are maintained of all appointments and visits by health and social care professionals to the service. The manager said that he carries out a monthly audit of the medication system on each unit and where errors are identified addresses this with relevant staff. The copy of recent audits were seen and shown to identify a number of discrepancies, however, some of these occurring for two consecutive months. It is recommended that the audits take place weekly to ensure that discrepancies Care Homes for Older People Page 12 of 25 Evidence: identified are managed promptly for the safety of people who use the service. We checked the medication system on one unit at the service, and a sample of medication records for some people who use the service. Appropriate records were maintained, including details of any allergies and a photograph of the person receiving the medication. A medication audit trail is also maintained to record stock ordered, received and disposed of. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have the opportunity to be involved in activities. People enjoy the meals provided at the home. Evidence: There is one full-time activity co-ordinator who plans and provides activities at the home. The manager explained that she is new to the position, due to the previous activity co-ordinator having left. An activity programme has been developed for the service for the year and includes trips out and a number of in-house activities, such as reminiscence and gardening. A new form has been developed to record what activity each person has been involved in throughout the day. Health and social care professionals said that people who use the service are supported to live the life they choose and that the service responds to diverse needs. People who use the service said that there are usually always some activities that they can get involved in. People who use the service also told us that they generally like the food provided by the home. However, one person did say that mealtimes are often disrupted where some people who use the service shout constantly through this. Where this happens in other homes, they have managed this by having different meal sitting times, which satisfies all parties, and it is recommended this is introduced at the service. Care Homes for Older People Page 14 of 25 Evidence: We spoke to the chef who said that he is aware of the dietary needs of each person who uses the service, and he showed us the records of each person nutritional plan. He said that the menus are provided following a four weekly menu. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to minimise risks to people who use the service. Evidence: The service has a complaints procedure that is displayed around the home. Feedback from most people who use the service is that they know how to make a complaint if there was something they were not happy about, however some people said that they do not know how to do this. Survey responses from staff demonstrated that they have a good awareness of how to deal with a complaint should they be approached, where they feedback that they would refer to the complaint procedure and direct the complainant to more senior staff in the service. The home has a complaints log to record any complaints received. Since the last inspection two complaints were received by the Commission and sent to the organisation to investigate, which they responded to appropriately. Records indicate that staff receive training in safeguarding adults, and the home holds copies of relevant local authority safeguarding procedures. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is welcoming and relaxed. The staff help create a calm atmosphere throughout the home. The decor and furnishings are good in most areas, though some improvements are needed to make the home more comfortable for people who use the service. Evidence: People who use the service at George Potter House comment that the home is fresh and clean. Staff also say that the environment is well-maintained and that there is appropriate equipment such as hoists to enable them to do their work. Since the last inspection the curtains in the lounge areas have been replaced, with new carpet also installed in the lounge and some new furniture. The rotting windows identified at the last inspection have also all been replaced, making the home much more comfortable for the people who live there. The ceilings in the ground floor hallways were seen to be damaged in areas and the manager said that these are planned to be replaced. The kitchen was also seen to be scruffy in areas, particularly the flooring which is patched up in areas and a potential health and safety risk. Care Homes for Older People Page 17 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service generally carries out appropriate recruitment procedures to minimise risks to people who use the service. Staff receive training to enhance their skills and knowledge to meet the needs of people who use the service. Evidence: George Potter House has a consistent staff team, some whom have worked at the home for a number of years, and who have a good understanding of the needs of the people who use the service. People who use the service were very positive about the staff at the home, with comments received such as: ...attitude of staff to residents is excellent and helpful..., ...good cheerful rapport between nurses and carers which makes for a pleasant and relaxed atmosphere.... One relative also said that the staff are ...nice and respectful to the residents.... One staff member stated ...the residents like it here and the staff like it here.... The people who use the service also told us that there are generally always staff available when they want them. However, one person did say that they would like to see more trained staff on duty, as did two professionals who responded to our survey. The manager said that the home has a full complement of staff, and since our survey Care Homes for Older People Page 18 of 25 Evidence: (May 2009) the home has recruited more staff and added additional staff to each day shift. During the inspection two staff members confirmed that there had been a recent increase in staffing levels, which they said they appreciate. The home holds recruitment information on each member of staff. The staff files contain relevant information such as proof of identification, correspondence relating to offer of job, Criminal Records Bureau (CRB) check, two references and record of the interview of staff. One file was found to only contain one reference for a staff member working at the service, and a requirement has been made to ensure that all appropriate recruitment information is obtained for all staff prior to their starting work. In some case the CRB checks for some staff were found to be four or five years old, and it is recommended that these are carried out approximately every three years. Staff said that they felt their recruitment was fair, with one saying that the team are diversely balanced regarding different races. However, as highlighted earlier in the report staff did say that sometimes staff speak to each other in their native language during working hours, making them feel left out. All new staff receive an induction to the service which covers areas such as the service policies, health and safety, moving and handling and introduction to the staff and people who use the service. New staff also shadow more experienced staff for the first week of their work. Staff who responded to the survey said that they feel the induction prepared them well for their role at the home. The staff said that they get enough training to support them, and that they have the right experience and knowledge to meet peoples needs. Training records indicate that staff have training in moving and handling, infection control, fire safety, basic food hygiene and heath and safety. A number of care staff have achieved their NVQ level 2 in Care. Care Homes for Older People Page 19 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the interests of the people who use the service. The service must ensure that appropriate records are maintained of all transactions regarding the monies held for people who use the service. Evidence: Since the last inspection the manager of the home for a years left and a new manager is in post. The new manager has worked in a number of previous care settings and is appropriately qualified for his position. We met with him during the inspection and he said that he gets good support from the organisation and his line manager, and attends regular meetings with other managers in the organisation. Within the home he is supported by a deputy manager, who has also just joined the service, and a staff team, of whom most have worked at the home for a number of years. He showed evidence that he is in the process of applying to the Commission to become the Registered Manager for the service. Care Homes for Older People Page 20 of 25 Evidence: The manager described that the service carries out quality assurance through regular audits and health and safety checks. He said they also have regular meetings with staff and relatives. Visits by the Responsible Person are carried out monthly, and a report maintained of these. The home holds a personal allowance for a number of people who use the service, which is funded by themselves, their family or through social services payments. This money is used for when the person wants to go shopping or use the hairdresser, etc. The records of these transactions were not able to be inspected properly during the inspection as there were no records of individual monies held, or of transactions that had taken place. There was a total only of the sum of all peoples monies held. We were informed that all the money is held in one bank account. Since the inspection we have received information from the manager that the account to which all the are held is non-interest bearing, and a breakdown has been given of each persons actual amount of money held. In a letter accompanying this information the manager stated that ...all residents will now have individual spreadsheets for the breakdown of their personal allowances, and can be access(ed) on request in the home.... As we were unable to properly inspect this area during the inspection, a requirement has been made to ensure that accurate records are maintained of each persons money held at the service, of all transactions and the receipts maintained to evidence this. Since the last inspection improvements have been made to the individual supervision of staff at the service, where records indicate that staff receive this approximately six times a year. Staff we spoke to said that they feel well supported in their role and that their work is enhanced by the training they receive. The service maintains records to demonstrate that appropriate health and safety checks are carried out on the fire system and equipment, electrical installation, gas safety and Legionella testing, etc. Care Homes for Older People Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 26 23 The service must ensure all areas of the home are kept in good state of repair. So that the home is comfortable and safe for the people who live there 04/01/2010 2 29 19 The service must ensure that all required recruitment information is obtained prior to staff starting work at the home. To ensure risks to people who use the service are minimised by thorough recruitment processes. 04/09/2009 3 35 16 The service must ensure that accurate records are maintained of all peoples monies held at the home, of all transactions and receipts maintained to evidence this. 04/09/2009 Care Homes for Older People Page 23 of 25 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action To assure people who use the service that their monies are being appropriately managed. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 It is recommended that the medication audits take place weekly to ensure that discrepancies identified are managed promptly for the safety of people who use the service. The service should ensure that at all times staff do not speak in their native language, to demonstrate respect for the people who use and work at the service. It is recommended having different meal sitting times, to give people who use the service the option of having their meals in relaxed surroundings. The CRB check for each member of staff should be re-new at least every three years, to minimise risks to people who use the service. 2 10 3 15 4 29 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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