Care Home: Gerald House

What the care home does well People that use services have important information gathered about their needs before they move into the home so they can decide if the home can meet their needs. Staff were aware of the needs of people that use services and how to meet them. People that use services spoke positively about the standards of care provided at the home. When asked about the care they receive from staff, people that use services said, "I trust the staff I can talk to them. I feel safe, protected and secure here. I have never felt so at home". Another person using the service said, " The staff are nice they always have time to sit and talk to you or join in activities. They are friendly girls". People that use services are able to decide their own routines and make choices about how they spend their day. People that use services know how to complain and would feel comfortable about doing so. This means that they are able to make their views known and protects their rights. People that use services benefit from staff being encouraged to complete a qualification in care so they have more knowledge and understanding of their needs. Staff were observed to be friendly and polite towards people that use services. This creates a pleasant and relaxed atmosphere within the home. A person using the service said, "I like the home and the atmosphere is lovely". What has improved since the last inspection? The information gathered and written about people that use services had improved. Information gathered about risks to people that use services was clear on how the home would protect people from falling, loosing weight and promoting their mobility through staff support and aids or equipment but these need to be revised more often. The environment has improved with a new central heating system fitted that allows water and radiator temperatures to be controlled. The home has told us about important information that effects the wellbeing of people that use services called notifications. What the care home could do better: Staff training in safety and first aid needs to improve so people that use services receive the right level of care. People that use services` care plans should include information on their personal and lifestyle routines, details for staff on how agreements and choices are decided with people and how they wish their routines and lifestyles to be decide when they receive care and support so they receive individual care. Records for maintaining the wellbeing and safety of people that use services called risk assessments should be revised more regularly so people that use services know they maintain their health and wellbeing. CARE HOMES FOR OLDER PEOPLE Gerald House 4 Gerald Road Oxton Birkenhead Wirral CH43 2JX Lead Inspector Anthony Cliffe Key Unannounced Inspection 08:50 3rd February 2009 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 Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 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. Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gerald House Address 4 Gerald Road Oxton Birkenhead Wirral CH43 2JX 0151 652 1606 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) george.shone@btinternet.com Mr George Alan Shone Mrs Kamini Shone Mrs Kamini Shone Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th June 2007 Brief Description of the Service: Gerald House is a detached property situated in Oxton, near Birkenhead, Wirral. The home is registered to provide personal care to 18 older people. The accommodation is provided on two floors with access to the first floor by stairs and a passenger lift. The home has 15 bedrooms, which, are all used as single rooms. A number of bedrooms have en-suite facilities. There are bathrooms and bedrooms on both floors of the home. People that use services have access to a large lounge and dining area. Outside there are car parking spaces to the front and a reasonably sized, enclosed rear garden, which has a summer house/activities room and green house. Gerald House is located in a residential area. There are some local shops within walking distance and the home is on a bus route to Birkenhead. At the time of this inspection, the weekly fees for the home ranged from £421.00 to £550.00. Additional charges are made for hairdressing, newspapers and chiropody. Information about the home is made available to people that may choose to live at the home by contacting the owners. Information is also available at the home this is called a service user guide and a statement of purpose, which describe the services offered is available to people that use services, their relatives and professionals. A copy of the most recent inspection report can be obtained from the manager. Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is a two star. This means that the people who use the service experience good quality outcomes. References to we or us represent the Commission for Social care Inspection. This unannounced visit took place on the 3rd February 2009 and lasted over eight hours. One inspector carried out the visit. This visit was just one part of the inspection. Other information received was also looked at. Some weeks before the visit the manager was asked to complete a questionnaire called an Annual Quality Assurance Assessment (AQAA) telling us what they thought they did well, what they needed to do better and what they had improved upon since the last visit, to provide up to date information about the service provided. This helps us to determine if the management of the home see the service they provide in the same way we do and if our judgements are consistent with homeowners or managers. We provided questionnaires for people that use services, staff employed at the home and social and healthcare professionals involved in their care to find out their views about the service the home provides. During the visit various records and the premises were looked at. People that use services were spoken with and gave their views about the service. We also received questionnaires from staff that said the home had good recruitment procedures and staff received support and training and a doctor that said that people that use services received good care. What the service does well: People that use services have important information gathered about their needs before they move into the home so they can decide if the home can meet their needs. Staff were aware of the needs of people that use services and how to meet them. People that use services spoke positively about the standards of care provided at the home. When asked about the care they receive from staff, people that use services said, “I trust the staff I can talk to them. I feel safe, protected and secure here. I have never felt so at home”. Another person using the service said, “ The staff are nice they always have time to sit and talk to you or join in activities. They are friendly girls”. People that use services are able to decide their own routines and make choices about how they spend their day. Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 6 People that use services know how to complain and would feel comfortable about doing so. This means that they are able to make their views known and protects their rights. People that use services benefit from staff being encouraged to complete a qualification in care so they have more knowledge and understanding of their needs. Staff were observed to be friendly and polite towards people that use services. This creates a pleasant and relaxed atmosphere within the home. A person using the service said, “I like the home and the atmosphere is lovely”. 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. The summary of this inspection report can be made available in other formats on request. Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 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 Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is provided for people that use services so they can make an informed choice about using the service. Information is gathered about their needs and choices so their needs can be met. EVIDENCE: Information provided to people that use services was available in the entrance to the home. The information available to people that use services contained details about the type of care offered to people that could live there so they were aware they were choosing a care home that could meet their needs. The owner said the information called the statement of purpose and service user guide could be made available to people who made enquiries about living at the home so they could decide if they wanted to live there. This included versions in large print, brail or as a talking book version so the information was available to people with visual or hearing problems. The information provided to people that may want to live at the home tells them about any additional fees they may be charged for. So they know what the fees they pay for their care covers. Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 9 The home use a document called a pre admission assessment on which to record information about people that use services before they move into the home so they can decide if they can meet the needs of people that want to live there. We looked at the records of two people to see how information had been gathered about their needs and both had been seen by the home manager before they decided to move into the home to discuss their needs and care so they could ask questions about their care and get further information. The document allowed information to be gathered about people that use services and included information about their personal details inclusive of personal choices about their care and routines so important information was available to staff about their needs. The information gathered could be transferred into a care plan that people could see and sign to say they agreed to the information so they could agree their care. The documents also included information on how known risks to the health and safety of people using services were recognised so plans were in place to maintain their safety This included information about how the home assisted people to use services to maintain their mobility, identified where they needed help or equipment and made sure they knew that people that use services were eating enough, or could fall and hurt themselves so they could put plans in place to make sure they remained healthy called risk assessments. Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People that use services receive their care with dignity and respect however information held about them does not support that they are directly included in the decision making process. Administration and management of medicines was safe so people that use services were supported to take their medicines safely. EVIDENCE: We examined the care records of three people that use services. The records we examined had care plans relating to their health, social and personal needs. The care plans we looked at were revised monthly or every three months depending upon the peoples’ needs and demonstrated positive outcomes for people that use services. An example of this was that a person using the service was being cared for by the district nurses for a leg ulcer and the ulcer were healing so people that use services had access to health care when needed. Another person had been encouraged to be responsible for their own personal care and looking after their own laundry and bedroom. The care plan review for this said the person was improving all the time but did not say how the person was improving and Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 11 care plans could be improved by them reflecting more personal information about people that use services such as their level of independence to care for themselves, their preferred daily routines and how they make choices about when and how they receive personal care so they provide more details about the lifestyles and choices of people that use services. Reviews of care could also be improved by them recording how the health of people that use services are improving for example how plans help to reduce the number of falls in the home as falls risk assessments and moving and handling assessments were being completed but not reviewed so we could not see if improvements were being made. The home had introduced an assessment of decision making capacity which was being completed with people that use services. This helped staff gather information of the capacity of people that use services to make and take decisions about their lives so they could understand them and support them to make decisions about their lives even though their decisions may place them at risk. Staff had the skills to recognise when people that use services need to be seen by their doctors or other health professionals such as a general practitioner, dietician, optician or dentist so they had access to appropriate healthcare. We could see by examining the records of people that use services that their healthcare needs were met. The home had registered people that use services with a doctor so their health needs could be monitored. Visits from local doctors to look at the health of people that use services were requested and visits from healthcare professionals had taken place. Before the visit took place people that use services returned surveys to us and said their healthcare needs were always cared for. A doctor returned a survey to us and said the home always sought advice on health care matters and used the advice to improve the health of people that use services the doctor said the home was well run and people that use services always seemed happy. We looked at the arrangements for receipt storage administration and disposal of medication including controlled drugs. The arrangements were satisfactory and the recording of the administration of medicines was good with no missing signatures found so staff follows the policies and procedures of the home. Each month the manager does an audit of the medicines. The home had suitable storage arrangements for medicines on the ground floor. The storage facilities had a drug fridge with the temperature of this monitored daily Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People that use services make decisions about their routines, take part in a range of activities and have a well balanced diet so have control over their lifestyle. EVIDENCE: The home gathered information on the life histories of people that used services. This information included details of their previous occupation, hobbies and interests, any medical problems affecting their joining in activities and interests so staff were able to plan activities around their needs. The home had a weekly plan of activities which included physical exercise, foot spas, word games, Bingo, discussions, Indian head massage and watching films. One to one activities were also available for example on person that lived at the home and had become a member of a reading group. Another person living at the home enjoyed cooking and doing their laundry. Another person said she enjoyed baking cakes and said she really enjoyed this activity. The owner has become the activities organiser and is involved in activities for twenty hours a week as well as staff doing other activities with people that use services so they have interests to be involved in during the day. This is helped by the home keeping records of what activities individuals enjoyed so staff Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 13 were aware of the interests of people that use services. As well as activities in the home entertainers are also arranged for people that use services. The owner said they arranged for people that use services to have take away meals and fish and chip suppers. The birthdays of people that use services were celebrated an example given was going out to the Indian restaurant to celebrate this. In addition to group activities also provide activities to help people that use services to retain their independence such as looking after their bedrooms and doing their laundry so they can still care for themselves. The home recognises that the population of the home changes so uses questionnaires to consult people on the activities they want and enjoy so they are able to decide what activities take place. Six people that use services returned surveys prior to the visit. People that use services said they could make decisions about what they did everyday and choose what to do during the day evening and at weekends. Surveys said that activities were always or usually arranged they could take part in. Mealtimes were said to be the centre of the day by one of the people that lived at the home. A four-week menu was in place and people that use services that do not wish to take the main meal on offer are provided with an alternative. The menus were based around the likes and dislikes of people that use services and this information was gathered when they first moved into the home so they could be offered a choice of meals they enjoyed. People that use services said they enjoyed the meals and meal times were an occasion to sit and talk with one another. Menus were not displayed for people that use services to see. Two people that use services said they did not know what was for lunch. One person said she enjoyed all her meals and said “I usually eat the lot”. The owner agreed to produce daily menus so people that use services were aware of the meals available on the day. Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies on promoting the welfare and safety of people that use services protect them from the risk of possible abuse, harm or injury but training could be improved so all staff are aware of how to deal with difficult incidents. EVIDENCE: The information the owner sent to us before the visit said that the home had not received any complaints in the last year. The complaints procedure was in the information provided to people that use services called the service user guide and displayed throughout the home sp people that use services knew how to make a complaint. Before the visit people that use services returned surveys to us and all said they knew who to speak to if they were unhappy and how to make a complaint. At the time of the visit the owner told us he had arranged for staff to attend training on the local council safeguarding adults’ procedure and had obtained copies of the local council safeguarding adults procedure from the internet and provided us with the details so we could be confident that staff would receive the right training and could protect people that use services. The safeguarding procedure is how the local council and other agencies involved respond to and manage allegtaions of abuse and neglect against vulnerable adults. Recently employed staff had not had safeguarding adults training but when spoke to confirmed they had gone through the homes policies and procedures on protecting vulnerable people and knew what to do if they saw or poor practices or heard any staff working at the home speaking to people that use services without dignity or respect. Staff said they would Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 15 report any concerns to the manager, Wirral social services or us. Staff records showed that staff last had training on safeguarding adults in 2006. The home had its own safeguarding policies and procedures which included the definitions of abuse, actions to be taken to prevent abuse and action to be taken to deal with allegations or suspicions of abuse so staff knew what to do if allegations of neglect or abuse against vulnerable adults were made. Staff also had a policy so they could tell people or the public about how the home was not managed in the best interests of people that use services so they could bring their concerns to the publics’ interest. This was called the whistle blowing policy. Staff were also provided with a code of practice that care staff working in social care services must follow so they were aware of their responsibilities and accountability for their care practice. Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The building is maintained to a good standard so people that use services live in a comfortable home. EVIDENCE: Since the last visit the owner had made improvements to the environment. The owner had created a level access around the side of the building and to the rear garden so people with mobility problems can access the outside garden facilities. The rear garden area had been paved and a summer house/activities centre built. The owner had also erected a greenhouse so people that use services can grow vegetables and flowers. The home no longer allows smoking inside the building so a covered area has been created for them so they have an area they can smoke in. Water storage tanks have been removed and a new central heating system installed so water is available to people that use services as a safe temperature and with environmentally friendly push taps so as to save water consumption. Radiators are regulated to provide safe surface temperatures so people that Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 17 use services are protected form injury. New carpets had been fitted to the lounge, dining area and some bedrooms. New furniture had been purchased for the lounge, dining room and some bedrooms. In the lounge a new large flat screen television had been purchased so people that use services with visual impairments could see the television clearer. Several bedrooms had been decorated and the owner said the programme of decoration would continue. An area they said they could improve in was how they could improve the home to help people with visual impairments or memory problems find their way around the home better so they could maintain their independence and dignity for example by remembering where the toilets were. Computer equipment had been purchased for people that use services so they could acquire computer skills and use the computer for entertainment. Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate employment policies and procedures and training are in place so staff are recruited however training in safe systems of care needs to be improved so people that use services receive appropriate care. EVIDENCE: We saw the staff rotas for the home. Staff were employed in sufficient numbers to meet the needs of people that use services so they receive consistent care. During the day the home in staffed by the owner and carers and at other times two carers are on duty one of which was a senior carer. At night the home has one carer that remains awake and one carer sleeping member of staff on call. Separate cooking and domestic staff are employed. Information provided by the owner shows that nine of the thirteen staff employed to provide personal care hold an NVQ level 2 qualification a recognised qualification in social care. Two other staff were working toward this qualification so the home would have a more skilled staff team to provide care to people that use services. Senior staff had also completed an NVQ level 3 qualification and both owners had NVQ level 4 qualifications. We looked at the recruitment records for staff employed since the last visit and all of them contained the information needed. Application forms, two references and confirmation of Criminal Records Bureau Checks (CRB) were completed. The CRB check is one of the recruitment checks that employers must complete when employing people to work in social care so they can Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 19 ensure that people who use services are protected from potential harm or abuse. We looked at the training records of staff. These showed that that staff received a brief induction which covered the home’s policies and procedures, day-to-day routines, the care plans of people that use services and health and safety issues. The owner said in the information provided to us before the visit that a more detailed induction programme had been introduced based on national standards produced by the organisation that set standards in training for social care called Skills for Care. The staff records we looked at contained details of this training so were provided with information on important skills to develop when providing support and care to people that use services. Staff we spoke with about the induction they received when they first started their jobs said it covered some things they needed to know but not all the things. The homes induction was described by a staff member as ‘vague’ and another said they could not remember what they had done on the home’s induction. Staff said when they later did the Skills for Care induction this covered what they needed to know about caring for people and wished they had done this when they were first employed at the home and not later. Before the visit staff returned surveys to us that said they received a good induction and training to meet their needs. The home provides training in the home and from training organisations. Training covers a variety of subjects. The owners provide most of the training ‘in house’ such as food hygiene and moving and handling. Outside organisations provide training on care of the dead, safer handling of medicines and training on conditions such as Parkinson’s disease. Staff we spoke with said that they could not remember when they had received training on health and safety so people that use services could be at risk form staff not understanding their responsibilities under health and safety laws. Training records we looked at did not record training in health and safety and the owner said this was discussed with staff during induction. Staff had received training in infection control but training in first aid was out of date for some staff so people that use services may not receive the right first aid treatment. Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s joint owners of which one is the manager both hold an NVQ level 4 in management so the home is owned and managed by experienced competent people. The joint owners have back grounds in nursing and caring for people. They are both involved in the day to management of the home, support staff and provide personal care of people that use services. The home has an informal quality assurance system which included people that use services. The home sends out questionnaires to people that use services to seek their views on the standards of care, services and facilities offered at the Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 21 home so they can contribute to the development of the home and how it offers personalised care to them. This was done in October 2008 when people that use services were asked about the activities that are provided to them and about living at the home. The questionnaires returned said overall standards of activities and for daily living were good. Two questionnaires were returned by relatives of people that use services so they could comment on the standards at the home. One said they would like to see more choice for people to do activities in the evening. The rating for activities was good overall. Questionnaires were provided for people that use services on the standards for standards within the home and personal care and support, which included daily living, the premises and management of the home. Eleven questionnaires were completed and all said either good or excellent services were provided by the home. The owner also looks at the standard of record keeping in the home to make sure regular reviews of care are done so the needs of people that use services are looked at. The owner also looks at how medicine administration is managed so people that use services receive their medicines safely. Monthly meetings for people that use services were taking place so they had an opportunity to regularly discuss the standards within the home. Staff meetings were held every two months and discussed matters such as providing personal care and putting away laundry respectfully. Policies and procedures had been revised and a policy on harassment developed so staff were aware of their responsibilities. The owner said further policies on sexual orientation, gender; disability age and culture are to be introduced so staff are aware of the laws relating to these matters. The owner had been completing supervision sessions with staff when they discussed how they were doing their job, personal development and training, but this was not happening as regularly as recommended so staff were not being given the opportunity to discuss important matters about how they did their work for example their knowledge and understanding of safeguarding adults. The owner gave assurance that supervisions would be dome more regularly. The finances of people that use services are managed by themselves, or by their family or a solicitor. The home looks after the personal allowances for some people that use services so they were safe and secure. The records of these were seen and were found to be correct. Before the visit took place the information the owner had given to us told us that all the necessary maintenance and safety checks had been completed as required. A sample of safety check records were seen for the fire safety systems and were seen and they were appropriately maintained so people that use services live in a safe home. Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 22 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 2 X 3 Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 23 No 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 OP30 Regulation 18( c)(1) Requirement The registered persons must ensure that staff receive training appropriate to the work they perform inclusive of training in health and safety and first aid. Timescale for action 01/07/09 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 OP7 Good Practice Recommendations People that use services’ care plans should include information on their personal and lifestyle routines, details for staff on how agreements and choices are decided with people and how they wish their routines and lifestyles to decide when they receive care and support so they receive individual care. Risk assessments for moving and handling, risk of falls and nutrition should be revised more regularly so People that use services know their health and wellbeing will be maintained. 2. OP7 Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries.northwest@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 Gerald House DS0000018888.V367782.R01.S.doc Version 5.2 Page 25 - 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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