Care Home: Gerald Street House

What the care home does well The home offers a pleasant environment, which is safe and well maintained. The atmosphere in the home is good and there were examples of friendly but respectful exchanges between staff and residents. There is a stable staff team who are very knowledgeable about the residents and how to care for them. The staff assist the residents to maintain their health care needs. The residents were complimentary about the staff and the care they receive. Comments include "the staff are lovely", and "the staff are always there help me do what I want". The residents are given good quality nutritious food that they enjoy in pleasant surroundings. What has improved since the last inspection? The pre-admission assessment information for residents is now available in sufficient detail to enable a decision about the suitability of placement and for a care plan to be developed. There have been improvements to the residents care plans, which now show the way the care is planned and given. The staff are aware of the need to keep any doors marked which need to be locked are secured when they are unattended. CARE HOMES FOR OLDER PEOPLE Gerald Street House Gerald Street Whiteleas Estate South Shields Tyne and Wear NE34 8RG Lead Inspector Suzanne McKean Key Unannounced Inspection 4th August 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Gerald Street House DS0000037965.V369211.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 Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gerald Street House Address Gerald Street Whiteleas Estate South Shields Tyne and Wear NE34 8RG 0191 536 9479 0191 536 9744 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) South Tyneside MBC Lorraine Gallagher Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Old Age, not falling within any other category, Code OP - maximum number of places 35 The maximum number of service users who can be accommodated is: 35 26th July 2006 2. Date of last inspection Brief Description of the Service: Gerald Street is a Local Authority owned residential care home, which provides permanent accommodation for up to thirty-five older people with personal care needs including a residential short break (respite care) service for up to three people. The Home does not provide nursing care. A day resource centre for older people is also operated on the same site. All accommodation is at ground floor level and is divided between four units, each with its own self-contained facilities including lounges, toilets and bathrooms and access to a central dining area. The property is situated on a housing estate in the Whiteleas area of South Shields and is within walking distance of a range of local amenities, including a small selection of shops and a Church. The area is well served by public transport therefore easily accessible. There is ample care parking to the front of the building. Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. How the inspection was carried out:Before the visit: We looked at: • Information we have received since the last visit on 26th July 2006. • The information we collected during the annul service review carried out on 7th December 2007. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 4th August 2008. During the visit we: • • • • • • • • Talked with people who use the service, relatives, staff, the manager & visitors. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building/parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. Spoke to residents and their representatives to get their views. Asked for the view of visiting professionals. We told the manager what we found. Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 6 What the service does well: 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 Street House DS0000037965.V369211.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 Street House DS0000037965.V369211.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): 3 & 6 (intermediate care not provide) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed assessments of the residents are carried out so that the home has enough information to make sure they can care for them, and they can be sure that their needs can be met. EVIDENCE: The care plans contained the necessary information to show that assessments are carried out before any resident is admitted to the home. The documentation is detailed and contains the necessary information for the staff to make a judgement as to if a place should be offered to the residents. These assessments then form the basis of the care planning process for the resident. Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 9 Residents said that they were given the opportunity to visit the home before they decided to move but the majority had relied upon their family to choose for them. Gerald Street House DS0000037965.V369211.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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good systems and records make sure that health and social care needs are delivered in a respectful way and the care plan documentation shows how this is achieved. EVIDENCE: All residents have a care plan which includes an assessment and a plan of care. They show that the personal and health care needs of the residents are being met. Staff have had some recent training in the completion of the documentation and ongoing use of these should result in further improvements as they become more used to them. One of the care plans was particularly well developed and was person centred. Necessary risk assessments are completed for as necessary. Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 11 Residents access NHS services and facilities as necessary. The care plans showed that specialist advisors are used for individual residents. The home liaises with the General Practitioners who provide care to the residents. The care was being given by staff who were pleasant and courteous and number of residents were enjoying the staffs company. Residents were dressed for the activities they were undertaking and looked smart and tidy. A number of residents were positive about the care being given. An example of this is “Its nice here” and “the staff are lovely”. Care is given in a discreet manner taking into account the individual residents previous lifestyles and the way they want to spend their time. Staff are knowledgeable about residents’ preferences and needs. They were seen being kind and polite with cheerful banter taking place throughout the day. Staff spoke to residents always explaining what was about to happen and what they were going to do so that residents knew what to expect when being helped to move around the home. All residents have individual rooms that they can use if they need to discuss issues with family, friends or staff so that their privacy is safeguarded. Gerald Street House DS0000037965.V369211.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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are well supported to spend their leisure time and are supported to maintain contact with their families and the local community. EVIDENCE: The residents said that they were content and pleased with the staff and the home. ‘the staff are really helpful and kind’ and ‘I get to do what I want”. The hairdresser visits every week and residents were supported to get newspapers. One resident said ‘You can get as much help as you need to”’. There have been recent trips to the beach for an ice cream and the residents confirmed that recently. Separate records are kept for each resident and these are part of the care plan documentation. Examples of recent activities provided for the residents to choose from are pizza supper, skittles, “toss the cross”. Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 13 Visitors were observed coming and going throughout the day. All were made welcome and appeared to have a good relationship with the staff. One spoken to was very positive about the home and the staff. Some time was spent with the residents over lunchtime. The dining room offers a light, airy and spacious space for the residents to take their meals. The tables were set out nicely and gave the residents a pleasant place to eat and spend time together. Residents were complementary about the food being served. Comments from residents included ‘The food is always nice’ and ‘there is always enough to eat, if you don’t like it they will make you something else’. Tables were set to promote independence with tablecloths, condiments, napkins, milk, sugar and a teapot for residents to help themselves. To promote independence and choice, serving dishes or tureens could be used so that residents could help themselves to whatever and how much they wanted. Alternate choices are available such as salad or jacket potatoes. Residents make their choice of meal the day before and talking to residents confirmed they thought this was good practice. The residents are also offered a flexible breakfast menu and are able to have a cooked breakfast if they wish, high tea that comprises of a choice of a hot or cold meal such as toasted ham sandwiches or beans on toast, and then sandwiches are available for supper. During the visit the residents were occupied in a variety of ways and were watching television or sitting in the lounges. Some were sitting in their rooms watching television or reading. There are newspapers, magazines and library visits. People are encouraged to bring their own possessions with them from home such as furnishings and keep sakes. This has made their own rooms individualised, reflecting their lifestyles and personalities. Gerald Street House DS0000037965.V369211.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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good policies and procedures in place to that make sure that complaints would be dealt with efficiently and that residents are safeguarded from abuse. EVIDENCE: There are comprehensive policies and procedures available setting out how to make a complaint. The procedure is displayed in the home and the staff knew how to deal with any complaints that are raised with them. The complaints processes were clear, and included the investigation and the outcome. The residents spoken to were aware of the complaints policy and said that they would know who to speak to if they had any concerns. There are policies and procedures in place for Adult Protection. The staff have received both in house and external training about how to deal with alleged abuse in the last twelve months and this training is ongoing, as not all staff have received it. Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a suitable, and clean environment to meet residents needs and maintain a comfortable place for them to live. EVIDENCE: The home was purpose built and has reasonably sized corridors and is designed to allow service users to use the entire home with ease and in safety. The decoration is in keeping with the style of the home and the furnishings are suitable for the residents living in the home. The home is designed in ‘wings’ that enable small groups of people to sit in separate lounges. This also means that residents do not have too far to go to their bedrooms if they are tired or have mobility problems. The home has a Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 16 small well- decorated sitting room for residents to use if they want a quiet space or if they wish to hold a family party. The home is decorated and furnished to a high standard and offers a pleasing homely environment to the residents. Some areas are now in need of some improvement to bring in back to the standards it has previously maintained. Although this is not a significant problem it does include some damaged walls (from wheelchairs) and doorframes). The residents spoken to were happy with the decoration and maintenance standards. The home is clean and was odour free. The residents’ bedrooms were personalised reflecting individual choices and preferences and all residents asked about their bedrooms said they were happy with the decoration and that they were kept clean by the staff. The laundry was clean, organised and well equipped. The sluices were tidy, clean and odour free and the disinfectors operational. Staff followed infection control policies throughout the day. The light and emergency call cords were all clean and all emergency cords reached skirting level. There are sufficient numbers of bathrooms and communal toilets for the numbers of resident in the home, however there are no showers and although this is not a requirement it would offer the residents a choice as to how they have their personal care needs met. The lounges and dining rooms were clean, tidy and furnished to a satisfactory standard. Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are skilled, well trained, and competent staff employed in sufficient numbers to make sure that they can provide good care to the residents. EVIDENCE: Staff records are completed in line with the policies and procedures, including two references and a completed application form. The requirement to have a CRB and POVA check in place is applied to all of the staff in the home. There have been some recent problems when staffing levels were not being maintained. This resulted in periods when staff had to work additional hours to fill the gaps on the rota. However, there is now only one vacancy. The reduction in the resident numbers has also contributed in the need for less staff on duty. There are a number of staff who have worked in the home for a long time and generally the turnover is very low. There are adequate numbers of domestic and laundry staff employed over a seven-day period. Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 18 Care staff are encouraged to complete National Vocational Qualifications in Care (NVQ). The home now has more than the 70 of care staff who have completed NVQ to level 2 and further progress is being made. Fire instruction and drills for staff is up to date and ongoing training is planned according to the training schedule. Moving and handling training is up to date and ongoing training is planned for continuing to update staff as necessary. Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management systems are working effectively to protect service users and staff and to meet their needs. EVIDENCE: The Registered Manager has the appropriate qualifications and experience to successfully manage the home. The manager contributes towards the general feeling of well being in the home. Staff said they felt well supported and were able to work toward qualifications. Supervision is offered to the staff so that they have an opportunity of one to one discussion with management. The way that supervision was being offered was discussed and there are plans to Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 20 develop the model further so that it can be provided in a flexible way to take into account the best way for particular staff and staff groups. The manager is responsible for both implementation of safe working practices such as testing water temperatures and fire safety but also for auditing all systems and procedures through the home to ensure safety of residents, visitors and staff. The manager completes a full audit and checking procedure that also includes medication and care plans. The home is subject to regular internal audit and has in the past achieved the highest rate of compliance in local authority services. Residents and visitors are asked their views on the service provided and there are questionnaires available through the home. There are regular resident meetings where they can be consulted in the way the home is run and records of these are kept. The accident recording in the home is robust. Case tracking showed that entries in the accident book were reflected in the daily record within individual care files. Accidents are monitored and analysed so that risks can be identified. Safety is promoted for residents by using these systems effectively and by having a staff group that is trained in fire safety, moving and assisting, infection control and food hygiene. Staff meetings are held regularly and staff said that they found them useful, giving the chance to hear what is planned in the home. They also have the chance to raise any concerns they have. The senior management team in the home are responsible for safeguarding residents’ personal monies, as the home does not employ an administrator. Each resident has an individual balance showing a running total of monies kept in the home. Each resident also has an individual wallet containing his or her money locked securely in the safe. Balances reflected the actual amounts held and recording was found to be correct. Transactions are signed and dated by two members of staff and are audited weekly by the manager. Residents can access their money at any time. Residents can be confident that their personal monies are handled safely and appropriately. Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP19 OP33 Good Practice Recommendations The plan to improve the decoration should be followed particularly around the damage to the walls. The quality assurance process could be further developed to show the way the service is being assessed and improved. Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Gerald Street House DS0000037965.V369211.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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