This is the latest available inspection report for this service, carried out on 11th February 2010.
CQC found this care home to be providing an Poor service.
The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.
Random inspection report
Care homes for older people
Name: Address: Gables Nursing Home Barrows Green, Bradfield Road Leighton Crewe Cheshire CW1 4QW one star adequate service 15/10/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Joan Adam Date: 1 1 0 2 2 0 1 0 Information about the care home
Name of care home: Address: Gables Nursing Home Barrows Green, Bradfield Road Leighton Crewe Cheshire CW1 4QW 01270588952 F/P01270588952 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr William Preston care home 34 Number of places (if applicable): Under 65 Over 65 34 old age, not falling within any other category Conditions of registration: 0 The registered person may provide the following category of service only: Care home with nursing - Code N. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 34. Date of last inspection Brief description of the care home The Gables is a care home providing accommodation and nursing care for 34 older people, 5 of whom may be aged between 55 and 65 years of age. The service is located in an extended, detached two storey property, situated in its own grounds in a semi-rural setting on the outskirts of Crewe. The home is easily accessible from Nantwich, Winsford, Middlewich and Sandbach. It is served by local transport and is close to railway networks, being two miles from Crewe station. Bedroom
Care Homes for Older People Page 2 of 9 1 5 1 0 2 0 0 9 Brief description of the care home accommodation is situated on both floors and is provided within single bedrooms. All bedrooms are provided with wash hand basins, but there are no en-suite facilities. Day space consists of three lounges, one of which is a smoking area. A separate dining room is also available. There is a passenger lift and staircase providing access to the first floor. The home is registered for nursing and personal care for persons with general physical frailty. The fees range from #353.91 per week for personal care only to #415.72 per week for those requiring nursing care. Care Homes for Older People Page 3 of 9 What we found:
Two inspectors visited Gables Nursing Home on 11 February 2010 to look at how the home was meeting the requirements from the key inspection in October 2009. We also checked on how the home was meeting regulations for infection control after concerns about this had been raised with us. We looked at the care plans of three people living at the home to see what care and support they received. We were told that some emergency admissions had been accepted by the home from the local hospital. We looked at one care plan for someone admitted as an emergency. The care plans and risk assessments were not fully completed so that staff did not have adequate guidance of how to fully meet the needs of this person. Another care plan we looked at was of a person living at the home who we saw lying in a recliner chair that was fully tipped back so that the only view the person had was of the ceiling. The person were shouting out for breakfast when we first went into the home and was wriggling around in the chair. A staff member assured us that the person had received their breakfast. When we looked at the persons care plan, we saw that a risk assessment for falls was partially completed and referred to them sleeping on the floor on a mattress and sitting in the recliner chair to minimise falls. This is potentially a form of restraint, as it puts considerable limits on the persons ability to move freely, but there was no information in the care plan about caring for the person on a mattress at night. Also the form regarding restraint and use of a recliner chair was very brief and did not include the actions staff needed to take to ensure that the degree of restraint was minimised. Advice had been sought from doctors about the persons care in relation to medication. However, it would be helpful to obtain advice from other health professionals about how to minimise the degree of restraint being used so that the persons quality of life could be improved. The manager said she walked the person around the home in the afternoon. We were concerned that this person could be susceptible to chest infections as they were lying flat for long periods. The care plans in place were not fully completed and gave little guidance about how to care for this person. When reading notes from the doctor who had recently visited the person, these said the person should have stimulation during the day to minimise the risk of them being awake at night. This person was asleep in the recliner chair for three hours during our visit. We looked at the management of medications in the home. We identified seven medicine administration sheets that had been handwritten by staff from the home. However, these had not been signed by two members of staff to confirm that the type of drug, dose and time of administering the drug were recorded correctly. On some of these records it was difficult to read the name of the drug required. This was the subject of a requirement that we made at our last inspection of Gables Nursing Home. It is important that all records about medications are clear so that staff know they are giving the right medicine to the right person and that errors do not occur. We looked at the medicines records of three people who live in the home and found there were still problems with recording that meant it was difficult to account for all medicines. Medication was recorded on the medication record sheets when it was received into the home. However, we found errors when we counted the number of tablets left in boxes and compared this to the tablets that had been signed for as given. For instance, one box had been recorded as arriving at the home on 31 January 2010 containing 28 tablets; ten tablets had been signed as given daily since 1 February 2010. When we counted the
Care Homes for Older People Page 4 of 9 tablets left there were twenty four tablets in the box. It was not clear whether medicines had been given or not. The nurse on duty said that if any medicines were left at the end of the month that these are destroyed and new boxes/bottles are used. Regular management checks of the medicines should be carried out to make sure that they are being given properly and safely and that staff continue to do this competently. This will help to make sure that people living in the home receive their medicines safely as prescribed by their doctors. We were told that the home was due to change the pharmacy suppliers at the beginning of March 2010, which they felt would alleviate some of the problems. What the care home does well: 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 2. Care Homes for Older People Page 5 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans need to be up dated So that staff are aware of up to date care needs. 04/11/2009 2 9 13 Medication administration 03/11/2009 records that are hand written must be checked by two staff members who sign the record. So that they are sure the correct drug, dose and time of administration is correct. 3 31 10 The home must have a manager in post who is registered with CQC So that the fitness of the manager has been assessed. 30/09/2009 Care Homes for Older People Page 6 of 9 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, 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 7 15 Each person living at the home must have a fully completed up to date care plan. This is so that staff have the guidance they need to make sure that they can meet the needs of the people living in the home. 02/03/2010 2 9 13 Records about medication must be clear and accurate so that they can show medicines are being administered as prescribed and that all medication can be accounted for. In order to safeguard the health of people living in the home 02/03/2010 3 9 13 Medication administration 02/03/2010 records that are hand written must be checked by two staff members who sign the record. So that they are sure the correct drug, dose and time of administration is correct.
Page 7 of 9 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 UNMET REQUIREMENT 03/11/09 4 9 13 All medication must be administered to people as prescribed and accurate records kept so that all medicines can be accounted for. This is to make sure that people living in the home receive their medicines as prescribed to maintain their health and well being. 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 02/03/2010 Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 9 of 9 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
