Inspection on 14/09/09 for Gate Cottage

This is the latest available inspection report for this service, carried out on 14th September 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Gate Cottage 11/10/06

Gate Cottage 14/02/06

Gate Cottage 01/09/05

Gate Cottage 06/01/05

Gate Cottage 15/09/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Key inspection report Care homes for older people Name: Address: Gate Cottage Bazehill Road Rottingdean Brighton East Sussex BN2 7DB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Gwyneth Bryant     Date: 1 4 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Gate Cottage Bazehill Road Rottingdean Brighton East Sussex BN2 7DB 01273301890 01273300071 info@gatecottageresthome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Michael Martin Sodeau,Mrs Brenda Georgina Sodeau care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 11 The registered person may provide the following category/ies of service only: Care home only (PC) 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 (OP) Date of last inspection Brief description of the care home Gate Cottage is registered to provide care and accommodation for up to eleven older people who do not have high dependency needs. The home is located in a quiet residential area of Rottingdean and it is close to public transport, local shops, amenities and the seafront. The home is an attractive two-storey property built on a slight incline and comprises of eleven single en suite rooms, lounge and dining area, a conservatory and very pleasant garden areas. A lift is available to the first floor. The property is furnished and maintained to a very high standard and provides a very Care Homes for Older People Page 4 of 26 Over 65 11 0 2 9 0 9 2 0 0 8 Brief description of the care home warm, caring and friendly environment for residents. The current weekly fees range from £615 to £720, with additional charges for chiropody, hairdressing and toiletries. Care Homes for Older People Page 5 of 26 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: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Gate Cottage care home will be referred to as residents. This was an unannounced inspection which begun at 09:05 and ended at 14:10. There were eleven people in residence on the day of which five were spoken with individually and three as a group. All aspects of the service was discussed with the appointed manager and a brief chat with one of the registered providers. A range of documentation was viewed including care plans,risk assessments, personnel files and medication records. Nine bedrooms were visited in addition to one communal bathroom and one communal toilet. Prior to the site visit we asked the Registered Providers to complete an Annual Quality Care Homes for Older People Page 6 of 26 Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. This was completed well and provided when we asked for it and the information included in this report as necessary. Four surveys from residents were returned as were two from care staff. All responses were positive and comments included: * they take care of me well. * everything is first class. * everything is clean and comfortable. * I am very happy here. * because all the staff get on well, it really shows in the work with team work and also creates a happy friendly environment for the residents to live in and for staff to work for. The last key inspection was carried out on 9 September 2008. Care Homes for Older People Page 7 of 26 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 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 8 of 26 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 9 of 26 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. The home needs to ensure all parts of the assessment record are completed and that prospective residents are informed in writing that the home can meet their needs prior to admission. Evidence: Two pre admission assessment records were viewed and while one showed that a detailed assessment had been carried out prior to admission, the other did not have all parts completed. It is important to complete all parts of the assessment records to ensure that all needs are assessed. The appointed manager agreed that this was an oversight and that this person had a full care plan completed when they arrived at the home. Currently the home does not inform prospective residents, in writing, that the home can meet their needs and the appointed manager agreed to do this for all future admissions therefore no requirement was made. Discussion with residents found that they felt their needs were met in full and a comment from a survey was when you first arrive you are made to feel very Care Homes for Older People Page 10 of 26 Evidence: welcome. Care Homes for Older People Page 11 of 26 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. The care planning systems ensure that the health, medical and personal needs of those living in the home are identified and planned for in a consistent and comprehensive manner. Evidence: Three care plans were viewed in depth and a further two looked at briefly for the purpose of cross referencing with other documents such as medication records. The appointed manager has introduced a new care plan format and is in the process of rewriting the plans for each resident. Of the plans completed, it was evident that she has worked hard to produce care plans that are comprehensive in their content but written in a way that ensures staff have a good point of reference for the delivery of care. Overall significant improvements have been achieved in all parts of the care planning process, including risk assessments. The plans were satisfactory in that they included clear information on the care needs of residents and the necessary action to be taken to meet those needs. Care plans also indicated residents personal preferences in respect of their daily routines and identified what the individual is able to do independently and which tasks they need help with. Daily notes were variable Care Homes for Older People Page 12 of 26 Evidence: with some giving good information as to how residents spent their day while others were limited to comments such as (name) is fine or recording information held elsewhere such as medication given. Daily records when well written, help ensure a consistent approach and good quality care for residents. It is in the homes interests to be able to show what they have done, along with providing the evidence on which to base the monthly review and to record that they are following the assessment of need. One plan for a resident who has become confused included very good information on the triggers for their challenging behaviour and distraction techniques to ensure staff provide a consistent approach that does not exacerbate the situation. Care plans include detailed information on meeting healthcare needs such as chiropody, hospital appointments, dentists and opticians. People living in the home are encouraged to remain independent within a risk-assessed framework. Risk assessments had been carried out and they clearly identified the hazards and included sufficient detail to direct staff in the reduction of risks. Medication Administration Records were viewed and were mostly clear, accurate and up to date, ensuring that it is clear whether or not medication has been given. However, correction tape had been used in one instance and this was discussed with the appointed manager on the day and she agreed to discuss the matter with the individual concerned. Where possible some residents handle their own medication and it was good to note that the home ensures their independence is maintained as long as possible. There was evidence of this as one resident is no longer safe to administer all of their medication but a risk assessment shows they are able to administer their own eye drops. There are policies and procedures on respecting residents dignity and privacy and staff were seen to knock on doors before entering. Throughout the site visit staff were seen to treat individuals with care and respect and it was evident that comfortable working relationships had been developed. All residents spoken with mentioned how wonderful staff were and one comment was nothing is ever too much trouble, they go out of their way to help me. Care Homes for Older People Page 13 of 26 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 in the home have some opportunities to experience a lifestyle that matches their expectations, choice and preferences in respect of leisure activities and meals. Evidence: Some activities are provided in the home, including board games, quizzes and bingo. The registered providers also provide weekly outings to the shops and local attractions. It was disappointing that the home still does not have a planned programme of daily activities but discussion with the appointed manager found that staff do activities with residents each day. While activities are recorded, the records are incomplete and do not reflect that each resident has a daily activity and from the records, group activities appear to be limited. For example, the weekly outings are not recorded at all so it is not possible to determine how many residents go out each week. This needs to be addressed by providing a list of activities that are available each day and to expand the range by providing outside entertainers and more group activities. One resident said they liked the art class but said the home no longer provides this, however the appointed manager said that it is still available. It was good to note that the records showed that some residents continue to visit local clubs and that residents have frequent visitors. Care Homes for Older People Page 14 of 26 Evidence: The home has an open house visiting policy with visitors welcome at all reasonable times. Visitors may stay for meals with prior notice and residents spoken with said their visitors are always made welcome. At the start of the site visit it was pleasing to note that people were observed to be getting up at a time of their choosing, with some still in bed and others dressed and in the lounge. The weekly menu is displayed on the dining room table and a choice is given for each meal. The menu showed that meals are varied, well balanced and nutritious. On the day people were seen to be enjoying a lunchtime meal of their choice, with some having wine with their meal. All of the residents spoken with said that the food was very good and they could have an alternative if they didnt like what was on the menu. One person said they knew the food would be particularly good on the day as (name) was the cook. Care Homes for Older People Page 15 of 26 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. The home has a satisfactory complaints procedure with evidence that those living in the home feel that their views are listened to and acted upon. People living in the home are further protected by satisfactory adult protection systems. Evidence: The AQAA showed that the home has up to date policies and procedures on both complaints and safeguarding adults. The complaints log was viewed and there have been no complaints since the last inspection. Residents spoken with said they would be happy to raise any concerns with the appointed manager and returned surveys indicated that residents know who to speak to if they had a complaint. Although staff training records did not show all staff have been trained in safeguarding adults, the appointed manager said they had but she had yet to add the training certificates to staff records. The appointed manager and the deputy manager have both done training in Deprivation of Liberty Safeguards and are due to be trained in the Mental Capacity Act in the next few months. One resident has left the home on several occasions in the past and discussion with the appointed manager found that she has taken advice from an appropriate agency to ensure that this resident is not deprived of their liberty. She added that the outcome at this time, a Best Interests Assessment is not necessary as the home has devised good distraction techniques to deal with this resident. Care Homes for Older People Page 16 of 26 Evidence: Care Homes for Older People Page 17 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of decor and maintenance within the home is excellent, providing people living in the home a safe, homely and comfortable environment. Evidence: Nine bedrooms were visited in addition to one communal bathroom and one communal toilet. The home continues to provide a safe and comfortable place in which to live. Residents bedrooms were well maintained and pleasingly decorated and it was evident that people are able to bring in their own possessions in order to personalise their bedrooms. All bedrooms have en-suite facilities and bathrooms have assisted baths. The communal bathroom was clean and tidy although plumbers were in the process of fitting temperature control valves to the hot taps as part of the homes refurbishment programme. The AQAA outlined a detailed maintenance plan including reflooring all bathrooms within the next twelve months. There are well maintained gardens to the front and rear of the home with all parts fully accessible and although there is a conservatory it is not currently used by residents. All staff have been trained in infection control and it was good to note that the home has been proactive in providing antibacterial hand gel in relevant parts of the home, including in the entrance hall. One carer was wearing gloves in a communal area and the appointed manager explained that she requested in as the carer was preparing drinks and snacks and had forgotten to remove her nail varnish. Again this Care Homes for Older People Page 18 of 26 Evidence: demonstrates a good understanding of measures that need to be taken to ensure risk of infection is minimal. Care Homes for Older People Page 19 of 26 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. There are sufficient staff with appropriate skills to meet the needs of residents and the recruitment practice is also sufficiently robust to safeguard those living in the home. Evidence: The staff rota shows there are two carers for all daytime shifts and one night waking staff and one on call. The home prides itself on not using agency staff with existing staff filling during holidays and sickness. Residents spoken with all spoke highly of the staff for their care, kindness and competence. Comments included they go out of their way to help, nothing is too much trouble; I consider myself very lucky to be here; the staff are lovely and I am looked after very well. Recruitment records for the last three people to be employed were viewed and these showed that all the required information had been provided including Criminal Record Bureau and Protection of Vulnerable Adults checks, two written references and proof of identity. Of the thirteen care staff nine have achieved National Vocational Qualifications (NVQ) in Care at level 2 and a further two staff are working towards this qualification therefore the home exceeds the required 50 of staff with this qualification. There is a comprehensive staff induction training programme in place that meets the Skills for Care requirements and ensures staff are familiar with working practices at the home. The staff training programme includes both mandatory training and additional training in dementia care, nutrition, medication management and palliative Care Homes for Older People Page 20 of 26 Evidence: care. The cook has enrolled on an NVQ catering course and is also due to begin a practical catering course in the next few weeks. Care Homes for Older People Page 21 of 26 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. People living in the home and staff benefit from clear leadership and direction and all aspects of their health, safety and welfare are protected and promoted. Evidence: The registered manager has delegated the day to day management of the home to an appointed manager who facilitated the site visit. Although the registered manager does not have the required qualifications in care and management, the appointed manager has both a care and management qualification. She has yet to register with the Commission and a discussion with one of the registered providers found that he thought she had registered and the Commission has been approached in this matter. Therefore, the home needs to continue with the plan to make an application to register the appointed manager with the Commission. The appointed manager updates her skills and knowledge with training such as Deprivation of Liberty Safeguards as an example. Throughout the site visit both residents and staff were comfortable in approaching her which demonstrates an open Care Homes for Older People Page 22 of 26 Evidence: management approach. The home has staff and resident meetings twice a year and good practice suggests that these meetings be more often to ensure regular consultation is carried out. As part of the quality monitoring process the home carries out resident surveys. Completed surveys were viewed on the day and all comments were positive. Where any issues were raised the appointed manager addresses them as soon as possible. Generally the home does not manage the finances of residents, their families or solicitors do so on their behalf but small amounts of cash are held for some residents and all transactions are appropriately recorded. The supervision records for three members of staff were viewed and these were comprehensive and demonstrated that they are used effectively to identify training needs and explore any issues relating to the staff team. The AQAA showed that regular checks are made on all electrical and gas appliances and systems. In addition checks are carried out on call bells, water delivery temperatures and emergency fire systems. All staff have been trained in fire safety and a fire safety risk assessment has been carried out for all parts of the premises. These systems ensure the safety of people living in the home in the event of fire. Accident records were viewed and found to be accurate and up to date. In order to ensure they are maintained in line with the Health and Safety Executive guidance each accident record needs to be numbered consecutively and the appointed manager agreed to address this matter on the day. Care Homes for Older People Page 23 of 26 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 24 of 26 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 12 16 That the home ensures service users are provided with a record of all activities provided in the home. To ensure service users are aware of what activities are available. 14/10/2009 2 31 8 That the plan to register the 14/12/2009 appointed manager with the Commission be implemented within the given timescale. To ensure the registered manager in post has the required qualifications. 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 33 That staff and service users meetings are convened more often. Care Homes for Older People Page 25 of 26 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). 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