Inspection on 04/01/08 for Red Gables

This is the latest available inspection report for this service, carried out on 4th January 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Red Gables 20/02/06

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Red Gables 1 Pinnocks Croft Berrow Burnham-on-sea Somerset TA8 2NF Lead Inspector Sally Murphy Unannounced Inspection 4th January 2008 10:30 Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 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 Red Gables DS0000061625.V355600.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 Adults 18-65. 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. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Red Gables Address 1 Pinnocks Croft Berrow Burnham-on-sea Somerset TA8 2NF 01278 786607 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) tingar@tthomas9.fsnet.co.uk Voyage Ltd Mrs Tina Ann Thomas Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users may be admitted to the home that have a concurrent physical disability. The home may admit service users aged 16 and 17 years. Date of last inspection 4th December 2006 Brief Description of the Service: Red Gables is a large detached property on the outskirts of Berrow. Accommodation is provided over two floors. All bedrooms have en-suite bathroom facilities. There is a range of communal space available to people living at the home, including an activities room and training kitchen. The home has been decorated and furnished to a high standard, and appropriate adaptations have been provided to meet peoples needs. Red Gables is registered with the Commission for Social Care Inspection to provide accommodation for up to ten people. The home is able to admit people aged 16-65 years who have a learning disability. People who also have a concurrent physical disability may be admitted to some ground floor rooms. Tina Thomas is the Registered Manager for the home. The Registered Provider is Milbury Care / Voyage Ltd. The current scale of charges is £1,400 and £2,200 each week. Red Gables DS0000061625.V355600.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. This key inspection was unannounced and was completed by Sally Murphy, Regulation Inspector. The previous inspection was completed on 4th December 2006 and was unannounced. Prior to the inspection the Registered Provider completed an Annual Quality Assurance Assessment, and surveys were issued to relatives, staff members and health and social care professionals. The findings from these documents have been incorporated within this report. During the course of the inspection, we conducted a tour of the premises, examined care records, staff files and health and safety documentation. Discussions were held with the Registered Manager, staff members, and people living at the home. Care practice was also observed. The Inspector would like to thank the Registered Manager, staff and people living at the home for their assistance during this inspection. What the service does well: The home provides care and support to people who have complex needs. Staff had been provided with appropriate training to meet people’s individual personal and health care needs. Staff support people to participate in a range of activities, attend college and access the local community. People are encouraged to exercise choice and develop daily living skills. Within the surveys received from health care professionals one person wrote ‘it is a pleasure to work with the manager and staff at the home because of the high standard of care they provide’. A relative stated that the staff are a ‘caring, fun and professional team’. The home has a range of communal areas available and appropriate equipment and adaptations have been provided to promote people’s independence. The home has been decorated and furnished to a high standard and bedrooms personalised to reflect individual tastes. Within the surveys received from staff and relatives there was positive feedback regarding the manager and staff team. One survey stated that the ‘manager is excellent’. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 6 The home operates a robust recruitment procedure that protects people living at the home. Care plans, health and safety and staff training records had been appropriately maintained. Staff are provided with regular training and supervision. What has improved since the last inspection? What they could do better: The Registered Manager must ensure that an assessment of competence is obtained for each staff member who is involved in the administration of insulin and that a written record is maintained. Medication records include instruction on how each person prefers to have their medication. This is good practice, however the Registered Manager must ensure that these instructions are signed and dated, and regularly reviewed. The complaints procedure should be updated to state that CSCI might be contacted at any stage. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 7 The waste bin within the laundry should be replaced within a foot operated flip top bin to reduce the risk of cross infection. Similarly foot operated flip top bins should be provided in bathrooms and toilets. The information provided within the Annual Quality Assurance Assessment (AQAA) largely related to the provider rather than the individual home. This document must provide detailed information on the strengths, areas for improvement, and plans for the next twelve months that relate to Red Gables. 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. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 & 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their families are provided with appropriate information to make an informed decision about the home. Prospective service users know that the home will be able to meet their needs and have the opportunity to visit the home to assess the facilities provided. EVIDENCE: The home has a Statement of Purpose and Service User Guide. The Statement of Purpose is presently being updated to reflect the changes within the organisation. The Service User Guide has been provided in pictorial format. It includes information on what Red Gables can offer you, Your rights, How much it costs?, What to do if you don’t like something? and, Where to find copy of CSCI report and contract. However this is a lengthy, and detailed document that may not be accessible to some people residing at this home. Copies of the contract between the provider and placing authorities are held at Head Office. A copy of the Residency contract is provided in each service users care plan. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 10 One person had recently moved into the home. A comprehensive assessment of need had been obtained, and staff from the home had visited the person to ensure that they would be able to meet their needs. The person was also able to visit and stay overnight at the home, and an advocate was involved. The Registered Manager had maintained clear records of the information gathered to support the person’s move and to ensure that staff had the necessary information to fully meet their needs. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans provide appropriate guidance to staff how to assist each person in meeting their needs. People living at the home are able to exercise choice and are supported to take risks. Information is stored securely and confidences maintained. EVIDENCE: Care plans are maintained for each person living at the home. Three care plans were examined in detail during this inspection. Care record provided guidance to staff on how to meet individual’s needs. This included information on health, medication, diet, self-help skills, daily living skills, activities, communication, social and behavioural needs. The Registered Manager advised that a new format is being introduced for recording care plans. This is aimed at providing greater opportunity for people living at the home and their relatives to be involved in developing and reviewing the plans of care. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 12 Monthly summaries are completed by key workers. For one person there had been a period when these had not been completed as the staff member had left, however this has now been addressed. Some summaries were particularly detailed and provided clear evidence of the work being undertaken to support people in achieving their goals. As part of the quality assurance process the Registered Manager has reviewed and double signed some documents to monitor that they are being completed appropriately. The wording within one plan was discussed with the Registered Manager, who advised that this would be reviewed as part of process for developing the new care plans. Within the information sent to CSCI prior to the inspection it states that the home will ‘ensure every service user has a copy of their individual plan in a format appropriate to their needs’, this is not reflective of the current care records, but should be part of the new care planning system. People living at the home are able to spend time in their bedroom or communal areas as they wish. Appropriate equipment and adaptations have been provided to promote their independence. On the day of the inspection some people went out with staff support, whilst other choose to watch DVDs. Some people spent time in the other communal areas listening to music or participating in activities. Within the information provided to CSCI prior to the inspection, it states that ‘staff support / enable service users to take responsible assessed risks’. It was evident from reviewing care records that people living at the home had been supported to take risk and increase their independence. For example one person is now able to access their bathroom without supervision, and some people have begun attending college courses without support from staff at the home. Risk assessments had been completed for each person and had been updated appropriately. Care plans included evidence of regularly communication with relatives. One person living at the home has advocate. Records relating to the peoples finances had been appropriately maintained and were supported by staff signatures and receipts. All care records had been stored securely and were up to date. . Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15 16 &17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are able to participate in a range of activities, and are provided with opportunities of personal development. People are part of the local community and are supported to maintain relationships. People are involved in the planning of menus and are provided with a healthy and nutritious diet. EVIDENCE: People living at the home are encouraged to participate in a wide range of activities. As previously mentioned three people now attend college. These individuals no longer require support from staff at Red Gables whilst at college. The Registered Manager had arranged for staff from the college to meet people Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 14 at the home, and assist is selecting the appropriate courses for each person. This is a significant and positive improvement for these people who have complex needs. On the day of inspection some people went shopping, or for a walk whilst other relaxed within the home. People are supported to access the local community including cafes, restaurants and leisure facilities. The Registered Manager advised that the people living at the home and staff enjoyed a Christmas meal together at a restaurant, and had thoroughly enjoyed this. The Registered Manager organised a summer ball, which provided an opportunity for people to spend time with others living at other homes owned by Voyage Ltd within the area. There are also plans to access another home for coffee mornings. People living at the home enjoyed a holiday in Cornwall last year, and plans are being made for this year’s holiday. Activities also take part within the home. The home has a sensory room and people visit the home each week to run arts and crafts sessions. One relative stated that people living at the home have a ‘great social life, trips out and various activities’. A computer has recently been purchased to provide people with opportunities to develop their skills and access the Internet. A Total Communication board is also being developed to provide people living at the home with more information. Relatives are encouraged to visit the home. Within the surveys received, relatives stated that they are kept up to date with any changes and are satisfied with communication from the home. People living at the home are involved in choosing the menu each week. A photograph has been provided of each meal to assist people in making this choice, and it is recorded on the menu who has chosen each week. One person living at the home assists staff with the weekly shopping. Meals are prepared by care staff. Staff spoken with demonstrated a good knowledge of individual’s dietary needs. One relative stated that the ‘meals and diet are excellent’. People are provided with appropriate equipment and support to promote their independence. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s physical and emotional needs are met. in the way that they prefer and require. People receive personal care The management of medication is generally safe and protects those people living at the home. EVIDENCE: People are provided with support to undertake personal care tasks as required. Care records include evidence of consultation with people regarding how they would like their personal care needs met. Within one care plan it recorded that this person wishes to receive assistance from female carers. All bedrooms at the home have en suite bathroom facilities. Within the annual service review completed by the registered provider Milbury / Voyage the provision of personal support and care scored highly. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 16 Many service users have complex health care needs. Staff support service people living at the home to access healthcare services and ensure that specialist advice is sought as necessary. Within those records seen there was evidence of visits made to the GP, dentist, chiropodist, optician, speech and language therapist, and physiotherapist. A record had been maintained of all healthcare appointments and the outcome from each visit. Staff have been provided with training on diabetes. Staff advised that this course included training on administering insulin and testing BM levels, however this information had not been included on the documentation provided. The Registered Manager must ensure that a assessment of competence is obtained for each staff member who is involved in the administration of insulin and that a written record is maintained. Some people living at the home have further specialist needs. There are protocols in place regarding the management of epilepsy medication, mic-key button and asthma for individual people. One person has a pressure-relieving mattress and regular advice is sought from nursing staff. The Registered Manager plans to arrange further epilepsy training for staff, particularly regarding the administration of midazolam. Care records evidenced that staff were regularly monitoring people’s personal care and health needs. Day to day sheets are completed. These are being expanded to include information on whether the person was offered a choice of meals and a record of those foods eaten. Within the surveys received from health professionals, one person wrote that staff ‘sometimes’ demonstrated an understanding of people’s needs, whilst another stated that ‘the service provides positive and holistic support to people with high level needs’. The home has a detailed medication policy. All medication had been stored securely. Medication Administration Records were examined. A signature sheet had been completed. Medication records included instruction on how each person has their medication. This is good practice. The Registered Manager must ensure that these instructions are signed and dated, and regularly reviewed. Medication Administration Records had been appropriately maintained. There is a separate fridge for storing medication. The fridge temperature had been monitored and recorded appropriately. An opening or discard date had been recorded for prescribed creams. Within the information provided to CSCI prior to the inspection, the registered provider stated that they planned to develop plans relating to ageing and death for each person. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has taken appropriate steps to ensure that people are listened to and protected from abuse. EVIDENCE: The home has complaints procedure. This includes details of external agencies that may be contacted. This procedure must be amended to state that CSCI may be contacted at any stage. People living at the home have been provided with an accessible version of the complaints procedure entitled ‘letting use know what you think’ and with ‘help’ cards so that they may let people know when they are not happy. Within the surveys received relatives confirmed that they would know how to raise a complaint. There has been one complaint received since the last inspection. The home has taken appropriate action to address the issues raised. All staff have received training on the Protection of Vulnerable Adults. The home has a whistle blowing policy. The Registered Manager has provided staff with copies of the policies on vulnerable adults and confidentiality. These have been signed by the staff member to confirm that they have read and understood these documents. Supervision records included evidence of the Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 18 whistle blowing policy being discussed. This is good practice and evidences a strong commitment to protecting both staff members and those people living at the home. There have been three allegations of abuse raised since the last key inspection. A meeting was held under the Safeguarding Adults procedures on 24/1/08. It was agreed that the Registered Manager has notified other agencies as required and taken appropriate actions to protect those people living at the home. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has been decorated and furnished to a high standard. The home has sufficient communal areas to meet peoples’ needs. People living have the specialist equipment they require to maximise independence. The home was found to have a good standard of cleanliness. EVIDENCE: Red Gables is a large detached property situated in the village of Berrow. The home has ready access to local shops within Berrow and Brean. Accommodation is provided over two floors. The home comprises of two lounges, a dining room, training kitchen, and two conservatories. There are sufficient communal spaces for people at the home. There is a large secluded garden to the rear of the property and sufficient parking to the front of the property. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 20 All rooms are single occupancy and have en-suite bathroom facilities. Bedrooms have been decorated to a good standard and are personalised with their own belongings such as photographs, television and DVD player, sensory lighting and decorative posters. Appropriate adaptations have been provided to promote the safety and independence of people living there. The laundry area was clean and well organised. A small area of plaster requires repair within the laundry. The waste bin within the laundry should be replaced within a foot operated flip top bin to reduce the risk of cross infection. Similarly foot operated flip top bin should be provided in bathrooms and toilets. The home had been maintained to a high standard of cleanliness. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 & 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are provided with the appropriate mandatory and specialist training to meet peoples’ needs. The home operates a robust recruitment procedure that protects people living at the home. Staff are well supported and receive regular supervision. EVIDENCE: Duty rotas are maintained. Copies of duty rotas were provided for the Christmas period. These evidenced appropriate staffing levels in relation the number of people residing at the home. Since the last inspection the Deputy Manager and two new care support workers have been appointed. Staff are able to access training via the EL Box which is a laptop computer based at the home. Individual training records are maintained. Staff have received appropriate updates in mandatory training, and training on NonRed Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 22 violent crisis intervention, intensive interaction and the protection of vulnerable adults. Staff spoken with during the inspection confirmed that it was a good place to work and that they received appropriate training and regular supervision. Staff stated that they had received thorough induction training, and appropriate information regarding people’s specialist needs such as diabetes, and oxygen therapy. The Registered Manager has advised that over half of the staff employed are currently studying for the NVQ Level 2 qualification in care. The Registered Manager and Deputy Manager have NVQ level 3. Some staff also have completed other courses such as nursing and HNC qualifications. Within the surveys staff were asked ‘Are there enough staff to meet individuals’ needs?’ to which three people answered usually, one sometimes and one never. One staff member stated that staffing could be difficult during periods of sickness or holiday. Recruitment records were examined for two newly appointed staff. These included a completed application form with evidence of gaps in employment being explored and recorded, proof of identity, two references and a POVA first and enhanced CRB being obtained. An interview record had been maintained. Staff had also been provided with a copy of their contract and job description, and the code of conduct was available. As part of the interview process candidates are introduced to people living at the home, and people have be opportunity to give feedback to the Registered Manager on the candidates. Within the file for one staff member there were copies of the vulnerable adults procedure, letting us know what you think and confidentiality policies that had been signed to confirm that the staff member had read and understood these. For the second staff member these policies had been copied and were planned to be discussed during the next supervision meeting. Staff records included evidence of regular supervision and appraisals. Supervision records were comprehensive and up to date. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41 42 & 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed. There is an open and relaxed atmosphere within the home. Appropriate actions have been taken to promote the health and safety of staff and people living at the home. EVIDENCE: The Registered Manager is Tina Thomas. Ms Thomas has many years experience working with vulnerable people. She has attained the NVQ level 3 in Care and completed the management development program provided by Milbury / Voyage. Ms Thomas advised that she is close to completing the Registered Managers Award. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 24 Staff spoken with confirmed that the manager was approachable and that they would be able to raise any concerns. Within the surveys received one health professional wrote that the home is ‘well managed’ and a relative that ‘The manager is excellent’. The Registered Provider has recently appointed a Regional Quality Assurance Manager. The home regularly seeks feedback from people living there, through meetings, individual discussions and regular reviews held with relatives and Social Workers. The Registered Provider completes monthly visits to the home in accordance with regulation 26 of the Care Home Regulations 2001. The information provided within the Annual Quality Assurance Assessment (AQAA) largely related to the provider rather than the individual home. During the inspection it was evident that there were a number of improvements since the last inspection that had not been recorded within this. The AQAA must provide detailed information on the strengths, areas for improvement, and plans for the next twelve months that relate to Red Gables. The home displays Employers liability insurance and has appropriate policies and procedures in place. Fire safety records were maintained. These included detailed plans for staff to follow and the support to be provided to each person in the event of a fire. All staff have received fire training within the last twelve months. The fire risk assessment was reviewed on 31/12/07. The home completes a comprehensive health and safety audit each month. Servicing records for lifting equipment, electrical and gas appliances had been appropriately maintained. Within the kitchen all food stored within the fridge and freezer had been covered and dated. Core food temperatures and fridge and freezer temperatures had been recorded daily. The temperature for one freezer was recorded as –17C, however this should be –18C or lower. This was reported to the Registered Manager who will monitor this and take any appropriate actions. The hazard analysis and cleaning rotas had been appropraitely maintained. All hazardous substances had been stored securely and were not accessible to people living at the home. Incident and accident records are completed appropriately and double signed by Registered Manager. These are audited regularly to identity any patterns. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 4 3 2 3 3 3 3 Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 26 N/a 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 YA20 Regulation 13 (2) Requirement The Registered Manager must ensure that an assessment of competence is obtained for each staff member who is involved in the administration of insulin and that a written record is maintained. Medication records included instruction on how each person has their medication. This is good practice. The Registered Manager must ensure that these instructions are signed and dated, and regularly reviewed. The AQAA must provide detailed information on the strengths, areas for improvement, and plans for the next twelve months that relate to the individual home. Timescale for action 28/02/08 2. YA20 13 (2) 01/02/08 3. YA39 24 (1) 30/06/08 Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 27 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 YA22 Good Practice Recommendations The complaints procedure should be updated to state that CSCI might be contacted at any stage. (This recommendation was also made at the last key inspection). 2. YA30 The waste bin within the laundry should be replaced within a foot operated flip top bin to reduce the risk of cross infection. Similarly foot operated flip top bin should be provided in bathrooms and toilets. Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Red Gables DS0000061625.V355600.R01.S.doc Version 5.2 Page 29 - 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. 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