Inspection on 14/01/08 for The Gables

This is the latest available inspection report for this service, carried out on 14th January 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Gables 23/02/06

The Gables 27/10/05

The Gables 11/11/04

The Gables 01/03/04

The Gables 30/09/03

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

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The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

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

CARE HOMES FOR OLDER PEOPLE The Gables 65 Skipton Road Silsden Keighley West Yorkshire BD20 9LN Lead Inspector Pamela Cunningham Key Unannounced Inspection 14th January 2008 10:50 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 The Gables DS0000029159.V358832.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. The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Gables Address 65 Skipton Road Silsden Keighley West Yorkshire BD20 9LN 01535 655846 F-P 01535 655846 rgsmith@tesco.net 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) Mrs C M Mallinson Mr R G Smith Mrs C M Mallinson Care Home 44 Category(ies) of Dementia - over 65 years of age (13), Old age, registration, with number not falling within any other category (44), of places Physical disability over 65 years of age (31), Terminally ill over 65 years of age (1) The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th February 2007 Brief Description of the Service: The Gables is in the outskirts of Silsden, a large village between Keighley and Skipton. It is a care home with nursing and provides a service to people over the ages of 65 who may have physical disabilities or dementia related illness. The Gables is a large, detached period property that has been adapted in keeping with its character and two extensions have been added to the original building. The home stands in its own grounds and there are pleasant garden areas near the reception area with a water feature and sitting areas where residents can enjoy the sights and sounds of the garden. Car parking areas have been provided. Accommodation is provided over three floors in single or double bedrooms. Most of the bedrooms have en suite facilities and there is ample provision of communal toilets and adapted bathing facilities. There are two lounges, a dining room and a large conservatory providing comfortable communal seating areas with views of the gardens. Information about the services provided by the home can be obtained from the providers in the form of a brochure and Service User Guide. Copies are kept in the reception area of the home and can be posted out on request. At the time of writing this report, the weekly charges for care are from £375 to £590. The fees include a £25 top up for a single room. The Gables DS0000029159.V358832.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. The inspection took place on 14 January 2008. The home did not know that this was going to happen. Feedback was given to the manager during and at the end of the visit. The purpose of the visit was to make sure the home was being managed for the benefit and wellbeing of the people who live there, to find out what improvements had been made since the last visit, and to confirm if all outstanding requirements had had appropriate action taken to comply with them. Before visiting the home, information was requested from the manager. This included asking about what policies and procedures were in place and when they were last reviewed, when maintenance and safety checks were carried out and by whom, menus used, staff details and training provided. It was returned in the AQAA (Annual Quality Assurance Assessment.) Comment cards were sent to certain relatives and other people involved in their care, such as GPs, to find out what their views of the home were. At the time of writing this report, four relatives’ responses had been returned. In order to find out how well staff knew residents, care plans were looked at during the visit, and residents, visitors and staff were spoken to. Other records in the home were looked at such as staff files, complaints, supervision records and accident records. Surveys from relatives said the home met the needs of their relative, and that they were always kept up to date with important issues. That they know how to make a complaint. That the care service responded appropriately if concerns were raised about care, and that the home was always clean and fresh. They also said the care staff appeared to have the right skills and experience, and that all the staff were very caring and sympathetic to individuals’ needs. There is ample information about services provided by the home that lets the people who live there, and their relatives, decide if the home will be suitable for them. Senior staff visit people in their own homes, or in the place they are currently being cared for before admission, to assess their needs to make sure that the home and staff team will be able to meet these. The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 6 Relationships between staff and residents appeared to be warm and friendly, yet professional. Certain people who live there said that they were happy with the care provided and that the staff were kind and caring. They said that they could choose how and where to spend to their time and whether or not they want to join in with the planned social activities. The home has an activities organiser and an excellent range of activities is provided such as crafts, exercise programmes, entertainers and trips out. People are also encouraged to join in special services at church, such as at Christmas, Easter and Remembrance Day. The activity organiser also visits those people who do not choose to join in planned activities to find out if there is anything they would like to do to make sure they are not bored. Complimentary therapies are also provided at no extra cost to the people who live there. What the service does well: A good standard of care is provided to the people who live there. The home is comfortable and very well maintained. Information about services provided by the home is available and lets residents and their relatives decide if the home will be suitable for them. Staff visit prospective residents to assess their needs to make sure that the home and staff team will be able to meet them. The pre-admission process benefits the people who are thinking of going to live there, because the information collected at this time makes it possible for intermediate care plans and risk assessments to be completed before admission. This gives information to the senior staff about the new prospective resident and the care they could require, and allows extra planning time for any special equipment that may be needed to meet their individual needs. The home employs an activity organiser for thirty hours per week who has completed various training courses especially for activity organisers in care home settings. It was clear from comments from people spoken to there were plenty of planned activities for them to be involved with if they wished to join in. Staff appeared to have good, friendly, yet professional relationships with the people who live there, some who I spoke to said they were happy with the care provided and that the staff were kind and caring. Relatives also said the care staff appeared to have the right skills and experience, and that all the staff were very caring and sympathetic to individuals’ needs. The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 7 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. The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 8 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 The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 9 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): 2, 3, 5 and 6 Quality in this outcome area is good. This judgement has been made using a range of available evidence including a visit to this service. People are able to make an informed choice about the home through visits and the information they are given. Standard 6 does not apply to the service, as intermediate managed care is not provided. EVIDENCE: Information about the home is available on request and in the Statement of Purpose and Service User Guide, which was last reviewed in June 2007 and updated with any changes that had been made. Information is always available in the reception area and copies are sent to any people who make enquiries about the services provided to enquirers. People spoken to during the visit said it was easy to read and provided good information about the home and the services it provides. The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 10 People who are thinking of coming to live at The Gables, and their relatives, are welcome to visit and look around the home at any time. The manager said trial visits are offered so that time can be spent talking to staff and getting to know the person before they make their minds up about coming to live in the home. They are told, at this time, that if they choose to come to the home, a pre-admission assessment will be carried out and the first few weeks will be a trial period. Three care plans were looked at. All people who live at The Gables have a written contract of residency, which clearly states anything that has to be paid for in excess of the fees. All showed evidence of a pre-admission assessment having taken place before the person came to live at The Gables. The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using a range of available evidence including a visit to this service. People’s care needs are met and they are treated with respect. The medication system is safe. EVIDENCE: Care plans are computer generated. The manager and nurses put in the information. Information care staff record, following care they give, is given to the qualified nurses who add this to the care plans as applicable. There is also information kept separately to the computer-generated files, and these can be printed off if any of the people who live there or their relatives would like to read them. Staff spoken to have good understanding of individual residents’ personalities and how to help them and this was documented in the plans seen. Three care plans were looked at; including the one of the person the tissue viability nurse had raised concerns about. One of the people the plans were about was spoken to. These showed that the manager or one of the nurses had visited the individual to assess their needs before they were admitted to the The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 12 home. This information was used to make sure that the home would be able to meet their needs. Information seen included the identified needs of the person and the intervention needed to make sure the needs were met. There was also an explanation of why the person required nursing care. All risk assessments are done at this time on the strength of the information gathered, and are updated a week after the person has been admitted to the home. It is possible to do this because of the in depth assessment details obtained pre-admission. There was also a consent form seen for the use of equipment such as bed rails and suitable seating which the next of kin had signed. There was a care plan for the control of continence for a person with the daily care of either an indwelling or special type of catheter. Dietary requirements were clearly identified with a dietary requirement plan in the file, and a copy duplicated and sent to the kitchen for the cook’s benefit. On the whole, the care plans were more person centred but the person centred approach could be improved by the addition of an activities care plan, and a person profile and past life history, which would better identify their personal needs and wishes. There was also evidence of the involvement of other health care professionals in the files, such as tissue viability, and evidence that other healthcare professionals such as GPs had been involved in any decisions regarding ‘not for resuscitation’ directives. Weight loss is managed by the home calling the GP and requesting input from the community dietician but the manager said, due to the demand for dietetic advice, it was sometimes delayed. Signed forms were also seen to indicate the involvement of either the person, or the next of kin when planning the care. Also documented is an overall assessment of care needs and a summary of care needs last updated 10/11/07. The medication system was reviewed. The home uses a monitored dosage style of medication control. Each person receives their medication from heat sealed blister packs prepared by the dispensing chemist of choice used by The Gables. The manager is in control of the medicines control system. MAR (Medication Administration Record) charts were appropriately recorded and identified with the photograph of the person. Each person has a top sheet identifying all current medication prescribed which is updated monthly. The system is safe. The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using a range of available evidence including a visit to this service. People are offered a good range of social activities; they are helped to exercise choice and control over their daily lives and to maintain contact with family and friends. EVIDENCE: Information in the AQAA said, ‘we have regular meetings (every two months) with residents to discuss matters of interest and/or concern in the home. Relatives are also invited.’ These are usually led by the Activities Co-ordinator with a registered nurse or senior carer in attendance. Those relatives who cannot attend are invited to submit questions/concerns/ideas/complaints to the Activities Co-ordinator so they can be addressed at the meeting. Usually each meeting has a theme, eg catering, ideas for trips out, what qualities residents like in care staff etc. An activity organiser is employed for thirty hours per week who has completed various training courses especially for activity organisers in care home settings. It was clear from comments from people spoken to there were plenty of planned activities for them to be involved with if they wished to join in, The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 14 although a couple of them said they liked to spend the majority of the time in their rooms doing crosswords, watching TV and reading. People spoken to in their rooms said, if they did not join in with group sessions, the activity organiser goes to their rooms to find out what they want to do, and make sure they are not bored. The activity organiser has made links with local churches and every month there is an in house service from the local parish church. Some of the residents said they go to the local community centre, another goes to the Salvation Army Citadel and others to support groups for people with mental health and eyesight problems. Links with local schools have been made and children come in to see the residents and sing for them at Christmas time. They also visit during Easter and the harvest festival. Each person has an activities plan that is kept in the activity organiser’s room. All people living in the home are given a leaflet every month to inform them of the activities planned. Since the last Inspection, two people have been to Bolton Abbey. A group have been on a canal boat trip and a mystery trip. There has been a trip to Harewood House when the home used the local Keighley Community transport. On this occasion, carers and some relatives accompanied them. One person spoken to said his daughter went with him, which made the home really feel as if it was his home. The home also arranges indoor activities such as bingo, snakes and ladders, reminiscence therapy, Reiki therapy, reflexology and Indian head massage. Indoor bowling and chair exercises are also arranged and visiting singers attend. Information from people spoken to during the visit said they liked living at The Gables, that the food was good and they had a choice. One person said, ‘the three best things about the Gables was the care and attention, the food, and the patience shown by the staff.’ Another person said ‘the home has always been lovely and clean, and that was what struck her when she first came to live in the home.’ The kitchen was clean and tidy with evidence that fresh fruit and vegetables are used in food preparation. Food in the fridges and freezers were stored correctly, and there was written evidence that the core food temperatures of the fridges and freezers had been monitored. Menus were four weekly and rotational. The cook said that she knew what residents’ likes and dislikes were and the menus were based around them. She said meals are discussed at residents’ meetings and residents can make suggestions for different meal ideas. Special diets are catered for, such as for people who are diabetics. The cook was The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 15 aware of ways of enriching food and meals for people who had lost or were at risk of losing weight. Resident satisfaction surveys seen gave the following information. • • • • • There was good care provided and attention from the staff. That the food was good. That staff were always on hands to help. That it was a first class nursing home that could not improve. That there was plenty of entertainment. The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using a range of available evidence including a visit to this service. People who live at The Gables feel safe and can be confident any complaints will be taken seriously but a concerted effort must be made to providing up to date training on abuse awareness for those staff that have not received it. EVIDENCE: The complaint procedure is displayed in the entrance hall of the home. It is clear and easy to follow. There have been no complaints either in house or lodged directly with the Commission since the last inspection. People spoken to during the visit said they knew how to complain, and who to, but had no cause to complain, as the care they received was good. Information from the AQAA said that training in abuse awareness had been provided for a number of staff, and this training is on going. The manager also needs to do the managers’ course so that she can cascade the training down to her staff to make sure they are all aware of the importance of recognising abuse. Information on how to access the training was provided at the time of feedback. The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 17 Staff spoken to during the visit were clear about the action they would take to report any suspicion that abuse had taken place. The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 18 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, 22, 23, 24, 25 and 26. Quality in this outcome area is excellent. This judgement has been made using a range of available evidence including a visit to this service. People who live at The Gables live in a home that is clean, tidy, well maintained and suitable for their needs, and with enough aids and adaptations to aid their mobility. EVIDENCE: Commitment to making sure that the home is well maintained and that there is a continual programme of redecoration and refurbishment is evident. Since the last inspection, all corridors and the corridor near the office have been replaced. The dining area has been provided with new furniture, which the people who live there said was very comfortable. There are two lounge areas and one dining area on the first floor, and a lounge on the ground floor. They provide views of the gardens and are comfortably The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 19 furnished, providing a pleasant place for people to sit. When the weather is good, residents can go out to walk round the gardens and patios have been provided with furniture so they can sit and enjoy the gardens and fresh air. Although in their winter state, the gardens looked very neat and tidy. Certain rooms were seen, and it was clear that residents are able to bring in their own belongings and make the room more homely and ‘theirs’. All of the rooms have height adjustable beds and a large number of these were profiling beds, some of which have been provided since the last inspection. Other equipment provided since the last visit has been a number of Kirton Chairs and beanbags. There are enough adapted bathrooms, communal toilets for the people’s use, including one assisted shower. Equipment to help with moving and handling needs is available. Since the last visit, a separate storage area has been found for these so that they are now not stored in corridor recesses. Good infection control practices were seen, staff were wearing disposable aprons, using disposable gloves and domestic staff used colour coordinated cloths and equipment for different areas of the home such as toilets or bedrooms. The manager said the staff also use protective arm bands when delivering care. The laundry room, though small, was tidy with effort taken to separate soiled from clean laundry. People spoken to during the visit said their clothing was well looked after, and returned to them speedily. People spoken to also said the home was always lovely and clean and fresh smelling. The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using a range of available evidence including a visit to this service. Although staffing is good, training in dementia care needs to be provided for all staff so that they fully understand the care needs of the people they care for. Formal supervision needs to be addressed, and recruitment procedures need to be tightened up to protect the people living in the home. EVIDENCE: Two weeks’ duty rotas were obtained at the time of the visit. Although there was one member of staff down at the morning time on the day of the inspection, these showed that there were still enough staff on duty to meet the needs of people living there. During the visit, staff were seen to be attending to the people’s needs efficiently, call bells were answered promptly and there was an air of calmness and orderliness. From talking to the manager and staff, it was clear that staff are encouraged to attend training sessions and events. Information in the AQAA said ‘since our last inspection the home have introduced a system of formal supervision for all care staff. These sessions take place approximately every eight weeks and details of the discussion are recorded. Over the past few months, nurses and carers have attended courses on adult protection, dementia, infection, The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 21 first aid and manual handling. Further training has been booked. We have strengthened our procedures in relation to obtaining references and CRB disclosures. Fourteen of our 23 care staff have completed an NVQ at level 2.’ However, on looking at training records, it was found that manual handling training was overdue. During the course of the visit, the physiotherapist arrived to instruct some of the care staff on safe manual handling techniques, first aid and manual handling. Further training has been booked. We have strengthened our procedures in relation to obtaining references and CRB disclosures. The manager said one of the carers had also completed the manual handlers trainers course. Training in care of people with Dementia related illnesses also need to be stepped up, as training records provided identified only five qualified staff and 3 unqualified staff have received training in 2007. However, looking at supervision records it was found that these were not up to date, with many of the staff not having had the required formal supervision six times per year. The manager was advised to look in the standards and regulations about formal supervision and adapt the form she uses for recording these as currently these only record answers, and do not give any indication of what the supervision involves. Three sets of recruitment documentation was reviewed where it was identified the system the home uses is not safe and does not help to protect the people who live there. Review of one set of documentation identified the manager had accepted references the new employee had brought her, instead of requesting the information. The general manager said he thought this was OK as the person was related to a staff member. Another set of recruitment documentation identified there was only one reference, again brought in by the person, however this was followed up by a telephone call to her previous employer. Neither set of documentation was identified by photograph. The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 22 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, 36 and 38. Quality in this outcome area is good. This judgement has been made using a range of available evidence including a visit to this service. The home is managed and run in the best interests of the people living there. EVIDENCE: The home has two registered providers who keep a very high profile at the home and attend every day. The registered manager is one of them. One of them deals with running the business side of the home, and the registered manager who is a qualified nurse deals with the care side of the business. The registered manager has been the manager of the home for 25 years and has a wealth of experience and keeps professionally updated by attending The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 23 refresher courses and reading the nursing journals. She is assertive, leads by example and regularly works with staff to give daily supervision. People spoken to during the visit said they are very approachable and will attend the home specifically if anyone asks to see them. Regular residents’ meetings are held. The activities organiser and one of the nurses continue to run these, and they use a different theme at each meeting. The last meeting at the end of 2007 focused on meals. Residents’ surveys are also done on an annual basis and echoed what the people said in their last residents’ meeting, which was they would like their main meal of the day to be at lunchtime. The manager said this is to be considered for early this year. They also said they would like to go out to more church events, and some of them were taken to Church at Christmas, and for Remembrance Day. The manager said that she still meets with staff all the time as part of the working day, and regular informal meetings are continually held to discuss any issues that arise on a day-to-day basis. This was confirmed by speaking to staff on duty during the visit. One of the providers still looks after financial matters for one resident at their request and has done so for a number of years. Appropriate records are kept of all financial transactions made on their behalf. The home has retained the Investors In People quality award having been reassessed for this. The manager said the home also has the Blue Cross mark of excellence which gives advice on policies and procedures which are used by the staff, particularly those who are completing the Registered Managers Award. Accident records are kept, and completed appropriately. The manager said she completed a monitoring audit every three months to identify any trends. As a result of this, it has been identified more accidents occur in the evenings when the people who live there are tired. Maintenance and safety records were checked and found to be up to date. The manager said that the handyman continues to carry out the weekly fire alarm checks. He has attended a fire safety training facilitators’ course and provides this to staff every six months. The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 24 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 3 4 X 3 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 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 4 x x 4 4 4 4 4 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 2 x 3 The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 OP18 Regulation 13 Requirement The Registered Provider must make sure that all staff receive training around abuse awareness and adult protection. Previous timescale of 30/09/07 not met. The Registered Provider must ensure manual handling training is provided for all staff on induction and twice yearly thereafter, and that up to date records are kept. The Registered Provider must ensure that all pre employment checks are in place before offering employment to staff. Previous timescale of 30/04/07 not met. The Registered Provider must ensure must make sure that training is provided on the specialist care needs of residents such as dementia Previous timescale 30/09/07 not met. Timescale for action 30/04/08 2. OP28 18(1)(i) 30/04/08 3. OP29 19 31/03/08 3. OP30 18 30/04/08 The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 26 4. OP36 18 The Registered Provider must make sure that staff receive formal supervision at least six times a year and that records are kept. Previous timescale of 30/09/07 not met. 31/03/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations The manager should look at making the care plans person centred and more detailed about how to meet individual residents needs. Their strengths and abilities should be included. The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 27 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 The Gables DS0000029159.V358832.R01.S.doc Version 5.2 Page 28 - 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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