CARE HOMES FOR OLDER PEOPLE
Freda Gunton Lodge Balkerne Gardens Colchester Essex CO1 1PR Lead Inspector
Diana Green Unannounced Inspection 11th January 2006 09:15 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 Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 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. Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Freda Gunton Lodge Address Balkerne Gardens Colchester Essex CO1 1PR 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) 01206 574786 01206 545037 Balkerne Gardens Trust Limited Mrs Virginia Giles Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 1st June 2005 Brief Description of the Service: Freda Gunton Lodge provides residential care for 40 older people. It does not offer nursing or dementia care. It is situated within the grounds of the Balkerne Garden Trust, who also have sheltered housing on the same site. The trust is a non-profit making charitable organisation that offers accommodation, predominantly, to service users who live in the Colchester area, or have family living in the area. Accommodation is provided on three levels with 36 single rooms and two double rooms, the majority of rooms having en-suite facilities. There are two passenger lifts. All rooms are well maintained, comfortably furnished and spacious.The home is situated within walking distance of the centre of Colchester and close to local amenities. These include shops, restaurants, a post office, a theatre, a library and parks.The complex has a security system in place for the protection of service users. Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 11 January 2006 beginning at 09.15 and ending at 12:20hours. The inspection process included: discussions with the registered manager, the deputy manager, three staff, four service users; observations on a number of residents’ rooms, several bathrooms, communal rooms and sluice rooms; a sample of policies and procedures and care records. Fourteen standards were covered, and two requirements made. The inspection found that the outcome for all sixteen standards inspected had been met and action had been taken promptly to address the previous requirement. The registered manager and staff were welcoming and helpful throughout the inspection. What the service does well:
From this inspection and knowledge gained over a number of previous inspections, it is evident that Freda Gunton Lodge aims to provide and is successful in achieving a high standard of personal and residential care for residents with emphasis on a person centred approach. The premises are clean, well decorated, well furnished and have a homely atmosphere. Good standards of health and safety and infection control are evident. Residents spoken with said that “this is a good home”; “staff are very good and the care is good”; “the food is very good, I have a cooked breakfast every day”. Staff are employed in sufficient numbers and are skilled to care for the needs of residents through regular training and supervision. There is good teamwork and good staff retention with some staff who have left returning some time later to work at the home. The home has a strong ethos of upholding privacy, dignity, choice and independence and enabling residents to pursue their own friendships and cultural interests, whilst at the same time providing support for those who need it. Residents are enabled a full choice of GP, chiropodist and hairdresser. The registered manager is well supported by the Director of Care who is based on the site and also very accessible to residents and their relatives. Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 6 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. Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 The service operates a thorough and responsible pre-admission assessment process: care and attention is given ensuring that the home can meet the individual’s needs, resulting in appropriate admissions. This home does not provide intermediate care EVIDENCE: The manager or deputy manager, assess all prospective residents either at home or hospital wherever possible. Evidence of pre-admission assessments was present on all of the three files inspected. Copies of care management assessments were held on file where relevant. Assessments covered all care needs and were detailed. The manager and staff demonstrated a good understanding of residents’ needs. This home does not provide intermediate care Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 The care planning process provides good information but this is not always sufficiently detailed for care staff to satisfactorily meet residents’ needs. Efforts are made to ensure care plans are agreed with residents and/or their representatives. The systems for the administration of medicines are good with clear and comprehensive arrangements being in place to ensure residents’ medication needs are met. EVIDENCE: A new system of documentation had been introduced and staff had worked hard to transfer all residents to the new system. Each file included a summary of the statement of purpose and aims and objectives of the home for staff information. This is particularly benefit in that it regularly reinforces the homes’ philosophy of care for staff guidance. Three care files were inspected. Two of the three contained care plans that covered all key needs (physical and social) and provided good detail of the action required of staff to meet residents’ needs. One had no social care needs or hobbies recorded and the assessment did not contain sufficient detail. The daily records were comprehensive and demonstrated that health; social and mental health needs were well-monitored and appropriate action taken promptly as required.
Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 10 The systems for ordering and return of medicines were satisfactory. Medicines were stored appropriately and temperatures were monitored but this also needs to be recorded to provide evidence that appropriate action is taken when temperatures are above 25°Centigrade. Records of administration were generally well recorded with only one omission. Temazepam was stored and monitored as for controlled drugs as is recommended as good practice. All staff had received training on medication dosage systems from Boots. Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 Daily routines are flexible, and choices are actively promoted. A good and appropriate range of therapeutic and social activities takes place in the home. EVIDENCE: Residents were enabled a full choice of GP, chiropodist and hairdresser. Several residents spoken with said they were enabled a choice of getting up, going to bed, where to eat, whether to take part in activities and several were observed going out of the home for shopping or to have lunch with friends and relatives. A range of activities was provided and this was displayed for residents’ information. Relatives and visitors were observed coming into the home at various times and residents spoken with said there were no restrictions on visiting times and they could see their visitors in private. The homes policy of visiting times in included in the statement of purpose and service users guide. Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Appropriate policies, procedures and practices were in place to promote the protection of residents from abuse. The manager actively promoted awareness of protection issues through staff training, recruitment practices and respecting individual rights. EVIDENCE: The home had a policy and procedures for the protection of vulnerable adults and whistle blowing. The manager had attended a training workshop held by Essex Vulnerable Adults Protection Committee and had obtained guidance books for distribution to all staff. The deputy manager had also undertaken training by EVAPC and had commenced training of staff from Freda Gunton and other Balkerne Garden’ homes on the prevention of abuse. There had been no incidents or allegations of abuse. Records inspected showed that appropriate pre-recruitment checks on new staff were undertaken prior to appointment (see standard 29). Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 Freda Gunton provides a safe, well maintained a homely environment for residents. EVIDENCE: A partial inspection of the premises was made that included communal areas, bathrooms, a number of residents’ room and the sluice. The home was in a good state of maintenance and decoration. There was a programme of regular maintenance in place. Communal rooms were clean and well decorated and furnished to provide a homely environment for residents. Residents spoken with said their rooms were always kept clean. The gardens were attractive and well maintained and provided a pleasant outlook with good access for residents. Records provided evidence that the building complied with the requirements of the local fire and environmental health department. Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 The staffing levels (skill mix, number and competence) were appropriate to the needs of residents. Recruitment practices were thorough and promoted the protection of service users. Staff benefit from a supportive management team that develops skills through an established training programme. EVIDENCE: There were thirty-nine residents at the home. Staffing levels were confirmed as 8 care assistants; from inspection of the staff duty rota and discussion with staff and residents, there was evidence that staffing levels were well maintained, and met the needs of residents. There were ten staff with NVQ level 2 and above. All new staff were registered on a TOPPS-certified training course. The files of two staff members were inspected: these contained evidence that all the required checks had been obtained (two satisfactory references, CRB/POVA checks). Copies of birth certificates, passports, photographs were present on one file. The second had no copy of birth certificate but evidence of identification had been obtained. Both staff had received a statement of terms and conditions of employment. The training records confirmed that most staff were up-to-date with all mandatory training including health and safety, fire safety, basic first aid and
Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 15 moving and handling. Since the last inspection training had also been provided on infection control, bereavement, abuse and NVQ training. Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35 The systems for service user consultation are good with sound evidence that indicates that their views are sought and acted upon. Residents financial interests are promoted and protected through robust systems that are well adhered to. EVIDENCE: Balkerne Gardens Trust had a business plan that included the aims and objectives of the charity and referred to all four homes it represented. The home had a quality assurance framework in place that included distribution of service users’ questionnaires alternating annually with those sent to relatives. Policies and procedures inspected were regularly reviewed and action from inspection reports was progressed within timescales as required. There was evidence from discussion with residents, the registered manager and staff and previous knowledge of the home that Freda Gunton was run in the interests of service users. There were plans for refurbishment of the home but an annual
Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 17 development plan had not yet been produced. There was evidence from discussion with residents and their relatives that their views on the home were sought through frequent informal discussion with the manager, through the complaints procedures, comment book and from thank-you letters received. The systems for the management of five residents’ monies were inspected. All were appropriately managed with records of receipts maintained and amounts confirmed as accurate. Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 3 x x x x x x x STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 3 x x x Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard 3 9 Regulation 15(1) 13(2) Requirement The registered person must ensure that care plans are always sufficiently well detailed. The registered person must ensure that the temperature of medicines storage is monitored and recorded. Timescale for action 31/01/06 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Freda Gunton Lodge DS0000017824.V277786.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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