Inspection on 23/10/07 for Gable Court Nursing Home

This inspection was carried out on 23rd October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Gable Court Nursing Home 06/02/07

Gable Court Nursing Home 04/01/06

Gable Court Nursing Home 15/09/04

Gable Court Nursing Home 21/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Gable Court Nursing Home 111 Roxy Avenue Chadwell Heath Lane Romford Essex RM6 4AZ Lead Inspector Ms Gwen Lording Unannounced Inspection 23rd October 2007 08:30 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 Gable Court Nursing Home DS0000025953.V353472.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. Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gable Court Nursing Home Address 111 Roxy Avenue Chadwell Heath Lane Romford Essex RM6 4AZ 0208 597 6041 0208 599 9257 soobenn@bupa.com www.bupa.co.uk BUPA Care Homes (CFC Homes) Ltd 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) Nalini Sooben Care Home 52 Category(ies) of Old age, not falling within any other category registration, with number (52), Physical disability (6) of places Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 6 beds may be used for named residents under 65 years with physical disabilities 6th February 2007 Date of last inspection Brief Description of the Service: Gable Court Nursing Home is operated by a BUPA owned company. The home is registered to provide accommodation with personal care and nursing for up to 52 residents. The majority of the residents are over the age of sixty-five years, but the home is also registered to provide care for up to six people between the ages of 18-65 years who have a physical disability. The home is a purpose built three storey building situated in a busy residential area of Chadwell Heath, with access to community facilities: via public transport links a short walk away. All the rooms are single occupancy and the majority have ensuite facilities. Not all the rooms are large enough to accommodate wheel chair users. The current manager has worked at the home for a number of years and has the qualifications and experience to understand and meet the needs of the residents. On the day of the inspection the range of fees for the home was between £545.00 and £700.00 per week. A copy of the Statement of Purpose and Service Guide to the home is made available to both the resident and the family. There is a copy of the guide in each bedroom, and copies of both these documents are available at the main reception. A copy of the most recent inspection report is also available at reception or on request. Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspected which started at 08.30am and took place over six hours. The inspection was undertaken by the lead inspector, Gwen Lording. The manager and head of care were available throughout the visit to aid the inspection process. This was a key inspection in the inspection programme for 2007/2008. Discussion took place with the manager; head of care; several members of nursing and care staff; head chef; housekeeper; maintenance person; and the home’s administrator. The inspector spoke to residents where possible; and they were asked to give their views on the service and their experience of living in the home. Nursing and care staff were asked about the care that residents receive and were observed carrying out their duties. A tour of the premises, including all communal areas, main kitchen and laundry was undertaken. The files of several residents were case tracked, together with the examination of other home and staff records. This included medication administration; training records; maintenance records; complaints; accidents/ incidents and staff recruitment files. Information was taken from an Annual Quality Assurance Assessment (AQAA), which was completed by the manager. This is a self-assessment process, which all providers are required to complete once a year. Additional information relevant to this inspection was also obtained from monthly Regulation 26 monitoring reports and Regulation 37, notification of events. As part of the inspection process the views of several community health professionals who provide a service to the home were sought, and are commented in this report. Surveys were sent out to the home prior to the inspection. Twenty surveys were sent to staff and sixteen were returned. Twenty surveys were sent to staff and thirteen were returned. Residents responses indicated that they were satisfied with the care and support they were receiving in the home. Staff responses indicated that they felt well supported by the manager and identified their strengths as good team working. Several residents were asked how people living in the home wished to be referred to. The majority expressed a wish for the term resident to be used. This is reflected accordingly in the report. The inspector would like to thank the residents and staff for their input during the inspection, and to those people who completed surveys. Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? New care planning documentation is being gradually implemented and all staff have received training in its use. This care planning documentation has the potential to be to be an effective working tool for all members of staff. There is new ‘decking’ in the garden, which has further improved the external areas of the home. New equipment has been provided in the main kitchen; a new assisted bath has been fitted in the ground floor bathroom, and the refurbishment programme for the bedrooms continues. All nursing staff have received training in the recently introduced Mental Capacity Act 2005, and the impact it will have upon the delivery of care to vulnerable people. This important training will be cascaded down to all staff working in the home. Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 7 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. Gable Court Nursing Home DS0000025953.V353472.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 Gable Court Nursing Home DS0000025953.V353472.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): Standards 3 & 4 People using the service experience good quality outcomes in this area. We have made this judgement using all available evidence including a visit to this service. A pre-admission assessment is undertaken for all prospective residents. Care plans are drawn up from the information in this assessment ensuring that the needs of the residents are identified, understood and met. The home does not offer intermediate care. EVIDENCE: Individual records are kept for each resident and a number of files were examined. All records examined had assessment information recorded and the information had been used to continue assessment following admission to the home. The records showed that residents, where possible and their relatives/ representatives are involved in the assessment process. Where appropriate, information provided by the placing authority was also included. Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 10 The inspector was satisfied that a full assessment of need is undertaken prior to residents moving into the home, and that the manager would not admit a new resident unless she was sure that the assessed needs could be met. The home actively encourages prospective residents and their relatives to visit the home prior to making any decision to move in. This has not always been possible when people are being admitted directly from hospital. However, the manager has identified in the AQAA, that this is an issue to be addressed for the future. Gable Court Nursing Home DS0000025953.V353472.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): Standards 7, 8, 9, 10 & 11 People using the service experience good quality outcomes in this area. We have made this judgement using all available evidence including a visit to this service. Residents health and personal care needs are set out in individual care plans. The care plans are generally detailed but need to be more specific with regards to the recording of outcomes for residents around the cultural and religious needs of the individual. Whilst the new care planning system is being implemented, staff must ensure that the existing care plans are kept up to date in respect of changing needs, to ensure that all care needs are being understood and continue to be met on a daily basis. There are clear medication policies and procedures and procedures to follow, so as to ensure that residents are safeguarded with regard to their medication. EVIDENCE: The home is currently in the process of implementing new care planning documentation Quest, and all staff have received training in its use. The implementation process is gradual and on the day of the inspection Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 12 approximately five residents care had transferred to the new care plans. Individual care plans were available for each resident and a total of seven residents were case tracked and their care plans and related documentation inspected. Care plans were generally detailed, but need to be more specific with regard to the recording of outcomes around the cultural and religious needs of residents. For example, residents religion is recorded but there was no evidence on the care plans as to the impact of a person’s religion or culture on the method and type of care to be provided. Although care plans made brief reference to a residents religion or culture, there were no references in the care plans to the implications of this on either care or health/ social needs, and to a limited degree on their dietary needs. Staff need to have a knowledge of what a persons religion and culture means in terms of care and activities. Care plans were generally comprehensive and detailed health, personal and social care needs. There was evidence that care plans were being reviewed at least monthly and updated to reflect changing needs. However, the care plan of one resident had not been updated following a review of the frequency of blood sugar monitoring. Whilst staff may be able to give a good verbal account of the change in care needs, it is important that any such changes are accurately reflected in written care plans. They must include sufficient information so that they can be easily used and understood by people who are not familiar with the resident, to ensure continuity of care. As far as possible, residents’ and/ or their relatives are involved in the drawing up of the care plan. It is also acknowledged that care plans are in the process of transfer to the new care planning documentation. However, whilst the new care planning system is being implemented, staff must ensure that the existing care plans are kept up to date in respect of changing needs, to ensure that all care needs are being understood and continue to be met on a daily basis. The new care planning documentation has the potential to be an effective working tool for all members of staff, that is nurses and care staff. The new care plans include specific night care and end of life care plans, and a lifestyle profile, which details residents usual and preferred routines in their day-to-day lives. The documentation/ health records relating to wound management; management of insulin dependant diabetes; control of infection, catheter care and a recently admitted resident were examined. The records for these residents were found to be detailed and being adequately maintained. Risk assessments are routinely undertaken on admission around nutrition, manual handling, continence, risk of falls, and pressure sore prevention; and are being reviewed on a regular basis. Records are maintained of nutrition, including weight loss or gain with appropriate action being taken where necessary. However, whilst weights were being undertaken monthly, or more frequently were indicated, staff must ensure that they consistently record this information on one source only. Some care plans examined had weights Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 13 recorded on three different sources. Files evidenced involvement from GP’s; tissue viability nurse; dietician; speech and language therapist; diabetic nurse specialist; optical, dental and chiropody services. There has been some development of care plans around ‘End of Life’ wishes and needs, and the new care plans will hopefully develop this important area further. From discussions with the manager and staff, and viewing cards and letters received from relatives, it was apparent that staff dealt with a person’s dying and death in a sensitive and understanding manner. One relative had written: “Thank you for giving (X) excellent care over the many years she was there with you”. Another had written: “I am so glad that (X) returned to Gable Court for the last days of his life”. Staff in the home routinely support relatives following the death of a resident through sympathy cards, floral tributes and support for staff to attend funerals. Staff talked about and were observed to treat residents in a respectful and sensitive manner. They understood the need to promote dignity through practices such as the way they addressed residents and were observed knocking on bedroom and bathroom doors before entering. Staff were observed undertaking moving and handling tasks and offered explanation and reassurance throughout. An audit was undertaken for the handling and recording of medicines within the home and a sample of Medication Administration Record (MAR) charts were examined. There are clear medication policies and procedures for staff to follow. Discussions with staff and the review of medication records show that staff are following the policies and procedures, so as to ensure that residents are safeguarded with regard to their medication. The inspector spoke to several residents about the care they receive in the home: “My family are not able to care for me now, but the staff treat me with the same kindness and care”. “I like the people who care for me and I really appreciate their support”. “Whenever I need help, the staff are there”. Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 14 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): Standards 12, 13, 14 & 15 People using the service experience good quality outcomes in this area. We have made this judgement using all available evidence including a visit to this service. Residents are given the opportunity to take part in a variety of activities and the lifestyle within the home matches the preferences of residents with regard to their social and recreational activities. The nutritional needs of the residents are well considered so that food and meal times are seen as being important and enjoyable for all residents. EVIDENCE: The home employs a full time activity co-ordinator. There is a general programme of planned activities for all residents, which includes regular visits by professional entertainers. All residents have an individual plan around activities and a record is maintained of activities that individual are involved, levels of interest and interaction. There are a variety of small and large group activities, as well as planned one to one activities. The activity co-ordinator takes into account the needs, preferences, expectations and capabilities of all residents in the home. She tries hard to offer a varied programme and arrange activities that are suited to individual’s interests. There is an annual summer fete and Christmas entertainment, which are popular and well attended by Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 15 residents and their relatives. The local senior school regularly invites a group of residents from the home to join in their annual Christmas party. Visiting times are flexible and relatives/ friends are encouraged to visit. Throughout the visit staff were observed allowing time for residents to express their wishes and supporting individuals to make choices in their everyday lives. All staff including administrative and ancillary staff are very aware that Gable Court is the home of the residents and try to make this as pleasant as possible. The inspector arrived at the home at 8.30pm and was able to observe breakfast being served as well as the lunchtime meal. In the morning residents either ate in the small dining rooms or in their rooms. Residents were able to choose from a variety of breakfast options including cooked breakfast, toast, porridge, cereals and fruit juice. There was a nice atmosphere during both meals. Staff were very attentive to residents needs and were seen to offer assistance and encouragement where necessary. The majority of residents have their lunchtime meal in the main dining room on the ground floor, though some residents choose to eat in their rooms. Dining tables are routinely laid with tablecloths, napkins, condiments, cutlery, glasses and fresh flowers. One resident did not want any of the menu options available for the meal that day, and was offered a number of alternatives. From discussion with the head chef, visit to the main kitchen, viewing menus and conversations with residents, the inspector was satisfied that the residents receive a varied, appealing, wholesome and nutritious diet which is suited to individual requirements. The head chef considers it important to get to know the residents well and is fully aware of the residents nutritional needs and choices. Culturally appropriate food is provided for example, plantain, rice, as a carbohydrate option, vegetarian and any religious dietary needs would be adequately catered for. Seasonal fruit platters are prepared daily and fruits are available on request. Custards, porridge and drinks are made with full cream milk and added cream and butter wherever possible, to supplement the diets of those residents with reduced food intake, weight loss, or diminished appetite. The kitchen was clean, food in the refrigerators was in date order and clearly labelled, as were dry goods and fresh foods. There is little reliance on tined, processed or frozen foods. The inspector had no concerns with regard to the management of the kitchen. Gable Court Nursing Home DS0000025953.V353472.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): Standards 16 & 18 People using the service experience good quality outcomes in this area. We have made this judgement using all available evidence including a visit to this service. The manager and staff make every effort to sort out any problems and concerns. Residents and their relatives can be confident that their complaints and concerns will be listened to and acted upon. Staff working in the home have received training in safeguarding adults to ensure that there is a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a written complaints policy and procedure for dealing with complaints, and staff spoken to were aware of the complaint procedure and how to deal with complaints and concerns made to them. The complaints log was inspected and indicated complaints received, details of investigation, action taken to resolve and the outcome for the complainant. Less formal concerns/ issues of dissatisfaction are currently recorded in the individuals care plan. However, it is recommended that the manager also record such concerns in the central complaints log so that during inspection or audit all information is recorded in one source. This will also highlight any trends/ patterns for subsequent follow up action by the manager and to inform areas for service improvement. Those residents spoken to were aware of how to complain and Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 17 to whom. No complaints have been received by the Commission since the last inspection. All staff working in the home have received training in safeguarding adults and this is included in induction training for all staff. This was evidenced on staff files and the training programme. Those staff spoken to were conversant with the action to be taken if they had any concerns about the safety and welfare of residents or if they witnessed any suspected abuse. Gable Court Nursing Home DS0000025953.V353472.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): Standards 19, 20, 23, 24, & 26 People using the service experience good quality outcomes in this area. We have made this judgement using all available evidence including a visit to this service. The overall atmosphere in the home is very welcoming. The physical environment is clean, comfortable and meets the needs of the people living in the home. Some areas are now looking ‘tired’ and in need of refurbishment. Priority areas have been identified by the manager for improvement within the next twelve months. EVIDENCE: The building was toured by the inspector at the start of the visit and all areas were visited again later during the day. Some bedrooms were seen either by invitation of the residents, whilst others were seen because the doors were open or being cleaned. All of the bedrooms seen were personalised and were reflective of the occupant’s interests, culture and religion. It was noted that some bedrooms were being used to store boxes of enteral feeds and nutritional Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 19 supplements. Whilst it is acknowledged that these are for the use of the occupant’s of the rooms, it is not acceptable to store surplus stocks in residents rooms, as it impinges on their individual, space, comfort and privacy. There were no offensive odours and the home was clean and tidy. The standard of the décor, furnishings and fittings are generally being maintained to a good standard. However, some areas of the home are now being to look ‘tired and worn’, and are in need of refurbishment. The AQAA completed by the manager has identified areas for improvement, which are planned to take place within the next twelve months. A maintenance person is employed and there is an effective system in place for staff to report items requiring attention or repair. The external grounds are well maintained and secure. The laundry area was visited and this was found to be clean, with soiled articles, clothing and foul linen being stored appropriately, pending washing. The manger has received information and is fully aware of the recent legislation regarding smoking in care homes, which came into effect on the 1st July 2007. Gable Court Nursing Home DS0000025953.V353472.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): Standards 27, 28, 29 & 30 People using the service experience good quality outcomes in this area. We have made this judgement using all available evidence including a visit to this service. Staffing levels are satisfactory and there are sufficient staff on duty to meet the individual assessed needs of the residents. Residents benefit from a committed staff team who have the skills and training to meet their needs. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. EVIDENCE: Staff rotas were inspected and the staffing levels and skill mix of qualified nurses and care staff, on all floors, was sufficient to meet the assessed nursing and personal care needs of the residents. The home has retained a stable workforce and there is no use of agency staff. Effective team working was observed throughout the visit, and staff interacted well, both with each other and the residents. Care workers were being effectively deployed throughout the home to ensure that residents who remain in their bedrooms, either by choice or for health reasons, were being cared for appropriately. A record is maintained of staff training and records showed that staff have undertaken training in essential areas such as manual handling, safeguarding adults, first aid, health and safety, infection control and fire safety. Other Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 21 training undertaken has included effective record keeping, use of a nutritional screening tool, and medication training. The AQAA completed by the manager stated that 75 of care staff are qualified to National Vocational Level Qualification (NVQ) level 2 or above. A discussion took place with the manager around the recently introduced Mental Capacity Act 2005, and the impact it will have upon the delivery of care to vulnerable people. All qualified nurses have recently received training in this important area and it will be cascaded down to all staff working in the home. The files of the most recently employed staff were inspected and these were found to be in good order with necessary references, Criminal Records Bureau (CRB) disclosures, and application forms duly completed. BUPA Care Homes Limited; as an organisation, employs a workforce from diverse cultures and backgrounds. It was apparent that the ethnicity of the majority of the staff team is not generally reflective of that of the resident group. However, in discussion with the manager and staff they were able to demonstrate an awareness and understanding of the importance in appropriately meeting the needs of all residents, wherever possible around equality and diversity issues. It is important that the manager continues to reinforce this issue through staff training and supervision. This will ensure that the spiritual, cultural, sexual and any other diverse need of residents at Gable Court is met through meaningful ‘person centred’ care. Gable Court Nursing Home DS0000025953.V353472.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): Standards 31, 32, 33, 35 & 38 People using the service experience good quality outcomes in this area. We have made this judgement using all available evidence including a visit to this service. The manager of the home is a well qualified and experienced person and residents benefit as the home is run in their best interests. Staff are appropriately supervised and the health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The manager has the qualifications and experience to manage the home and is able to demonstrate a clear understanding of the needs of the residents. Mrs Sooben is very resident focused and works continuously to improve the service Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 23 and provide an increased quality of life for residents. She is ably supported by an experienced head of care and a strong committed team of staff. From viewing staff records and talking to staff it was evident that staff receive regular supervision. The use of observational and peer supervision could be used to contribute to the supervision process. Staff meetings are held regularly and are minuted. The manager holds regular Health and Safety meetings with the home’s respective heads of department. The responsible individual undertakes Regulation 26 monitoring visits on a monthly basis to monitor and report on the quality of the service being provided in the home. A copy of the report is sent to the Commission. Currently the manager does not act as an appointed agent for any resident. Residents’ financial affairs are managed by their relatives/ representatives. Through discussion with the home’s administrator and records inspected, it was evident that residents financial interests are safeguarded. Secure facilities are provided for the safekeeping of money and valuables held on residents behalf. A wide range of records were looked at including fire safety, emergency lighting, water temperature checks, bedside rails safety checks and accident/ incident records. These records were found to be detailed, up to date and accurate. Gable Court Nursing Home DS0000025953.V353472.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 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 2 X 3 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 4 4 3 X 3 X X 3 Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 25 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. Standard OP7 Regulation 12 & 15 Requirement Care plans must be more specific with regard to the recording of outcomes for residents around the cultural and religious needs of the individual. This will ensure that residents are provided with the right care and support in respect of such needs. Whilst the new care planning system is being implemented the manager must ensure that existing care plans are kept up to date in respect of changing needs, to ensure that all care needs are being understood, known and continue to be met on a daily basis. The registered providers must ensure that more suitable arrangements are made for the storage of surplus stock such as nutritional supplements. This will ensure that the storage of such items does not impinge on the individual’s space, comfort and privacy. Timescale for action 31/12/07 2. OP7 12 & 15 23/10/07 3. OP24 23 (2)(l) 23/10/07 Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 26 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 OP16 Good Practice Recommendations It is recommended that the manager record verbal complaints, less formal concerns/ issues of dissatisfaction in the central complaints log. Gable Court Nursing Home DS0000025953.V353472.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Gable Court Nursing Home DS0000025953.V353472.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. 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