Inspection on 04/01/06 for Gable Court Nursing Home

This inspection was carried out on 4th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 23/10/07

Gable Court Nursing Home 06/02/07

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 4th January 2006 11:00 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.V276245.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. Gable Court Nursing Home DS0000025953.V276245.R01.S.doc Version 5.1 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 sooben@bupa.com www.bupa.co.uk BUPA Care Homes (CFCHomes) Limited 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.V276245.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 6 beds may be used for named residents under 65 years with physical disabilities 15th September 2004 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. Gable Court Nursing Home DS0000025953.V276245.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 11am. It took place over four hours during the late morning and afternoon. Discussion took place with the registered manager, head of care, administrative, catering, laundry, domestic staff, the maintenance person and several members of nursing and care staff. The inspector spoke to several residents in the lounge and a number of residents on each of the three floors who were in their rooms. In addition the relatives/ visitors of four residents were spoken to and asked their views and comments about the care in the home. A tour of the home was made and a number of care and staff records were looked at. This was the second statutory inspection visit in the inspection programme for 2005/2006. Over the course of the two visits, all key standards have now been assessed. The Inspector would like to thank the staff, residents’, and their relatives/ visitors for their input during the inspection. What the service does well: What has improved since the last inspection? New furniture has been purchased for the dining rooms and the lounges and the programme for the refurbishment of the bedrooms continues. Gable Court Nursing Home DS0000025953.V276245.R01.S.doc Version 5.1 Page 6 The glass partition in the reception area has been removed, opening up this area and making it appear more accessible and welcoming to visitors. An additional hoist has been purchased for the ground floor. 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. Gable Court Nursing Home DS0000025953.V276245.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 Gable Court Nursing Home DS0000025953.V276245.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): These standards were not tested on this visit. However, evidence from the last inspection was that the home is undertaking a comprehensive pre-admission assessment for all residents prior to them moving into the home. Care plans are drawn up from this assessment, ensuring that the needs of the residents are identified, understood and met. The home does not offer intermediate care. EVIDENCE: The above standards were not specifically tested on this visit, as there were no outstanding requirements in relation to Standard 3. At the time of the inspection, all of the outcome standards were assessed as met. This standard will be re-tested at a future inspection. Gable Court Nursing Home DS0000025953.V276245.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): Standard 9 There are clear medications policies and procedures for staff to follow. However, there are some inconsistencies in the recording of medication, which may result in unsafe practices. Standards 7, 8 and 10 were not tested on this visit. However, evidence from the last inspection was that: • There is a clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily identify and meet residents’ needs. • Residents are treated with respect and the arrangements for their personal care ensure that their right to privacy is upheld. EVIDENCE: The above standards were not specifically tested on this visit, as there were no outstanding requirements in relation to Standards 7, 8 and 10. At the time of the last inspection, all of the outcome standards were assessed as met. These standards will be re-tested at a future inspection. Gable Court Nursing Home DS0000025953.V276245.R01.S.doc Version 5.1 Page 10 The Medication Administration Records (MAR) charts for each floor were inspected. The following issues were noted and discussed with the manager: • Handwritten entries on MAR charts must be signed and dated by the person making the entry i.e. GP, registered nurse. The entry must also include the source of the information i.e. GP, relative. When directions for administering medications are variable e.g. one or two tablets, then the dose given is to be entered on the MAR chart. • Gable Court Nursing Home DS0000025953.V276245.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): Standards 12 and 14 There is a varied programme of activities available, which suit individual needs, preferences and capacities. Social activities are well managed and provide daily variation and interest for people living in the home. Standards 13 and 15 were not tested on this visit. However, evidence from the last inspection was that: • Visiting times are flexible and people are made to feel welcome in the home so that residents are able to maintain contact with their family and friends as they wish. • The meals in the home are well presented and offer both choice and variety for residents living in the home. EVIDENCE: The Inspector observed members of staff allowing time for residents to express their wishes and supporting individuals to make choices in their daily lives, for example choosing a drink, newspaper, type of music to listen to, taking a walk or where they wish to eat their meal. The home employs an activity co-ordinator who works in the home four days a week. There is a programme of activities, which includes both small and large group activities, visiting professional entertainers and outings. Each resident Gable Court Nursing Home DS0000025953.V276245.R01.S.doc Version 5.1 Page 12 has a social assessment sheet and social care plan, which details individual preferences and capacities. A daily record is maintained of activities and records the individual names of the resident involved and their level of participation. The choice of those residents’ not to be involved in some or any activities is respected: “I like to spend time in my own room”. Relatives and friends are encouraged and welcomed to be involved in special events in the home so that residents were able to maintain contact with their family and friends: “ Staff are very friendly and will always involve us at special times like Christmas”. Gable Court Nursing Home DS0000025953.V276245.R01.S.doc Version 5.1 Page 13 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): Standards 16 and 18 were not tested on this visit. However, evidence from the last inspection was that: • The manager and staff make every effort to sort out any problems or concerns and makes sure that residents and their relatives feel confident that their complaints and concerns are listened to and will be acted upon. Staff working in the home have received training in Adult Protection/ Abuse Awareness to ensure that there is a proper response to any suspicion or allegation of abuse. • EVIDENCE: The above standards were not specifically tested on this visit, as there were no outstanding requirements in relation to both these standards. At the time of the last inspection, all of the outcome standards were assessed as met. These standards will be re-tested at a future inspection. Gable Court Nursing Home DS0000025953.V276245.R01.S.doc Version 5.1 Page 14 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): Standard 19, 22 and 26 The overall atmosphere in the home is very welcoming, with a good standard of cleanliness and hygiene, providing a safe and comfortable environment for people to live in. EVIDENCE: The building was toured, unaccompanied by the Inspector. Some bedrooms were seen either by invitation of the residents, whilst others were seen because the doors were open or rooms being cleaned. All areas of the home were clean, tidy and free from odour throughout. The environment in the laundry premises has improved considerably. The laundry area was noted to be tidier, cleaner and less cluttered. The head of laundry services has implemented a system for the speedy repair of resident’s personal clothing and other laundered items. A visit was made to the home on 7/12/05 by the Public Protection Department. They undertook an environmental health inspection of the kitchen premises Gable Court Nursing Home DS0000025953.V276245.R01.S.doc Version 5.1 Page 15 and the report stated: “Very good, excellent cleanliness and hygiene standards”. The dishwasher required repair but has been subsequently replaced. There is a very homely atmosphere throughout the home and provides a number of rooms in which a variety of activities can take place. There is an ongoing programme of renewal for the fabric and decoration of the premises and the standard of the environment within the home provides residents with an attractive and comfortable place in which to live. New furniture has been purchased for the dining rooms and lounges and the programme for the refurbishment of bedrooms continues. The glass partition in the reception has been removed, opening up this area and making it appear more accessible and welcoming to visitors. An additional hoist has been purchased for the ground floor. A requirement was made at the last inspection around a small number of areas in the home in need of minor repair. The manager was able to evidence that this requirement has been addressed. Gable Court Nursing Home DS0000025953.V276245.R01.S.doc Version 5.1 Page 16 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): Standards 28 and 30 Resident’s benefit from a committed staff team who have the skills and training to meet their needs. Standards 27 and 29 were not tested on this visit. However, evidence from the last inspection was that: • • Staffing levels are satisfactory and there are sufficient staff on duty to meet the individual assessed needs of the residents. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. EVIDENCE: Standards 27 and 29 were not specifically tested on this visit, as there were no outstanding requirements in relation to these two standards. At the time of the last inspection, all of the outcome standards were assessed as met. These standards will be re-tested at a future inspection. Staff files showed that staff had done training in essential areas such as fire safety, administering medication, manual handling, first aid and adult protection/ abuse awareness. 90 of care staff are qualified to NVQ level 2 and this demonstrates a very positive commitment to training from both the organisation and the care staff. Gable Court Nursing Home DS0000025953.V276245.R01.S.doc Version 5.1 Page 17 All members of staff receive induction training to National Training Organisation (NTO) workforce training targets within six weeks of appointment to their posts. All staff are issued with personal workbooks, which includes essential areas such as, nutrition, health and safety, food hygiene and information on people living with dementia. Gable Court Nursing Home DS0000025953.V276245.R01.S.doc Version 5.1 Page 18 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): Standards 35 and 38 All staff are appropriately supervised to ensure that residents best interests are safeguarded by the homes record keeping. Standards 31, 32 and 33 were not tested on this visit. However, evidence from the last inspection was that: • The manager of the home is a well qualified and experienced person and residents benefit as the home is run in their best interests. EVIDENCE: Resident’s financial affairs are managed by their relatives/ representatives. The home has responsibility for the personal allowance of several residents. There is a computerised financial system in place, which is managed by the home’s administrator. Through discussion with the administrator and records Gable Court Nursing Home DS0000025953.V276245.R01.S.doc Version 5.1 Page 19 inspected, there was evidence to show that resident’s financial interests are safeguarded and there are robust procedures in place. Secure facilities are provided for the safekeeping of money and valuables held on behalf of residents’. A wide range of records were looked at, including fire safety, emergency lighting, recording of water temperatures and accidents/ incidents. These records were detailed, up to date and accurate. Gable Court Nursing Home DS0000025953.V276245.R01.S.doc Version 5.1 Page 20 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 X 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X 3 X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 3 Gable Court Nursing Home DS0000025953.V276245.R01.S.doc Version 5.1 Page 21 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 OP9 Regulation 13 Requirement All handwritten entries on Medication Administration Record (MAR) charts must be signed and dated by the person making the entry and include the source of the information. When directions for administering medications are variable e.g. one or two tablets, then the dose given is to be entered on the MAR chart. Timescale for action 04/01/06 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 Gable Court Nursing Home DS0000025953.V276245.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: 0845 015 0120 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.V276245.R01.S.doc Version 5.1 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!