Inspection on 14/01/09 for Gables Nursing Home

This inspection was carried out on 14th January 2009.

CSCI found this care home to be providing an Poor 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

Gables Nursing Home 15/10/09

Gables Nursing Home 14/04/09

Gables Nursing Home 23/12/08

Gables Nursing Home 21/08/07

Gables Nursing Home 06/06/06

Gables Nursing Home 16/09/05

Gables Nursing Home 25/05/05

Gables Nursing Home 19/10/04

Gables Nursing Home 13/05/04

Gables Nursing Home 03/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 20/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Gables Nursing Home Barrows Green, Bradfield Road Leighton Crewe Cheshire CW1 4QW     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Joan Adam     Date: 1 4 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: Gables Nursing Home Barrows Green, Bradfield Road Leighton Crewe Cheshire CW1 4QW 01270588952 F/P01270588952 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr William Preston care home 34 Number of places (if applicable): Under 65 Over 65 34 0 old age, not falling within any other category physical disability Additional conditions: 0 5 This home is registered for a maximum of 34 service users to include:- * Up to 34 service users in the category of OP (Old age, not falling within any other category) * Up to 5 service users aged 55 years and over in the category of PD (Physical disability) Date of last inspection Brief description of the care home The Gables is a care home providing accommodation and nursing care for 34 older people, 5 of whom may be aged between 55 and 65 years of age. The service is located in an extended, detached two storey property, situated in its own grounds in a semi-rural setting on the outskirts of Crewe. The home is easily accessible from Nantwich, Winsford, Middlewich and Sandbach. It is served by local transport and is close to railway networks, being two miles from Crewe station. Bedroom accommodation is situated on both floors and is provided within single bedrooms. All bedrooms are provided with wash hand basins, but there are no en-suite facilities. Day space consists of three lounges, one of which is a smoking area. A separate dining room is also available. There is a passenger lift and staircase providing access to the Care Homes for Older People Page 4 of 32 Brief description of the care home first floor. The home is registered for nursing and personal care for persons with general physical frailty. The fees range from #353.91 per week for personal care only to #415.72 per week for those requiring nursing care. Care Homes for Older People Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The site visit was carried out by two inspectors of the Commission for Social Care Inspection(CSCI) on 14th January 2009 over a period of six hours. This was to assess if peoples needs were being met at the home. A tour of the premises took place, a majority of bedrooms were looked at and the shared areas such as dining rooms and lounges, shared bathrooms and toilets. The manager, several staff and people cared for were spoken with and their views contributed to the inspection of the home. This visit was just one part of the inspection. Before the visit the home was asked to complete a self audit called an annual quality assurance assessment! (AQAA) to provide up to date information about the services at the home. The previous manager of The Gables had completed this form. Other information sent to us by the home and other professionals such as social services since the last key inspection was also Care Homes for Older People Page 6 of 32 reviewed so that we could plan what we needed to look at when we visited. We made a visit to the home in December 2008 following concerns raised by relatives at the home and social services. This is called a random inspection. Requirements were made at the random inspection and progress on how they were being met was looked at on this visit. Feedback was given to the manager and owner at the end of the visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 32 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 32 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home have their needs assessed so that they know their needs can be met. Evidence: The care file for one resident who was admitted in November 2008 were looked at and the previous manager had assessed this person before they were admitted to the home so that they knew their needs could be met. The home has not had any admissions since November. Care Homes for Older People Page 11 of 32 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of the people who live at the home are met, however the accuracy of record keeping falls below the required standard to make sure that peoples needs are met effectively. Evidence: The new manager has made some progress in up dating care plans for people who live at the home. The work on improving care plans must be completed so that they are easy to follow and and a consistent approach to supporting people will be maintained. Two care plans looked at contained files going back as far as 2001 making it difficult for staff to obtain up to date information, these folders need a complete clear out and starting again from an assessment of their needs in 2009. Some care plans were detailed but some wording was obscure and did not give enough information so that care staff would know what the needs of the residents are and how to meet them. One person who was a diabetic did not have a care plan in place for the management of her diabetes. A moving and handling assessment had not been updated to show that this person had Care Homes for Older People Page 12 of 32 Evidence: deteriorated and now needed two staff to transfer. There are a number of people who live at the home who have pressure sores. The care plans for the treatment of these is in a separate file. There is no indication in the main notes as to the fact that these people have pressure sores. Storing information about individual people in different places may lead agency or bank staff not being able to find it quickly to ensure that they can give the correct support or treatment to people who have pressure sores. One care plan had not been updated for some time and no wound progress had been recorded. The information recorded indicated that the wound had changed dramatically but the notes were difficult to follow. This was discussed with one of the trained nurses on duty who did not seem to know how the wound was progressing. We were unable to establish a clear picture of how the pressure sore had developed over time. This lack of an easy to access audit trail could result in people not getting the correct treatment they needed. Care plans had been reviewed but comments such as care plan implemented was written which does not give any information as to how the person has been that month or what if any changes had occurred. A lack of detailed reviewing of care plans may mean that people may not be getting all of the support they need to remain as healthy as possible. The new risk assessments in place for bed rails, falls prevention and tissue viability, which had been written by the new manager were good. We observed positive interaction between staff and residents. We observed good use of the stand aid hoist and staff gave reassurance to the person being hoisted. All staff appeared to have a kind and caring attitude. People spoken to during the visit looked well cared for and told us they were happy living to the home. Some people spoken to were confused and were unable to communicate their needs. Medication management was looked at and an action plan was seen which had been formulated between the manager and the local pharmacy. This gave good instructions to all trained staff as to the monthly ordering system that was required to make sure all people who live in the home had good stocks of medicines that had been prescribed. Staff had been asked to sign this to ensure that they understood what was expected of them. Controlled drug storage was looked at and all quantities were correct. Some medicine recording sheets had gaps so it was unclear if the medicine had been given or if the resident had refused. Some nurses recorded when a pulse was taken before giving digoxen but some did not. There were large stocks of dietary supplements on shelving in the dining room. It was unclear as to who these were for and how often they should be given. Two staff members were spoken to and we were told that a white board in the satellite kitchen had a list of the names of people who needed these supplements and when they should be given, however, not all the supplements on the shelves were listed. A better Care Homes for Older People Page 13 of 32 Evidence: way of communicating to all staff as to the use of these prescribed supplements should be devised so that the people who need them are ensured that they get them as they are prescribed. Care Homes for Older People Page 14 of 32 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at The Gables do not have regular activities provided and their personal choices are not recorded. The menus and choice of meals has improved so that people have a nourishing, varied diet. Evidence: The home employs an activities co-coordinator who also assists at mealtimes and giving out drinks during the day. She was on holiday at the time of our visit. No activities programme was seen to be displayed in the home and there were no social activities recorded in the care plans that were looked at. The hairdresser was in the home and most of the ladies had their hair set. People spoken with could not indicate whether they chose to sit in the main lounge and there was no evidence of choice recorded in the care plans looked at. At a previous visit in December the cleanliness of the kitchen was very poor and the stocks of food were low. However, a new cook has been employed and the kitchen and store rooms were clean. All fridges had been cleaned and the temperatures had been taken and recorded on a daily basis. The broken grill had been removed, the cooker was clean and the fat in the deep fat fryer had been changed. A new cooker was on order and the proprietor had made arrangements for an extractor fan to be installed Care Homes for Older People Page 15 of 32 Evidence: and some areas of the kitchen to be improved to make more room.The flooring in the doorway of the main kitchen was ripped and worn and this was to be replaced. The cook said that the proprietor shopped weekly for all foods on the menu and that she could shop for additional foods if she felt this was necessary. The stocks of food seen had improved and no food was out of date. Fresh vegetables and fruit were seen and these were delivered twice weekly. The lunch on offer was cottage pie or fish fingers and chips. The food looked well cooked. Care Homes for Older People Page 16 of 32 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is no evidence that complaints have been dealt with appropriatly and there is no documentation to prove that staff have received training so that they know what to do to protect people from abuse. Evidence: The complaints procedure is displayed in the entrance hall of the home. The new manager could not find any evidence of any complaints at the home. There have been three complaints made to CSCI in the last year which have been given to the proprietor to investigate , one is still being investigated. These had not been logged anywhere so the progress and outcome of these and any action taken by the home to prevent the incidents happening again had not been recorded. The new manager was unable to find any training records for staff working in the home so it was not possible to say when staff last had any training on safeguarding adults. They may not know what to do if an incident occurs. An AQAA sent in by the previous manager in June 2008 states that staff have received training but there was no evidence of this. The AQQA also stated that all new staff members have a Criminal Bureau Check (CRB)check before they commence work at the home. There was one staff member who has been working at the home for some time who did not have an up to date CRB sent for by the home. The home was not able to demonstrate that appropriate checks were made on staff to ensure people who live at the home are protected from abuse. Care Homes for Older People Page 17 of 32 Care Homes for Older People Page 18 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment needs to improve to give the people who live in the home a safe and comfortable place to live. Evidence: The home does not have a handyman in post at the present time. An interview has taken place and following all relevant safety checks this post would be filled in the near future. All areas of the home look shabby and in need of redecoration. The proprietor has had a heating engineer in the home to look at the heating system and the home is now warm. It was recommended at the visit by us in December that all bedrooms have a thermometer in place so that temperatures of bedrooms can be monitored. The sluice is not working and has been broken for some time. The commode pots are being sprayed with Milton solution until this is mended.An engineer from the company that installed the sluice machine has been called to fix it. No date has been given for this visit. During a walk around the home bedrooms were looked at and these had been well personalised. Carpets appeared to have no underlay underneath making the floor hard underfoot. The bathing facilities for people who needed assistance were limited and the proprietor has not as yet installed a shower for people who preferred this method of bathing.This is an unmet requirement from the last inspection report. Care Homes for Older People Page 19 of 32 Evidence: The hoist used for assisting the people who live in the home has now been repaired to enable staff to bathe people safely. Some radiator covers in corridors were broken and could be hazardous to people living in or visiting the home. The nurse call bell system had been checked by the manager and in some areas this was not working. The water temperatures in bedrooms and bathrooms had been checked by the manager and these temperatures were either too hot or too cold and this must be rectified as soon as possible. A wing of the home is not being used at present but the bedrooms and bathrooms are not in a fit state to show people who may want to live in the home as they are being used as store rooms. The flags outside the home on the patio areas are uneven and are a trip hazard. A full assessment of all areas of the home must be made and a planned redecoration and must be made. The home looked cleaner than the last visit and there were no unpleasant smells. All laundry equipment was working. There was evidence of equipment for the prevention of cross infection such as gloves and wipes. Care Homes for Older People Page 20 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing needs to improve so that the people who live at the home are looked after by permanent staff members.Staff training needs to improve so that staff can developer and improve the care given. Recruitment procedures need to be more robust to protect the people living at the home. Evidence: Duty rotas were looked at and the numbers of staff on duty for the current week were satisfactory. The home is not fully staffed at present and the new manager has advertised for care staff to fill the vacancies. Agency staff is being used but it is not always possible for a regular care staff member to be on duty when agency staff are at the home. Although there is use of regular agency staff this can result in an unsettled staff team who can not provide a consistent service to the people living there. The manager is looking at ways to address this. It was noted that the gaps in the duty rotas for the coming week did not have agency staff member names and the manager explained that the agency may give her names of staff to be supplied the day before. This is unsatisfactory as the manager has to plan the rotas to ensure that adequate staff are on duty at all times. The manager has increased the staffing numbers since she commenced work at the home to ensure that the needs of the residents are met. The AQAA from the previous manager stated that staff have received training but no Care Homes for Older People Page 21 of 32 Evidence: training records could be found. Training needs to take place for all staff with regard to moving and handling so that people who live at the home are moved safely, safeguarding adults so that staff know what to do to recognize and act on the abuse or mistreatment of residents. Fire awareness training so that staff would know what to do in the case of a fire. The staff who have been working in the kitchen do not have an up to date food hygiene safety certificate. The manager has started to address these issues by booking training sessions with the local PCT and she has sent for a Mulberry training pack so that she can commence staff training as soon as possible. An overall training plan and record would help to identify the training needs of all staff to make sure that the individual needs of the people living at The Gables are met and a plan is in place to deliver this. Staff files looked at during the visit in December by us showed that new staff working at the home did not have a POVA first or CRB check in place so the home would know if they were suitable to work with older people.One staff member has been suspended until this has been applied for. No formal supervision of staff is taking place as yet, the manager is to commence this as soon as possible. Over fifty per cent of care staff have achieved NVQ level 2 in care. Care Homes for Older People Page 22 of 32 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. More work is needed to ensure that the management systems in the home maintain the safety of the people living at there. Evidence: The home has a new manager in post who has been at the home since December 2008. She is a qualified nurse and has experience in care home management. She is not yet registered with CSCI. The new manager has worked hard to improve the problems identified at the home by social services and since a visit made by us in December. She has improved some care plan documentation and risk assessments although some work still needs to be done to ensure that these contain more detail. She has increased the numbers of staff on duty so that the needs of the people who live in the home can be met. She is recruiting new staff so that less agency staff can be used to give more continuity of care. She has arranged visits to the home from the tissue viability nurse and the infection control nurse for advice in these areas and has arranged training sessions for all staff from the PCT. She has arranged staff meetings Care Homes for Older People Page 23 of 32 Evidence: and a relatives meeting to keep everyone informed of the improvements that need to be made. A meeting has also took place with the local pharmacy to improve the ordering and supply of medications at the home. The AQAA received from the previous manager stated that records were kept of all complaints, staff training and formal staff supervision , however no records of these could be found. Training needs to be arranged for all staff in moving and handling, fire awareness, safeguarding adults and for staff who work in the kitchen food handling certificate. The manager has ordered a Mulberry training pack so that training can commence as soon as possible for all staff. More work will be needed to raise standards to improve the outcomes for people living at the Gables.Regular audits will need to be put in to place to help to check the quality of the service and so that the manager can deal quickly with any matters that arise. Meetings will need to take place on a regular basis with the proprietor so that all areas of work are progressing. The views of people who live at the home and their relatives have not been formally obtained recently and the manager needs to look at ways of obtaining information so that the people who live at the home can have their say. The home has been without a handy man for some time so regular checks on the call bell system or the hot water temperatures had not been carried. The manager has identified problems with the call bell system and the hot water in some bedrooms and bathrooms and has discussed this with the proprietor so that these problems can be rectified quickly. The proprietor must supply us with a current business and financial plan. The file regarding fire safety checks was looked at and it was recorded that the fire alarm checks and emergency lighting had been checked on a weekly basis but there was no record of any fire drills taking place. Care Homes for Older People Page 24 of 32 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 12 16(2)(n) People who live at the home must be given access to more activities to enable them to be mentally stimulated. 31/10/2007 2 21 23(2)(j) A shower must be provided 31/12/2007 at the care home to enable the people who live there to be given a choice of bathing. ( Timescale of 6/12/06 not met) Care Homes for Older People Page 25 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans relating to wound 28/02/2009 management must be kept up dated and the main care file must inform the staff if the resident has a pressure sore. So that all staff are aware of how wounds are treated and know where to look for the information. 2 7 15 Care plans must be kept 28/02/2009 under review to demonstrate that people changing care needs have been identified. So that effective measures can be put in place to meet the changed needs. 3 7 4 Each resident must have a 28/02/2009 detailed up to date care plan that shows how their needs can be met. ( unmet requirement 13/01/09) Care Homes for Older People Page 26 of 32 So that all staff have the information they need to provide care for each person. 4 9 13 All staff must be aware of 28/02/2009 which prescribed dietry supplements are to be given to which resident and how often. So that people who live in the home receive the supplements that have been prescribed. 5 9 13 All medicine administration 28/02/2009 sheets must be signed when a person has been given their medications. So that people living in the home can be confident that they receive medicines as they have been prescribed. 6 12 16 An individual social activities 12/02/2009 programme must be made available for all people living at the home. Timescale of 31/10/07 not met So that the people who live at the home have enough to do. 7 14 13 Choices of people who live at the home must be recorded. So that people who live at the home can choose how to spend their day. 28/02/2009 Care Homes for Older People Page 27 of 32 8 16 22 All complaints received by 28/02/2009 the home must be recorded and action taken in response to complaints must also be recorded. So that people who live at the home know their complaints will be acted upon. 9 18 13 All staff must receive training regarding the safeguarding of adults. So that they know what to do if an allegation of abuse is suspected or occurs. 28/02/2009 10 19 13 The patio areas outside the home must be made safe . So that the people who live in the home can use the gardens safely. 31/03/2009 11 19 23 The sluice in the home must be repaired or replaced. So that staff can dispose of waste safely. 20/02/2009 12 19 23 An inventory of the radiator covers throughout the home must be made and these must be repaired or replaced. to make sure that the people who live in the home do not burn themselves or receive injury from broken surfaces. 28/02/2009 Care Homes for Older People Page 28 of 32 13 21 23 A shower which can be used 28/02/2009 by people who need assisitance must be provided Timescale of 6/12/06 and 31/12/07 not met. So that people who live in the home can be gien a choice of bathing. 14 22 13 The call bell system in all areas of the home must be repaired or replaced So that people who live at the home and need assisitance or help can contact the staff. 28/02/2009 15 25 23 The water temperatures in bedrooms and bathrooms are checked and recorded and maintained at 43 degrees centigrade. So that people who live in the home are kept safe from risk of scalding and have warm water to wash in. 28/02/2009 16 27 13 Staff working in the kitchen must have an up to date food hygeine certificate. So that the staff are aware of good food hygeine practices. 28/02/2009 17 27 13 The manager must obtain 28/02/2009 the names of agency staff who will work at the home in advance. So that the needs of the people who live at the home can be met. Care Homes for Older People Page 29 of 32 18 27 18 There must be sufficient care staff on duty to meet the needs of the people living at the home. So that the needs of the people living at the home are fully met. 28/02/2009 19 28 23 All staff working at the home 28/02/2009 must undertake training in fire safety So that they know what to do in case of fire 20 29 13 All staff working at the home 28/02/2009 must undertake training in moving and handling . So that people who live at the home can be moved safely. 21 34 25 The proprietor must supply CSCI with a copy of the current accounts and details of the running costs and expenditure of the care home. So that information regarding the financial status of the home can be assessed 28/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 19 It is recommended that a planned programme of redecoration and maintenance is produced and a copy sent to CSCI. An overall training analyis must be drawn up. This should Page 30 of 32 2 30 Care Homes for Older People take in to account the needs of the people living at The Gables. Once this is in place an overall training plan should be drawn up. Clear records should be maintained of all training undertaken by staff. So that staff receive appropriate training to support the people living at the Gables. 3 33 The views of people living at the home should be obtained. Care Homes for Older People Page 31 of 32 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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