This inspection was carried out on 23rd December 2008.
CSCI found this care home to be providing an Good service.
The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.
Inspecting for better lives Random 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: The rating was made on: two star good 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Joan Adam Date: 2 3 1 2 2 0 0 8 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: Mr William Preston care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability 0 5 Over 65 34 0 Conditions of registration: 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 Care Homes for Older People
Page 2 of 9 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 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 3 of 9 What we found:
Care plans still need some work but provide good evidence that the new manager has been spending considerable time and effort identifying risks and putting plans in place for moving and handling, nutrition, pressure area care and bed rail safety. Dietary supplements had been prescribed by GPs, however a stock of the supplements were seen in the satellite kitchen area that were out of date which means that people who need these may not be receiving them on a regular basis. The manager has introduced an audit system for all medications including dietary supplements and is in the process of checking all stocks of medicines on a daily basis so that medications do not run out and all people who live at the home receive medications as they are prescribed. We looked in the kitchen and found that the standard of cleanliness was poor. The grill over the cooker was thick with grease and staff said it had not been in working order for some time. The cooker was in a filthy state and did not look like it had been cleaned on a regular basis. There were no cleaning schedules completed therefore it was difficult to know when this had last been cleaned. The cook was off sick on the day of the visit and a member of the care staff was providing lunch for the residents. This consisted of sausages in gravy or fishcakes with chips and frozen garden peas. The meal looked adequate and was nicely presented. The deep fat fryer was dirty and the fat used to cook the chips was thick and smelly. There was no record of this being cleaned or when the fat had last been changed. We looked in the store rooms and these were found to be untidy. In one store room we found a supply of cakes and biscuits, these were in packets. In the main food store we found a variety of tins on soup, beans, corned beef and tinned tomatoes. We looked in the freezer and found a plentiful supply of frozen vegetables and sausages. One leg of lamb was present but this would not have been enough to feed 20 people. The owner said he shops on a regular basis and the cook will give him a shopping list to buy meat as she needs it so that the meals on the menus are followed. The manager said that a delivery of fresh fruit and vegetables was due in the home on the day of the visit. One main fridge was dirty and had water pooling in the bottom. It was unclear as to whether this was due to the drain in the bottom being blocked or that the temperature of the fridge was too low as fridge and freezer temperatures were not recorded. The fridge contained milk and eggs.The second fridge appeared to be in working order and had a tray of sandwiches prepared for the evening meal, these were covered by cling film. Packets of pasties which were out of date by three days, were in this fridge and were disposed of by me. The flooring in the doorway of the main kitchen area was ripped and worn and needs to be replaced or repaired to a good standard as this is a trip hazard and can not be properly cleaned. The fridge in the satellite kitchen was dirty and leaking water on to the floor. The bins in this area were full and one had no lid so that cross infection could be controlled. The microwave was filthy with encrusted food stuck to it and had not been cleaned for some time. A visit had been made to the home on 9th December by the environmental health officer which also highlighted some of these problems and a report was made to the proprietor. Care Homes for Older People Page 4 of 9 We looked at the bedrooms on the first floor of the home as reports had been made that they were not adequately heated. The occupied bedrooms were found to be warm, however, there are a number of bedrooms on one wing of the home that are not occupied at present and the heating has been turned off. It was discussed with the manager and it was recommended that thermometers should be purchased and a record of the room temperatures should be made on a daily basis. It was found when walking around the home that it was untidy, had a odour and that some empty rooms and a bathroom had furniture stored in them. The standard of carpeting was poor and appeared to have no underlay underneath making it hard underfoot. A radiator cover in the upstairs corridor was broken and could be a hazard if residents touched it or fell against it. The main hoist used for assisting the people who live at the home in to the bath safely has been broken for some weeks which means that people are not getting bathed. The manager has reported this to the proprietor who has not as yet made the correct arrangements for this to be repaired. The employment records were looked at for two staff members who had been employed at the Gables in the last six months. These contained a full employment history and two written references. A Criminal Record Bureau check or a Protection of Vulnerable Adults check(POVA 1st) had not been made on either of these staff members so the proprietor would not be aware if they were suitable and safe to work with elderly people. It was agreed that the staff members would be suspended until a POVA first check had been applied for and returned. What the care home does well: 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 2. Care Homes for Older People Page 5 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
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 6 of 9 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 Each person must have a 13/01/2009 clearly written care plan that shows how their needs are to be met. So that staff have access to the information they need to provide correct care for each person. 2 8 13 The hoists used to assist in 20/01/2009 the bathing of people is kept in good repair and maintained. So that people can have a bath as they require one. 3 9 13 Stocks of dietry supplements 13/01/2009 must be checked so that they are not out of date. So that people are not given supplements that are out of date and may cause harm. 4 15 16 There must be adequate food 13/01/2009 supplies in the home including bread and milk So that people have enough to eat and drink. 5 15 16 The kitchen and equipment 13/01/2009
Page 7 of 9 Care Homes for Older People must be cleaned regularly and cleaning shedules should be kept. So that people have food prepared and cooked in a hygeinic environment. 6 15 16 Food provided is not out of date. So that people do not eat food which is out of date and may do them harm 7 29 19 No staff must work in the home until a POVA first check has been received. To protect residents from poor practice and abuse. 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 13/01/2009 13/01/2009 1 19 It is recommended that all areas of the home have thermometers in place so that the temperature of the home is monitored and recorded on a daily basis. Care Homes for Older People Page 8 of 9 Reader Information
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