Inspection on 04/01/06 for Gables Nursing & Residential 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 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

Gables Nursing & Residential Home 13/06/07

Gables Nursing & Residential Home 19/07/05

Gables Nursing & Residential Home 07/10/04

Gables Nursing & Residential Home 12/05/04

Gables Nursing & Residential Home 01/03/04

Gables Nursing & Residential Home 05/12/03

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

CARE HOMES FOR OLDER PEOPLE Gables Nursing & Residential Home 6 Marine Parade Gorleston Norfolk NR31 6DU Lead Inspector Hilda Stephenson Unannounced Inspection 4th January 2006 10:00 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 Gables Nursing & Residential Home DS0000015638.V274701.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. Gables Nursing & Residential Home DS0000015638.V274701.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Gables Nursing & Residential Home Address 6 Marine Parade Gorleston Norfolk NR31 6DU 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) 01493 667839 01493 601646 Pri-Med Group Ltd. Ms Karon Yvonne Dunleavy Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43), Physical disability (43) of places Gables Nursing & Residential Home DS0000015638.V274701.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The PD service user category to be limited to people over the age of 50 years 19th July 2005 Date of last inspection Brief Description of the Service: The Gables is a large detached Victorian property, overlooking the esplanade and beach at Gorleston on Sea. The care home offers accommodation on three floors, in a mixture of single and double rooms to a maximum of 43 older persons. Service users may fall within the category of older people, or the category of older people with physical disabilities. The town centre and seaside recreational amenities are within walking distance of the care home. The home is owned by the Pri-Med company. Gables Nursing & Residential Home DS0000015638.V274701.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit to the home was undertaken during the busy morning period of Wednesday 4th January 2006. The evidence gathered to publish this report was obtained by speaking to nine of the forty-two residents, five staff and one of the Directors of Pri-Med and checking a sample of care plans and medication records. The home was found to be clean, tidy and free from odour. The majority of residents were either in their bedrooms or sitting in the lounge areas either watching television or listening to the radio. The manager has left the home since the previous inspection and the company have a temporary manager in place, who is one of the training directors of the company. The home provides both nursing, residential care and has four transitional beds to offer short-term accommodation for up to six weeks within the forty-three places. What the service does well: What has improved since the last inspection? The home is clean and tidy with several bedrooms having been redecorated. There were no obvious improvements identified due to the high consistent standard of care offered within the home. Gables Nursing & Residential Home DS0000015638.V274701.R01.S.doc Version 5.1 Page 6 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. Gables Nursing & Residential Home DS0000015638.V274701.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 Gables Nursing & Residential Home DS0000015638.V274701.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4 All residents are admitted after an assessment of their needs. EVIDENCE: The temporary manager visits prospective residents to assess their care and nursing needs to ensure that the home can meet their needs. The assessment records form part of the care plan. A sample of the last two residents admitted to the home were seen and found to contain adequate details for the nursing staff to compile the care plans. Due to some residents admitted who are frail, the home invites their relatives to become involved with the personal details to ensure that the home can meet their individual needs. Gables Nursing & Residential Home DS0000015638.V274701.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Care plans and health needs of residents are identified, reviewed and are met, with knowledgeable staff having a good understanding of the residents’ needs. Safe procedures are in place for the administration of medicines. EVIDENCE: Two residents who spoke to the Inspector had their care plans looked at. Both contained details of residents personal, social, health and medical needs to enable the nurse to write the care plan. Evidence that the nurses discuss the care plan with the resident or their close relative was seen which is good practice. Risk assessments were in place to ensure that residents overall lifestyle had been reviewed. One resident stated ‘the nurse asks me how I am and if there is anything I would like changing with how they look after me, but they do it so well’. The home has several air mattresses, shaped chairs and other pieces of equipment to continue to care for frailer dependent residents to ensure skin remains intact. The home has improved their record for treating residents with pressure sores, with some trained nurses having developed their skills for wound and skin care. Gables Nursing & Residential Home DS0000015638.V274701.R01.S.doc Version 5.1 Page 10 The trained nurses administer the medication within the home. One nurse was observed dispensing the morning medication in a satisfactory and safe manner. A sample of the Medication Record Sheets (MAR) were seen and well completed. There is a safe procedure in place for residents who wish to selfadminister with lockable facilities for storing medicines. Several residents were spoken to during the inspection and confirmed that the staff respect their right to privacy, with some preferring to stay in their own room rather than spend time in the lounges. Gables Nursing & Residential Home DS0000015638.V274701.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): 13,14 Residents can entertain their visitors in a number of lounges or their own rooms. EVIDENCE: Residents who wish to smoke can do so in one of the small lounges. Two residents confirmed that they continue to see their family when they visit and sometimes sit in the lounge or go to their room. Care staff visit residents who prefer to stay in their own rooms, with one stating ‘the staff pop in to speak to me and I sometimes play dominoes or cards to pass the time, it makes a change from watching television’. Another resident explained that she chooses her meals from the menu and the chef caters for favourite dishes on occasions. Activities are organised by outside entertainers, and the afternoons sociable activity, a visiting musician was booked to entertain residents in the large dining room. Comments received from residents who were spoken to indicate that they choose when they want to go to bed or what they would like for their meal, with this individual information being included within the care plans. Gables Nursing & Residential Home DS0000015638.V274701.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of these standards were inspection on this occasion. Gables Nursing & Residential Home DS0000015638.V274701.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Residents live in a comfortable tidy home. EVIDENCE: The Gables consists of three floors, access to bedrooms can be via a shaft lift. There are a mix of single and shared bedrooms, some having en-suite facilities. Adequate numbers of toilets and assisted bathrooms were situated throughout the building. There are four communal rooms in various sizes where chairs and dining facilities are combined. A constraint of the building is the lack of communal space with separate dining facilities, although the directors have future plans for an extension to include a conservatory. The home was clean and tidy and free from any unpleasant odour. Gables Nursing & Residential Home DS0000015638.V274701.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 Sufficient numbers of staff are on duty to meet residents’ needs with extra staff brought in to cover busy periods. EVIDENCE: During this inspection there were adequate numbers of staff on duty. One of the two trained nurses was in charge for the morning shift, supported by eight care staff, three domestic staff, one housekeeper, one handyman, two tea staff and one laundry staff. One of the Pri-Med Directors also visited the home while the temporary manager was on annual leave. The duty rota was seen and confirmed similar numbers of staff were on duty during the rest of the working week. Gables Nursing & Residential Home DS0000015638.V274701.R01.S.doc Version 5.1 Page 15 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): EVIDENCE: None of these standards were inspected on this occasion. Gables Nursing & Residential Home DS0000015638.V274701.R01.S.doc Version 5.1 Page 16 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Gables Nursing & Residential Home DS0000015638.V274701.R01.S.doc Version 5.1 Page 17 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. Standard Regulation Requirement Timescale for action 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 Gables Nursing & Residential Home DS0000015638.V274701.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Gables Nursing & Residential Home DS0000015638.V274701.R01.S.doc Version 5.1 Page 19 - 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!