Inspection on 21/07/05 for Gables Residential Care Home Ltd

This inspection was carried out on 21st July 2005.

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 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 Residential Care Home Ltd 09/05/07

Gables Residential Care Home Ltd 27/02/06

Gables Residential Care Home Ltd 16/03/05

Gables Residential Care Home Ltd 04/05/04

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

CARE HOMES FOR OLDER PEOPLE The Gables Residential Care Home Ltd 1a Sydenham Way Hanham Green South Glos BS15 3TG Lead Inspector Grace Agu Unannounced 21 July 2005 09:30 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 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. The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Gables Residential Care Home Ltd Address 1a Sydenham Way Hanham Green South Glos BS15 3TG 0117 914 0799 0117 914 0799 Mrs Linda Marie Cooke Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ms Ann Kathrine Aubrey Care Home for Older People 20 Category(ies) of OP Old age for 20 registration, with number of places The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 20 persons aged 65 years and over requiring personal care only Date of last inspection 16 March 2005 Brief Description of the Service: The Gables Care Home provides personal care for up to 20 service users aged 65 years and over. The home is owned by Mr David Cooke and Mrs Linda Cooke. Mrs Cooke and Mrs Ann Aubrey share the responsibilities of the Registered Manager role. The home is situated in a suburb on the eastern outskirts of South Gloucestershire. There are shops, a post office and public house nearby. The home is close to the Avon ring road and the motorway network. The home has a purpose built extension providing bedrooms and utility areas. There are attractive communal areas. The well maintained gardens extend to the front and back of the building and include a courtyard space and sitting areas. The service users have individual rooms with ensuite facilities and these exceed the spatial National Minimum Standards. The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which was undertaken over six hours to review the requirements made at the last inspection and also to review the care practice to ensure that it is in line with the legislation. At the last inspection, eight requirements were made; two of the requirements were not met. One was a requirement in relation to providing a lockable space for a self-medicating resident. The other requirement was in relation to undertaking risk assessments in the kitchen and laundry. In discussion with the manager Mrs Aubrey stated that she is proposing to undertake the risk assessments for the kitchen and the laundry. The inspector visited the person on self-medication and noted that the person stored her medication in a non-secured bedside table. An immediate requirement was made with seven days deadline for the home to provide the resident with a lockable space to ensure that medication is securely locked. Generally the atmosphere at the home was found to be relaxed and the residents looked well cared for, staff were noted interacting with the residents in a positive and respectful manner. A follow up visit was made by two inspectors on 8/8/05 in relation to the immediate requirement made at the inspection. At the visit one of the registered managers on duty informed the inspectors that the requirement had not been met. The manager stated that the resident is not registered as a resident at The Gables although she occupies a room at the home. The inspectors were informed that the resident lives there because she is a relative of the providers. In addition the inspectors were informed that the person has a lockable wardrobe where she could store the medication if she wished to do so. The resident is always in her room and would lock the door if she was not in her room to ensure that no other resident could gain access to her room. This information was not given to the inspector at the previous inspections and the requirement was withdrawn. The follow up visit was also to review the new care planning system recently purchased by the home to ensure that it is personalised and comprehensive to meet the needs of the residents. The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 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 standard(s) 1,2,3,4,5. The process of admission of prospective residents is comprehensive, detailed and well planned to enable residents to make a positive choice of moving to the home with the assurance that their needs will be met. EVIDENCE: The home’s statement of purpose has detailed information about services and facilities to be provided at the home. The home also has a Service User’s Guide that is given to prospective residents or their representatives when they visit the home to enable them to make an informed decision about moving to the home. The manager stated during a discussion that the prospective resident is encouraged to visit the home for a day of for lunch only in order to interact with other residents and receive more information about the services provided at the home. There was entry in one of the care files that the resident was assessed at the home when he/ she came to look round and also have lunch with other residents. Two care files of recently admitted residents viewed contained pre-admission assessment information on activities of daily living and other relevant information to enable staff to meet his/her needs. The manager informed the The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 Page 9 inspector that residents and their relatives are informed of a one month trial period on admission to enable the resident to make a decision to stay at the home permanently. Both care files had Terms and Conditions of the residents’ stay at the home. The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 Page 10 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 standard(s) 7,8,9,10,11. The home offers support to residents throughout their lives and towards the end, it also protects residents by reviewing their health needs and appropriate drug administration, however it fails to evidence this through weak care planning documentation. EVIDENCE: The home has recently purchased comprehensive care planning documentation and is currently transferring residents’ information into the new care files. One of the completed care files viewed contained pre-assessment information, activities of daily living, likes and dislikes of the resident, Dr’s visits and medical history. Residents spoken with stated that they chose when they wake and when they retire. Two residents spoken with stated that staff respect their privacy and dignity when providing them with personal care. One of the completed care files showed evidence of professional visits, to include General Practitioner, Chiropodist, Optician, and Dentist. A district nurse was visiting the home on the day of inspection, she/he stated that she/he visits the home regularly and on each occasion the residents looked well cared for and that the home is amongst the best in the area. The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 Page 11 The new care files viewed showed little evidence of care planning in relation to how the care needs of the residents were being met. During a discussion with Mrs Aubrey (one of the registered managers), she stated that she is working hard to transfer the residents details to the new care files as well as drawing up the care plan and the reviews and it can be heavy for one person to manage, however Mrs Aubrey is optimistic that the new care files will be completed and will be ready for viewing at the next inspection. At a follow up visit by two inspectors on 8/8/05 the new care files were discussed with the manager met on duty and guidance and advice was given on individualised care planning, it was also agreed that this will be reviewed at the next visit. Medication training for staff administering medication was reviewed. The manager stated that the home has recently acquired the services of a new pharmacy and that the pharmacist would be providing medication training for all staff and that the first training is being booked for 23/08/05 and subsequently on 30/08/05. Two residents care files viewed contained information in the event of death. The home has a Death and Dying policy and procedure. The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 Page 12 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 standard(s) 12,13,14,15. The home provides meaningful activities for residents, enables them to maintain contact with the local community, families and friends and ensures that choice is provided to residents in respect of meals and meal times. EVIDENCE: Residents spoken with stated that the home provides them with weekly activities information to enable them to decide which activities to attend. Evidence of this information was noted in a residents room, activities noted on the sheet included 18/7/05 -Glaze and shine, 20/07/05- Holy communion, 25/07/05- minibus to Clevedon, 27/07/05- music with Andy, and 28/07/05 Teddy Bear’s picnic. Other activities noted include file and nail painting by a beautician and hairdressing. The manager informed the inspector that the home had raised money through organising fund raising events and was able to purchase a summerhouse put in the corner of the garden. Wooden seats, which were donated by a resident’s family, were noted around the garden for the residents to relax in when the weather is good. Residents spoken with stated that they enjoyed the activities provided at the home and that relatives, friends and families visit the home regularly and at any time. One resident stated that her/his friends visit very often because her/his daughter lives not far from Bristol, another resident stated that that his/her daughter takes him/her out whenever she visits. The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 Page 13 During a discussion with one relative who was visiting her/his uncle on the day, she /he stated that she/he visits regularly, the uncle is well looked after and that the atmosphere in the home is very good and that the home is ‘excellent’. Residents spoken with on the day stated that they have a choice of when to get up and when to retire and would have their breakfast in bed or in their rooms if they wanted to, residents also have a choice to participate in any leisure activities at the home. The menu for the day was noted displayed on the residents’ notice board in the small lounge and the dinning room. The lunch menu on the day included Roast Pork Loin or Chicken Kiev with cauliflower cheese, carrots and potatoes and assorted desserts. Residents spoken with after their meal stated that they enjoyed the meal and that food at the home is ‘always good. Staff were noted interacting with the residents at the mealtime and residents who needed assistance were helped in a sensitive and dignified manner. The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 Page 14 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 standard(s) 16,17,18. Residents are enabled to complain and are confident that the home is able to protect them from abuse. EVIDENCE: The home has a complaint procedure, which is displayed, at the entrance hall. The complaint procedure has information about the Commission for Social Care Inspection (CSCI) to enable residents and their representatives to contact the Commission if they were not satisfied with the outcome of their complaint. Residents spoken with on the day stated that they would complain to Ann if they had any concerns. No complaint was noted in the complaint book when viewed. A policy on Whistle blowing to enable staff to report any bad practices without fear of any reprisal was noted and staff files showed evidence of training on Protection of Vulnerable Adults, it was also noted that Criminal Record Bureau disclosures have been obtained for all staff to include recently employed staff members. Records of residents monies viewed corresponded with the amount in the individual accounts in the safe and residents interviewed stated that they were able to vote using the postal voting system. The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19,25,26 The home has a safe well maintained environment where residents feel happy to live in. EVIDENCE: The home was found clean and tidy and some residents were noted relaxed and enjoying each other’s company in the lounges. Staff were noted well presented in uniform and were wearing disposable aprons when serving and assisting residents with their meals to ensure that infection control and principles of hygiene are maintained at the home. Whilst walking around and interviewing residents, it was noted that the home is comfortable, suitable and well maintained. It was also noted to be generally light, bright with attractive gardens. One resident noted sitting in the secured garden between the original and purpose built extension stated that she/he sits out in the garden whenever the weather is good. Another resident stated that she/he likes her/his room because she can look at the ‘lovely garden’. The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30. The recruitment procedure of the home is robust and offers protection to residents at the home. There is adequate numbers of staff who are competent to meet the needs of residents. EVIDENCE: On the day of inspection, there were three staff on duty from 07.30 –1500, two care staff from1500-2200, one care staff on sleep-in duty from 22000800, one waking night care staff from 2200-0800, and also two house keeping staff, one laundry staff, and two kitchen staff. The home has a robust recruitment procedure to ensure that suitable staff are recruited to meet residents needs. The record of one recently employed staff member contained required information to include personal details’ previous employment details, two satisfactory references, Criminal Records Bureau disclosure and relevant qualifications. The manager stated that six care staff have achieved NVQ level 2 in care one staff have achieved NVQ level3. This shows that the home would have achieve 80 NVQ level 2 by the year 2005. It was noted staff have attended other training courses to include basic food hygiene, manual handling, fire safety, abuse training and first aid and other relevant courses in relation to their roles and responsibilities. One staff member interview confirmed that she had attended training courses to enable her to perform her duties effectively. Residents spoken with stated that staff are very kind and are sensitive to their needs. One resident stated that ‘staff answer the bell promptly and assist me with my bathing’. The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 Page 17 The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36,37,38. The home benefits from good leadership and management, its’ practices have offered protection to the health and safety of residents. EVIDENCE: One of the registered managers met on the day of inspection stated that she had completed the Registered Managers Award. Other courses she had completed included Dealing with Challenging Behaviour and that in addition both registered managers attended a course on being a Fire Warden and Control of substances Hazardous to Health (COSHH). Furthermore staff have been booked for more training on Protection of Vulnerable Adults from Abuse scheduled for 3/10/05, 3/11/05 and 12/05 On the day of inspection, residents and the staff member spoken with commended positively about the managers’ ability to manage the home. One resident stated that Ann and Linda are good managers. Another resident stated that Ann is ’very nice’ and she would listen to you if you have any concerns. The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 Page 19 Staff supervision was viewed and it was noted that staff supervision is being carried out on regular basis. The manager met on the day showed the inspector a new format recently purchased to be used for staff supervision, this paperwork, also had forms to be completed at staff induction and foundation training. The manager stated that she intends to use the new supervision format in two weeks at the next staff supervision. It was noted from the records that the home has a structured induction programme to ensure that the new staff member is competent to assist residents with their care needs. A recently purchased Quality Assurance audit tool to be used by the home to review its services was viewed and the main areas to be audited include’ How staff treat residents’, ‘How residents feel about their room’, ‘How residents feel about activities in the home’. The manager stated that she would have a meeting with residents and their representatives in a week’s time to discuss the questionnaire. It was agreed that the home obtains the views of other health professionals visiting the home. To ensure that the residents are adequately protected the fire logbook was noted to be in date and staff have attended regular fire drills. Other document reviewed in relation to resident’s safety and protection includes servicing of the Nurse Call system, lifts, hoists and portable appliance testing (PAT). Policies and Procedure in relation to Protection of Vulnerable Adults for Abuse, Whistle Blowing and Complaints were noted to be recently reviewed. Records of residents’ monies viewed was noted to be correct with the amount stored in the safe and residents care files and other documentation were stored in a securely locked cabinet. The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 Page 21 YES Are there any outstanding requirements from the last inspection? 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 7 Regulation 15 Requirement Prepare written care plans detailing how the care needs of all residents are to be met. Timescale for action 30/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG 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 The Gables Residential Care Home Ltd D56 D05 S3397 Gables RCH Ltd V228929 210705 Stage 4.doc Version 1.30 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. 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