Inspection on 11/02/09 for Gabriel Court Residential Care Home

This inspection was carried out on 11th February 2009.

CSCI found this care home to be providing an Good service.

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

Gabriel Court Residential Care... 12/12/06

Gabriel Court Residential Care... 14/11/05

Gabriel Court Residential Care... 20/07/05

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Gabriel Court Residential Care Home 17-23 Broadway Kettering Northants NN15 6DD     The quality rating for this care home is:   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. Lead inspector: Keith Charlton     Date: 1 1 0 2 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 28 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Gabriel Court Residential Care Home 17-23 Broadway Kettering Northants NN15 6DD 01536510019 01536500838 rosewonfor@yahoo.co.uk 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) : Gabriel Court Limited care home 44 Number of places (if applicable): Under 65 Over 65 0 0 44 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 44 44 0 The maximum number of service users who can be accommodated is: 44 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE Mental Disorder, excluding learning disability or dementia - Code MD Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home The last key inspection of the service was on the 12th December 2006. Gabriel Court is a large Victorian period property located in Kettering in a quiet residential street and provides personal care and not nursing care for up to forty four older people. There is a relatively new extension to the rear of the original building that provides additional ground floor bedroom accommodation. The original building has lifts to the upper floor and along with the extension Gabriel Court provides a Care Homes for Older People Page 4 of 28 Brief description of the care home comfortable homely environment conducive to the care of this large group of service users. Additionally there is an attractive paved garden to the rear of the building that leads to a laid lawn patio area purpose built pagoda a vegetable garden and a sensory garden. These are accessible for able bodied and wheel chair accessible. There is an electronic entrance gate which is a secure automated system that provides a safe and secure environment for service users. As Gabriel Court is located close to the centre of Kettering there is ready access to community resources. Further information about the home can be obtained from the Registered Owner or the Registered Manager in the form of the Statement of Purpose and Service Users Guide. The range of fees is from 342 to 475 pounds per week with charges for extras such as private chiropody, hairdressing and transport. This information was provided by the Manager on the day of the inspection. Care Homes for Older People Page 5 of 28 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: two star good 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: This key inspection included a visit to the service. We (the CSCI) visited Gabriel Court on the 10th February 2009. The Registered Manager and Provider and staff in the home helped us during the visit. The main method of inspection we used was case tracking. This means looking at the care given to people in different ways. We did this by, - talking to the people who live in the home and some relatives, - talking to staff and management, Care Homes for Older People Page 6 of 28 - watching how people are given support, - looking at records. We also looked at the Annual Quality Assurance Assessment (AQAA). This is a document the provider (the person who owns the service) sends to us at the CSCI, and it tells us what the provider thinks about the service they deliver to people who live at Gabriel. As well as this, we looked at information that had come to our attention since the last key inspection in December 2006. We spoke with six people who live at Gabriel during our visit. People told us that staff were very friendly and caring and did a good job. One person said staff could not be better. None of the people spoken with had any complaints about the attitude of staff. We spoke with two members of staff during our visit to the home who told us about working in the home and gave us their views. They all were very positive about working at Gabriel and wanted to provide the best care to people living there. One staff member said:Its one big happy family here. We are all trying to do our best for the residents. We sent out and received surveys from relevant parties - residents (seven received), relatives (six received) and staff (two received). We checked all the standards that the Commission for Social Care Inspection has decided are key standards during this inspection. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report to make sure we respected their confidences. What the care home does well: What has improved since the last inspection? What they could do better: All aspects of residents lives should be included in the Care Plan, including preferred living routines and how frequently to assist residents with their continence. Medication records need to be kept securely to preserve confidentiality. The Provider needs to ensure staff know all the Agencies to refer to if they suspect abuse has taken place. The Provider is recommended to undertake an environmental audit of the home to determine how the service can best meet the needs of people with dementia living at Gabriel. Staff training on residents conditions needs to be extended to ensure staff skills in Care Homes for Older People Page 8 of 28 these issues. That a full audit regarding safe working practices needs to be implemented so that there are detailed risk assessments in place for all of the building. Hot water needs to be kept to a safe temperature at all times. It is recommended that unannounced fire drills take place to test staff (though not with evacuation of residents) and give them a good grounding of what to do if a fire happens. 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. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 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 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Gabriel have had their needs properly assessed before moving into the home. Evidence: Residents and relatives spoken with said they had enough information at the time of the admission to make up their minds about the home. Yes, my relative was given a brochure though I was more interested in seeing what the home was like, one resident said. Surveys received by us from residents and relatives stated that residents had been provided with contracts and relevant information regarding the services the home provides. We case tracked a person living in the home who had moved into Gabriel in the past year. We checked that her family had received information to help with the choice of home, and the relative said he had received enough information. We also checked that Care Homes for Older People Page 11 of 28 Evidence: this person had her needs properly assessed prior to moving in, to ensure that the staff at the home could meet their needs and we found that the assessment system was detailed regarding residents needs. The AQAA stated that prospective residents are invited to the home, relevant information is provided and assessments are carried out by the management at the point of contact - home/hospital etc. Care Homes for Older People Page 12 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at Gabriel receive good health and social care practice. Evidence: Residents said that staff provided excellent personal care to them: staff are lovely. They would do anything for you and you couldnt ask for better staff, were some of the many very positive comments that residents made. Surveys stated that residents and relatives were very satisfied with the personal care that staff provide. No residents spoken to could recall having a care plan though were not interested in looking at it to see it reflected their care needs. We checked the care plans of four people living at the home who were case tracked. Plans showed detail regarding the support required by staff to ensure the physical health of people living at the home, and there was information to inform staff of the residents personal history though no information of preferred daily living routines of residents to ensure their social and emotional well being is fully supported. Continence Care Homes for Older People Page 13 of 28 Evidence: information was recorded though this assessment needed more detail to work out the individual needs of a residents so staff could prompt before they needed to go to the toilet. Details as to at which point staff needed to take action in respect of residents with diabetes were not in place. The Manager later contacted us to say she had liaised with the district nurse to put this in place. There were gaps on health check recording insofar as appointments for sight and teeth had not been recorded so that residents could have waited too long before having these appointments. The Manager said that this would be followed up. Accident records were checked and medical services were contacted when a resident had a potentially serious injury.There was also a detailed checking procedure in place so that residents were frequently checked as to the after effects of a potential injury, thus protecting their health. We checked the medication records, and found that there was accurate recording of the administration of the medicines in the home. It was found that the medication records were on top of the medication trolley with open access to anyone. The Manager said this was not normal practice and they were removed to preserve confidentiality. Staff were seen to issue medication properly to residents. Controlled medicines storage was in a secured cabinet. The Manager said she would check that this storage conformed to the latest legal requirements. We spent time watching staff interaction with people living at Gabriel. We saw staff being friendly and caring to people throughout the day doing their best to meet the needs of people living at the home and residents confirmed that staff respected their privacy and addressed them by their preferred names, which respected their dignity. Staff were seen to assist residents in various ways - getting spectacles for a resident, making sure a pressure cushion was in place etc. Care Homes for Older People Page 14 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are opportunities for people to take part in activities and have a relaxed lifestyle. Evidence: Residents said that they were satisfied with the current activities. One resident said There are lots of activities and trips out. Another resident said, I used to spend all my time in my bedroom but staff took me to the library, which was good and I now go to a lot of the activities now. Surveys stated that residents thought that there was a good activities programme. The AQAA stated that there are activities. We saw that there is a current list of activities, including a museum trip, quiz, guide dogs visit, jumble sale, afternoon tea parties to celebrate the different nations of Britain, easter bonnet parade etc. The home employs an Activities Organiser who comes every weekday. We saw the activities organiser providing an activity for residents. The Provider was passionate about the need to have lots of varied activities to residents and showed us photos of residents gardening and residents enjoying a fish and chip outing. Care Homes for Older People Page 15 of 28 Evidence: There are one-to-one activities such as walking around the garden, taking residents outside - to the shops, to the library if they want to go, reminiscing with people, communal activities such as chair exercises and games etc. Visitors are welcomed at Gabriel and we were informed by residents and visiting relatives that they could come at any reasonable time and they were always warmly greeted by staff. Residents all said that they enjoyed the food: food is home cooked and tasty, one resident said. We observed lunch being served. There was a choice of a hot dinner or alternative. Food was well presented and looked appetising, with good portions being served to each person, with two fresh vegetables served showing a good regard for healthy eating, followed by a home baked dessert or yogurt. One resident had an alternative. We also saw that there were a number of fruit bowls with a variety of fruit for residents to help themselves to. Food records showed a good variety of traditional food served. There was no displayed menu to provide infomation to residents. Care Homes for Older People Page 16 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Gabriel has systems in place to protect residents from abuse and to listen and act on their concerns. Evidence: Residents said that they had no complaints but if they did they thought the staff or management would quickly get it sorted out. A resident said, I think if I ever had a complaint it would be quickly put right. The AQAA stated that there is zero tolerance of abuse, staff have pova training and an open door policy for residents/representatives to talk to management regarding their concerns. We have only once been contacted by a complainant since the last key inspection in December 2006 and management confirmed that there was no evidence to prove the complaint. Surveys stated that residents had been provided with contracts and relevant information. We saw that there have been three minor complaints since the last inspection in the complaints book. All were speedily resolved by management. We talked to staff to find out how much they knew about protecting people in the home from abuse. Records showed they had received training about safeguarding adults from abuse, and they knew the in house procedure, though not all Agencies to whistle blow to if the in house procedure failed. Care Homes for Older People Page 17 of 28 Evidence: We looked at the staff recruitment records to see whether all the proper checks had been made on staff before they started employment at Gabriel. We found records which showed staff had started work with written references and legal checks in place to help management reach the judgement that people were safe to start employment. Care Homes for Older People Page 18 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Gabriel live in a homely and well maintained environment. Evidence: All residents spoken with said that they liked their bedrooms: My bedroom is well decorated, clean and tidy with no smells. The laundry service is marvelous, one resident said. Surveys stated that residents were satisfied with facilities and thought the home was kept very clean. We saw people at Gabriel living in a clean and well maintained environment. The furnishings in communal areas are homely, and people are encouraged to bring their personal possessions into their bedrooms. We discussed the idea of having an environmental assessment of the home to further assist residents with dementia, e.g. colour coding toilet doors, pictures of residents favorite scenes etc to orientate residents to go to their own bedrooms etc. The AQAA stated that there has been deep cleaning of the homes carpets and double glazed windows installed. Records show that the home is well maintained, and good measures are in place to Care Homes for Older People Page 19 of 28 Evidence: keep the home hygienic. There were no odours. There are no radiator covers as the Provider said that the thermostatic radiator valves have been fitted to ensure that residents are protected from burn risks. Care Homes for Older People Page 20 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are met by a well trained and competent staff group. Evidence: Residents and staff said that there were enough staff to meet residents needs regarding personal care. Staff are around if you need them, one resident said. A number of residents and relatives and the staff we spoke to thought staffing levels were good and met residents needs. The AQAA states that most residents needed assistance with their personal care from staff. Surveys stated that either there were enough staff or usually enough staff to meet resident needs. We spoke with the Manager about the staffing - excluding the Manager there are seven care staff on duty until 2.00pm, and then five staff on duty to 9.00pm.This is in addition to kitchen and domestic staff shown in the staff rota, seven days a week. The AQAA stated that staff had training on essential care practice and that over fifty per cent of staff had attained at least NVQ 2 with a number of staff also being enrolled on this course at present. A staff member said that although she had only been working at the home for a year she had been encouraged by management to do this course and had already studied for this and passed it. We found that staff have been on a number of training events to help update their practice on areas such as Moving Care Homes for Older People Page 21 of 28 Evidence: and Handling, Fire Safety, Infection Control and Dementia, residents conditions such as mental health needs though some issues regarding residents health conditions were missing - e.g. Sight and Hearing Impairment, Stroke, Parkinsons Disease etc. The Manager said that these would be added to the training programme. Staff records showed that proper checks had been carried out to protect residents from unsuitable staff. Care Homes for Older People Page 22 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management maintain a high quality of life for people at Gabriel. Evidence: Rose Wanfor is the registered manager of the home. Rose has completed the NVQ 4 Award in management skills and also the Registered Managers Award. She has been updating the staff with training, and this was confirmed by the staff spoken with. Satisfaction questionnaires were sent around the home last year, which were seen to be very positive. They contained an analysis of the results to see if improvements in the service were needed. Written records re finances for residents are properly in place and monies were checked for three residents and totals found to be correct. There was evidence of residents meetings discussing relevant issues - activities, food Care Homes for Older People Page 23 of 28 Evidence: etc, which showed residents are involved in the running of the home. Safe working practices were observed as we went around the home - e.g. a resident was observed to be helped onto a zimmer frame and not lifted. Staff informed us that they were able to tell management of the problems they were facing and there were regular meetings and supervision to support them. The AQAA states that there are proper Health and Safety systems in place in the home. Proper fire records were in place though the Manager was asked to check with the Fire Officer as to how frequently fire drills need to take place as the record only stated that they occurred once a year - the Provider faxed the latest fire drills which showed that two a year were undertaken as training, though none were unannounced. Staff were asked re the fire drill and they knew what to do. There was a Health and Safety folder with Risk Assessments though they were only completed following a fault, not in a systematic preventative way. The Manager was asked to do complete a Risk Assessment on radiators as they do not have covers on them. The Provider faxed to state that they had thermostatic controls installed and therefore posed no risk. Hot water was tested and found to be 47c. The Manager was asked to arrange for this to be turned down to approx 43c - the National Standard. The Provider subsequently faxed to state this had been done. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 25 of 28 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 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 7 All aspects of residents lives should be included in the Care Plan, including preferred living routines and how frequently to assist residents with their continence. Medication records need to be kept securely to preserve confidentiality. The Provider needs to ensure staff know all the Agencies to refer to if they suspect abuse has taken place. The Provider is recommended to undertake an environmental audit of the home to determine how the service can best meet the needs of people with dementia living at Gabriel. The Provider should review staffing levels to ensure they always meet residents needs. That a full audit regarding safe working practices needs to be implemented so that there are detailed risk assessments in place for all of the building. Hot water needs to be kept to a safe temperature at all times. It is recommended that unannounced fire drills take place 2 3 4 9 18 19 5 6 27 38 Care Homes for Older People Page 26 of 28 to test staff (though not with evacuation of residents) and give them a good grounding of what to do if a fire happens. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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). 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. Care Homes for Older People Page 28 of 28 - 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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