Inspection on 12/12/06 for Gabriel Court Residential Care Home

This inspection was carried out on 12th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Gabriel Court Residential Care... 11/02/09

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Gabriel Court Residential Care Home 17-23 Broadway Kettering Northants NN15 6DD Lead Inspector Ms Sarah Jenkins Unannounced Inspection 12th December 2006 07:45 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 Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 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. Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gabriel Court Residential Care Home Address 17-23 Broadway Kettering Northants NN15 6DD 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) 01536 510019 01536 500838 www.gabrielcourtltd.co.uk Gabriel Court Limited Mrs Carola Rose Wonfor Care Home 44 Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (34) Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Gabriel Court residential care home is registered to provide personal care to male and female service users who fall within categories Old Age (OP) 34, Demential over 65 years of age (DE(E) 10, Mental Disorder over 65 years of age (MD(E)) 1 No person falling with the category DE(E) should be accommodated in Gabriel Court when there are already 10 accommodated with this category at the home. No person falling with the category of OP should be accommodated at Gabriel Court when there are already 34 persons accommodated within this category at the home. No person falling within the category MD(E) should be accommodated at Gabriel Court when there is already 1 person accommodated within this category at the home. The maximum number of persons to be accommodated at Gabriel Court is 44. 14th November 2005 2. 3. 4. 5. Date of last inspection Brief Description of the Service: 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 now has lifts to the upper floor, and along with the extension Gabriel Court provides a 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 the service users enjoy during fine weather. 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 £288.45 - £348.55 with charges for extras such as private chiropody, hairdressing and transport. Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting four service users and tracking the care they receive through meeting with the service users, a review of their records, discussions with the care staff and observation of care practices. The Inspector spent approximately two hours reviewing the history of the home and preparing for the inspection, and visited the home for six and a half hours during the early morning and lunchtime period to observe practices by staff and to meet with service users. Some Service Users have diagnosed Dementia conditions or confusional states and thereby communication for some is difficult. Establishing Service Users choices and informed decisions is dependant to some extent upon the consistency of staff, service users relationships with staff, and the quality of communication. Feedback obtained from Service Users in this report was in part through observations of their relationships with staff, and also through interpretations of their general levels of happiness with their routines. Feedback comment cards were received from three General Practitioner surgeries and all were positive. Feedback comment forms were sent to a sample of 10 service users chosen randomly and 10 were returned. All comments were positive and several service users praised staff. 4 relatives returned feedback forms, which were mainly positive although there was a comment on one that occasionally at teatime staff numbers seemed marginal for the needs of the service users, the Registered Manager has been asked to look at this as part of the Quality Assurance process. The pre inspection questionnaire response from the home also informed the inspection. What the service does well: The Registered persons are promoting a sensitive understanding of Service Users individual holistic needs, and relevant training and guidance to enhance staff knowledge understanding and practice continues to be provided. Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 6 Staff are alert to the individuality and needs of Service Users and were seen to be caring in their approach and relationships. Service Users told the Inspector that staff were caring and attentive. The registered persons are committed to continuing to develop the quality of the service and to this end a number of improvements have been made. Among these are a greater involvement from service users in the running and decision making of the home. Service users have responded positively to this and are now actively involved in the recruitment of staff. The home was found to be very clean, and a programme of maintenance and decoration are ongoing. 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 summary of this inspection report can be made available in other formats on request. Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 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 Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are fully assessed prior to admission. EVIDENCE: The Inspector case tracked and met with new service users and reviewed records. Service users were satisfied with the information that they had received or their relatives had received on their behalf, and the care plans that had been developed from the original assessment. There was evidence from discussions with staff that prospective service users needs are fully assessed prior to their admission to the home. The Inspector met with a relative of a service user who had recently been admitted and said that she was very happy with the way the home had helped her relative to settle in. Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 9 Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7.8.9.10. Quality in this outcome area is generally good. This judgement has been made using available evidence including a visit to this service. Health care is properly delivered although a few issues were identified, the resolution of which could improve the overall outcomes for service users. EVIDENCE: Service users are aware of their care plans, and happy with ways in which staff deliver care. They feel that staff are sensitive and responsive to their needs, and respect their privacy and rights. Care plans on the working file are adequate although on some occasions new relevant information recorded by staff has not been passed on from the daily log to the working care plan. Health care is good. Staff are alert and responsive to service users changing needs and seek advice appropriately from relevant health care professionals. Service users were very happy with the response to their needs in this area. Records were not always as well organized, as they should be. Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 11 Medication is generally well managed and staff are properly trained in the procedures. The inspector observed the administration of medicines in the morning and found that this was generally properly done, although sometimes staff members were being interrupted from other care duties to “watch the trolley” when the staff member administrating medicines left it to deliver a medication. Service users said that they always received their medications on time but there was a record indicating that an essential medication had been delayed due to a “one off” problem with the re-ordering system. Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12.13.14.15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are suitably stimulated by their lifestyles within the home and express general satisfaction with the activity levels. EVIDENCE: Early morning routines were seen to be flexible in accordance with service users needs and choices. Service users were enjoying breakfasts of their choice with healthy eating options and the availability of a cooked breakfast if they wished. Unusually, no service users raised any issues at all about the food. Since the last inspection the Registered persons have addressed and resolved an issue about the serving of food in the “new side” of the home and service users now appear to be fully satisfied. Service users expressed general content with the activity levels at the home. They said that they were enabled to engage in as much activity as they wished including regular organized activities. The appointment of a new activities Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 13 organizer has enabled service users to be involved in creative activities if they wish, and they had evidently enjoyed some recent sessions. Visitors are welcomed and involved in service users activities appropriately, and there is a proper recognition of the holistic needs of service users in the general ethos of the home. The Inspector observed that staff were spending time talking with service users in addition to meeting their care needs. The Responsible Individual and the Registered Manager meet with service users individually on a regular basis to establish how they are feeling and whether there are any new emotional or social needs that are not being responded to. Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16.18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users are confidant that they are listened to and that any concerns that they raise will be responded to. EVIDENCE: The complaints book shows that concerns from service users and relatives are heard and responded to promptly and, when formalized as complaints, they are responded to in accordance with the homes procedure. Given the close communication maintained between the Responsible Individual and the Registered Manager, and the Quality Assurance processes it is likely that most issues of concern are resolved very early and prior to the need for a complaint to be formalized. One formal complaint has recently been received by the home and copied to the Commission for Social Care Inspection and this is in the process of being responded to by the Responsible Individual within the standard timescales. Service users showed great confidence in the staff, the Registered Manager and the Registered Owner and when asked by the Inspector if they had any complaints they said “No”. Some service users explained that they would Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 15 speak to the staff, the owner or the manager if they had any concerns, and that they were confident that they would get a prompt and effective response. It was clear from discussions and observations that the Registered Owner and the Registered Manager maintain regular personal contact with the service users. The good relationships that had been established were evident. Staff have been properly trained in the protection of vulnerable adults from abuse, and are aware of the importance of safeguarding adults and “whistle blowing”. Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19.26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment of the home is pleasant homely and well maintained and decorated. EVIDENCE: The home is well maintained and homely. Service users expressed general satisfaction with the environment which they found to be “nice” “comfy” and “clean”. A number of improvements have been made to both the house and the garden over the last year and more are planned. There is an ongoing programme of decoration and maintenance and increased storage space is to be provided shortly without detriment to current facilities. Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 17 Advice was given on the importance of maintaining functional privacy locks on all bathrooms and toilets. This item was already listed on the maintenance programme at the time of the inspection. There is an ongoing programme to improve hand-washing facilities and given the amount of modernization that was identified by the Registered Owner as needed at the time of the last inspection, very good progress has been achieved. The home was found to be very clean and odour free. Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27.28.29.30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a professional approach to staff employment and training and service users are appropriately involved in recruitment. EVIDENCE: Staffing hours have been increased since the last inspection. At the time of the inspection there were sufficient staff on duty to meet service users current needs. Staff were found to be caring and conscientious in their duties and observations of interactions between staff and service users showed that staff had a good understanding of the importance of warmth, sensitivity and reassurance in their relationships with service users. There was evidence of relatives’ appreciation of the sensitivity and responsiveness of staff in a recent letter of commendation. Staff on duty were appropriately trained and experienced. Staff training needs, in relation to the service users conditions are identified and met. Advice was given to the Registered Manager to ensure the staff-training matrix is maintained with up to date information to ensure refresher courses are always delivered promptly, although there were no shortfalls in staff training identified at the time of the inspection. Staff spoke positively of their training Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 19 opportunities and service users felt that they were suitably trained and experienced. The recruitment process for new staff is professional, and this was evidenced on staff files. Service users have started to be fully involved in the recruitment process through sitting on the interview panel and this has been found to be very successful. Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management of the home is good. There has been a lot of hard work by the Registered persons throughout the year to achieve improvements and assure good outcomes for service users. EVIDENCE: The Registered Manager has achieved her NVQ4 this year and is enrolling on a further relevant course. She shows a commitment to achieving and maintaining a very good quality service for residents. Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 21 Quality Assurance is central to the management of the home. There are regular informal discussions with service users both through residents meetings, and through meeting with them individually. The Registered Owner and the Registered Manager hear and respond to service users everyday comments. There are also formal processes. Responses to questionnaires that are sent to service users, relatives, and involved professionals are analysed; and improvements developed and implemented as needed. The Registered Manager undertakes regular audits on different aspects of the running of the home. Financial procedures are robust, and service users properly protected in relation to this. Staff performance appraisal and supervision have been fully implemented since the last inspection and staff feel happy with the support that they receive. Some aspects of record keeping were identified with the Registered persons as in need of improvement. The quality of recording by staff is sometimes too casual and the organization of daily records should be improved. This could be an area where staff require greater supervision or training. Other records kept by the Registered Manager were good. Policies and procedures were sampled and advice given on ensuring that the procedures of the home are clearly identifiable by staff, through the provision of more specific information in some areas. The Registered Persons are aware of the importance Health and Safety issues within the home. Generally this is well managed and good records are kept. Advice was given on the need to complete the provision of disposable towels in all communal areas around the home to guard against cross infection; and on the need to move some furniture in the lounge area in the “new part” of the home as it was causing a problem for service users in moving around the dining table. The Responsible Individual said that he had identified this problem already and the piano was to be moved into storage. Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 22 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 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 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 3 x 4 x 3 x 2 3 Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 23 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. 1 Standard OP10 Regulation 13 Requirement Essential medications must be available to service users as per the prescription. Timescale for action 12/12/06 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 2 Refer to Standard OP37 OP38 Good Practice Recommendations Daily records should be improved to promote professionalism and to ensure relevant information is passed onto care plans. Health and Safety issues should always be responded to promptly to ensure the avoidance of unnecessary risk. Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Gabriel Court Residential Care Home DS0000063955.V321528.R01.S.doc Version 5.2 Page 25 - 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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