Inspection on 20/07/05 for Gabriel Court Residential Care Home

This inspection was carried out on 20th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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... 12/12/06

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

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 Sarah Jenkins Unannounced 20 July 2005 @ 07.30 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. Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Gabriel Court Residential Home Address 17-23 Broadway Kettering Northants NN15 6DD 01536 510019 01536 500838 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) Gabriel Court Limited Mrs Shirley Day Care Home Only 44 Category(ies) of Older People (OP) 34 registration, with number Dementia - over 65 (DE(E)) 10 of places Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home will limit its services to the following service user categories: 2. No person falling within the category Older Persons (OP) can be admitted where there are already 44 persons of category OP already in the Home. 3. No person falling within the category DE (E) can be admitted where there are 10 persons in the category DE (E) already in the Home. 4. The total number of service users in the Home must not exceed 44. Date of last inspection 26.10.04 Brief Description of the Service: Gabriel Court is a large 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 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. Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 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 two 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. On this occasion one of the Service Users chosen for case tracking was asleep and the inspector therefore did not disturb her. The inspector spoke with a number of other Service Users. The Inspector visited the home for three and a half hours during the early morning period from 7.30am 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. At the time of the inspection the inspector had not received any comment cards from Service Users or their relatives, nor the homes self assessment form. These will be reviewed and included in the next Inspection report. The Registered Manager has been undertaking a complaint investigation over the last two weeks although the inspector had not seen the findings of this investigation at the time of the inspection. What the service does well: Service Users consistently reported to the inspector that they felt that their physical care was good. Staff were considered to be caring and often exceptional. Night care was felt to be very good with staff checking on Service Users throughout the night. Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 Page 6 The home was found to be very clean. The Registered Manager felt that staff had a range of different skills and qualities between them and that they work well as a team. 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. Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 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 Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 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 and 3 Service Users are assisted to make an informed choice about the home, and their needs are properly assessed before they move in. EVIDENCE: A recently admitted Service Users informed the inspector that she was assisted to choose the home by a relative and that she had seen the brochure which she felt gave her sufficient information Records contained detail of Service Users needs and interests in assessment documentation drawn up prior to admission. Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 9 Health and personal care needs are not fully met. EVIDENCE: Service Users were very confident in the healthcare that they received. There were details of Service Users access to healthcare professionals on their files and the Service Users and staff reported good relationships with local surgeries. The inspector observed poor lifting techniques by staff although the Registered Manager informed her that staff had all been properly trained. There was insufficient Moving and Handling detail on some care plans to properly guide staff in the techniques and equipment needed for individual Service Users. Poor practice was observed in the administration of medicines, for example a Service Users tablets were left on a table for her. Medication procedures were insufficiently detailed to properly guide staff on the correct procedure although the Inspector was informed that staff were properly aware, and that normally two staff administer medication to ensure procedures are correctly undertaken. It was not clear on this occasion why procedures were not being followed and the Registered Manager assured the Inspector that she would follow this up. Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 Page 10 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 Some Service Users would benefit from increased focus by staff on their individual lifestyles. EVIDENCE: A number of Service Users are comparatively immobile and/or suffer from confusional states. Some Service Users are very alert and able. Some Service Users expressed a mild dissatisfaction with their lifestyles feeling that there could be more input from staff, who they saw to be “very busy”. Others appeared quite content and informed the inspector that all areas of care were “alright”, “fine” or “good”. Whilst the staff investigate Service Users past interests, there is some lack of focus in meeting these. For example a Service User with a high interest in the land army expressed a wish that she had seen the recent documentary on this. Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 Page 11 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) 18 The homes practices could be improved to guard against abuse. EVIDENCE: Service Users finances should be recorded better, in that staff should double sign entries where Service Users are not able to. Entries in the daily records should be reviewed on a regular basis to ensure that staff are professional, competent in their recording skills, and record accurately. Where staff entries need to be followed up through supervision etc, a record should be kept of this. Most staff have had some training in understanding abuse issues but there may need to be increased up to date training to take into account changes that have occurred in the process since the system of referral was first set up. All care staff have recently attended training in Dementia care and this included issues of abuse relating to this particular client group. Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 Page 12 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, 20 and 26 Service Users have a pleasant and generally well maintained environment. EVIDENCE: The Registered Owners take care to ensure the environment is properly maintained and checks are undertaken on a regular basis. Service Users informed the Inspector that the fire officer visits calls regularly and he called in to check fire protection equipment at the time of the inspection. Service Users have a number of pleasant indoor areas where they can spend their time and a pleasant well maintained garden. Service Users told the Inspector that they enjoyed the garden and one lady has a birdbath placed on the grass outside her room where she can see visiting birds which she enjoys. The home was exceptionally clean pleasant and odour free at this early morning visit. This cleanliness has been noted on previous inspections. Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 Page 13 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 and 28 Staffing numbers at the time of the inspection met Service Users needs EVIDENCE: There were seven staff members on duty at the time of the visit and further ancillary staff and the Registered Manager had arrived by 9.am. The Inspector observed that staff were mainly available to meet Service Users needs although there was a short period when the lounge area in the old part of the building was unattended. Service Users were generally complimentary about the staff, although several Service Users observed that they were often “very busy”. Staff were observed to relate very well to Service Users suffering from confusion, with caring and understanding responses to Service Users perceived problems. Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 Page 14 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) 38 There is a need for greater management input to ensure staff are fully aware and responsive to Health and Safety issues, and that the home fully and continuously meets its responsibilities in this area. EVIDENCE: There are not sufficient up to date First Aiders employed to provide continuous cover. Hazardous substances must always be stored correctly in line with COHSS regulations. Storage in one of the homes bathrooms was potentially hazardous for Service Users. Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 Page 15 The sash cord on one of the upstairs windows was broken and the window was inappropriately propped open with a toilet roll. Staff supervision should be increased to promote good practice at all times. Policies and procedures should be fuller and detail practices expected of staff in the home (for example Medication). Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 x COMPLAINTS AND PROTECTION 2 3 x x x x x 4 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x x x x x x x 1 Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 Page 17 NO 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 13,15 Requirement Details of Moving and Handling procedures, techniques and equipment for each individual Service User must be on their care plans. Good practice must be evident in the administration of medicines to guard against risk. To this end detailed procedures must be documented and available for staff, and staff must comply with these at all times. A qualified first aider must be on duty at all times. Hazardous substances must be properly stored at all times when not in use, in accordance with COHSS regulations. Staff must be reminded of their responsibilities under Health and Safety legislation and to this end windows must not be propped open inappropriately. Staff must comply with safe manual handling practices and if necessary undertake refresher training. Timescale for action By August 20th 2005 2. 9 13 By August 20th 2005 3. 4. 38 38 13 13 By September 1st 2005 By August 20th 2005 By August 20th 2005 5. 38 13 6. 7 13 By August 20th 2005 Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 Page 18 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. 3. 4. Refer to Standard 7 12 18 38 Good Practice Recommendations Records including care plans should be better organized to enhance access to relevant information. Staff should explore Service Users individual interests to establish where activity and stimulation for individuals may be improved. Service Users records of finances should be double signed where possible. Policies and Procedures should be reviewed to ensure that all relevant information is detailed for staff and that indexing enhances access. Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Northamptonshire Area Office Newland House, First Floor Campbell Square Northants, NN1 3EB 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 Gabriel Court Residential Care Home C51 C08 S63955 Gabriel Court Residential Care Home V236032 Stage 4.doc Version 1.40 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!