Inspection on 11/05/09 for Gailey Lodge

This inspection was carried out on 11th May 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gailey Lodge 17/12/09

Gailey Lodge 01/05/08

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Gailey Lodge 32-33 Victoria Avenue Whitley Bay Tyne & Wear NE26 2AZ     The quality rating for this care home is:   one star adequate 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: Jim Lamb     Date: 1 1 0 5 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 30 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 Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Gailey Lodge 32-33 Victoria Avenue Whitley Bay Tyne & Wear NE26 2AZ 01912970890 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): gaileylodgeltd@aol.com Gailey Lodge Limited Name of registered manager (if applicable) Brigette Stephenson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: The maximum number of service users who can be accommodated is: 19 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 category: Physical disability Code PD, maximum number of places: 19 Date of last inspection Brief description of the care home Gailey Lodge provides personal care accommodation for up to 19 service users mainly with physical disabilities. The building is a large converted Victorian house. The home is located in a busy area of Whitley Bay, within walking distance of the local shops, library, post office churches and leisure facilities. The beach is also a short walk from the home. There is easy access to the town centre and public transport routes. All the bedrooms are single and seven rooms have en-suite facilities. There are two lounge areas and a separate dining room. Service users also have access to a small Care Homes for Adults (18-65 years) Page 4 of 30 care home 19 Over 65 0 19 Brief description of the care home kitchen area where they can prepare snacks and drinks. Fees for the home start at 414.00 per week. Information about the home and copies of inspection reports are available in the home. Care Homes for Adults (18-65 years) Page 5 of 30 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 1 star. This means that the people who use the service experience adequate quality outcomes. How the inspection was carried out. Care Homes for Adults (18-65 years) Page 6 of 30 Before the visit we looked at information we have received since the last visit, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people, and the views of people who use the service and their relatives, staff and other professionals. During the visit we talked with people who use the service, staff, proprietor the manager and visitors, looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building/parts of the building to make sure it was clean, safe and comfortable,and checked what improvements had been made since the last visit. We told the manager/provider what we found. What the care home does well: What has improved since the last inspection? What they could do better: The service users care records need to be re-organised and old information should be archived, this will make information much more accessible. Care Homes for Adults (18-65 years) Page 8 of 30 The service users care plans need to be clearly defined and separated from the risk assessments, currently these are merged together and this makes it difficult for staff to review and evaluate the plans properly. All prescribed medication must clearly be recorded/documented on the Mar charts and in the controlled drugs record book, the records must state the full name of the medicine, dose, frequency etc. No controlled medicine should ever be prescribed AS REQUIRED. To protect the health and welfare of the service users, the hygiene practices in the kitchen must be reviewed. 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 Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users are provided with enough information about the service to enable them to make an informed choice about whether this is where they want to live. Evidence: The home has a Statement of Purpose and Service Users Guide that gives clear information about the service. These include good details of the accommodation for the people who have moved here. There is comprehensive assessment process that includes the input of the prospective service user, their relatives, social worker, care manager and, where appropriate, psychology, and psychiatry services. This ensures that the needs of each prospective service user are fully assessed before a decision is made about whether the service can meet their individual needs. The pre-assessment information in the home gives very clear details of service users Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: specific needs. All the people who live here have contracts that outline their rights and responsibilities whilst living here. These are kept in their care files which they can access, with support if necessary. The contracts also include details of the individual fees for each service user and their contribution. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning system is not clear enough to ensure that staff have the information they need to meet the assessed needs of the service users. Evidence: There are a range of assessments in the service users care records. There is also a comprehensive risk assessment of service users. There are advocacy arrangements, as well as family input to represent service users. Life plans are drawn up with service users. These are amended and reviewed every six months, or more frequently if needed. Staff were observed to demonstrate their skill in communication during the inspection, and were observed to discuss and explain routines and activities clearly with service users. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: Service users are asked and allowed to make decisions affecting day-to-day choices and about the activities they participate in. Service users and staff discuss routines in the home, and service users have been able to make choices about decor schemes, trips out, holidays, personal purchases and meals. There are regular house meetings between staff and service users. The service users co-ordinate and chair these meetings. The way people communicate is also outlined within each persons life plan. These follow a standardised format. The life plans are person centred, and they clearly relate specifically to each persons individual needs. However, these need to be clearly linked to a format that has monitoring, evaluation and review notes written up. At the moment there is a merger of care plans and risk assessments in place. The current documentation is to complicated and unwieldy and requires further streamlining to ensure its application is more effective for people. The individual care records also need to be more organised, currently they contain new and old formats that were used by the previous provider, with old and out of date information going back to 2005. Areas of risk are documented within each persons care file, including assessments relating to activities out of the home and behaviours that may challenge the service. Current and additional control measures are documented, and this is then reviewed. All care plans and risk assessments are not clearly defined in seperate forms and forms are not signed by the service users (or their representatives) to show they have been agreed. There are systems in place that will ensure that the placement of the service users are reviewed annually. These involve the care managers and the service users representatives. The service users confirmed that their privacy and dignity are respected at all times. All were very positive about the care that they received, and they spoke highly of the staff. One service user said, The staff are like my family, the care i receive is excellent. Another said, Although i am still quite young, and several care managers have suggested moving back into the community, i do not intend ever leaving here because this is my real home now. Care Homes for Adults (18-65 years) Page 14 of 30 Care Homes for Adults (18-65 years) Page 15 of 30 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. The service users are offered a good quality lifestyle, which includes varied social contact and activities. Evidence: Each service user has a social skills assessment carried out. This is reviewed and updated on a regular basis. All service users participate in this process. Service users are supported and encouraged to be in control of their own lives, to enjoy their own interests and hobbies. There are daily activities available, and service users have a choice of activities they want to do. All are provided with opportunities to further education and if required supported employment schemes. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: Outings and activities are planned. There are meals out, visits to cafes, shops, pubs,football matches and trips to local theatres, etc. All service users are supported to maintain very close links with their families and friends. They can choose who they want to see and when. The Homes menus are based on the known likes and dislikes of the service users. At least two hot meals are provided each day. Service users have access to a small kichen where they can prepare snacks and drinks. The service users said that the meals were very good and that they were always offered a choice. Service users are supported to attend weekly Religious services of their choice if they wish. Care Homes for Adults (18-65 years) Page 17 of 30 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The promotion of health care is taken seriously, and service users have their personal needs fully met. The medication recording system needs to be reviewed to ensure that medicine supplied by the GP and pharmacist are properly detailed. Evidence: The service users are registered with a local GP practice, and have access to community dental, optician and chiropody services as and when required. If necessary specialist health care services are available i.e. psychiatry, psychology, Speech and Language Therapists and Dietician input. In this way the home ensures that service users health care needs are met by appropriate health care services. At this time some of the current service users, with support from staff, have been assessed as able to manage their own medication. Trained, designated staff continue to manage and oversee the medication nomad system. Medication is securely stored in a locked cupboard. Records of the administration of Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: medication are in place and generally up to date. One controlled drugs prescribed for one person was not correctly documented in the controlled drug register or on the Mar chart, the instruction for administration of the drug stated, AS REQUIRED. The manager agreed to contact the persons GP and the dispensing pharmacist immediately to inform them that this practice is unacceptable. The medication records must clearly state the quantity of medicine received, the specified dose to be given and the specified frequency. Any handwritten mar chart entries must be signed and dated, the full contents of the medication label should be copied onto the MAR chart including the specific directions. A second person should then check the entry for accuracy and then countersign each entry. Care Homes for Adults (18-65 years) Page 19 of 30 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. The complaints management is effective, and this results in the service users being protected from harm and abuse. Evidence: There is a complaints procedure. The procedure is written in a way that ensures service users fully understand its contents. One service user said that she had been given a copy of the procedure and that staff always listened to any concerns and always dealt with them fairly. The home keeps a record of complaints. The home has a Whistle Blowing policy, the Local Authorities Vulnerable Adults procedures, and a copy of the Department of Healths document, NO SECRETS. Staff are aware of these procedures and have easy access to them. Since the last inspection visit, there have been no complaints received. Safeguarding adults training is ongoing for all staff. Service users can deposit cash for safe keeping in the homes safe and records are kept of accounts. A sample of personal finances records was examined. Transactions were appropriately recorded for each entry. There was plenty of evidence of personal Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: spending. Receipts are obtained for purchases and numbered to cross-reference to the transaction. Weekly checks of balances and cash are carried out. Care Homes for Adults (18-65 years) Page 21 of 30 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In the main the home has a comfortable environment for people to live in. However, some hygiene practices are poor and this may present risks to the health and safety of the people using the service. Evidence: The home provides a spacious, comfortable, and well-maintained house. It is decorated and furnished to a fairly good standard. The house includes a small kitchen that service users have access to. There is an attractive lounge so service users can spend time together.The lounge has just been decorated, and the service users selected the new colour schemes. There is a second lounge overlooking an attractive garden, new laminate flooring has been laid in here. The dining room has recently been decorated. The bedrooms are decorated and furnished in a way that suits the age and lifestyle of the people who live here. All have individualised and personalised their own bedrooms to suit their own styles. It was clear during this visit that people spend time in the privacy of their own room whenever they wish. All bedrooms are lockable by service users, if they wish. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: There is a small laundry area which is well organised. The provider is still considering replacing the lift, at the moment the lift remains in good working order. The night storage heating system has been up-dated, new heating elements have been fitted to the majority of the units throughout the home. New flooring has been fitted in the main kitchen, laundry, service users kitchen and some of the bathrooms/WCs. The provider has submitted plans to extend the home, if approved this will create two additional en suite bedrooms. The main kitchen was found to be in need of a thorough deep clean, there was grime on storage shelves, the ventilation system, and the top of the upright freezer. The cooker extractor fan vents were clogged with grease, and the inside of the oven needed to be cleaned. The proprietor said that he was going to purchase a new oven. He agreed to make immediate arrangements to have the kitchen deep cleaned. Care Homes for Adults (18-65 years) Page 23 of 30 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. There is a good match of well-qualified staff, who are appropriately recruited and supervised. Evidence: Staff levels on the day of the inspection met the agreed level for the number of service users. On the day of the inspection there were 19 service users. In addition to the manager, the required numbers of staff were on duty: there are 3 care staff between 8am and 10pm. There are 2 night staff between 10pm and 8am. The home has a part time administrator, 30 hours maintenance, domestic and catering staff. All staff were over 18 years of age and those left in charge were at least 21. The training needs of the staff are identified in supervision and appraisal sessions. The homes training programme meets the National Training Organisation requirements for the first six months. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: Staff receive at least three days paid training each year. The service has a rigorous staff recruitment and selection process to ensure that all appropriate checks and references are in place prior to employment. The service has a good staff training and development programme in place. All statutory training was up to date and 80 of the staff team has completed NVQ level 2/3. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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. The manager is supported by the proprietor in providing good leadership throughout the home, with staff demonstrating an awareness of their roles and responsibilities. Evidence: The manager had obtained relevant qualifications, and has commenced the Registered Managers Award. She had extensive experience and displayed the professional competence required to manage the home. There was evidence that the staff team worked hard to improve the lives of the people living at the home. Staff and service users felt that the managers style of leadership was fair, supportive and understanding. The majority of service users had requested that the home take on day-to-day responsibility for overseeing their money. A safe was available to ensure that their money could be kept secure. Financial records showed evidence of regular audits. The home does not acting as an appointee for any of the service users. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: A quality assurance system had been developed to monitor the quality of care provided in the home. For example, quality surveys had been sent to people living at that the home and their relatives. The manager confirmed that she intends to send surveys to other professionals visiting the home.The manager intends to devise a detailed annual development/business plan. The manager will also ensure that all prospective service users will have access to the results of the service users surveys. A tour of the premises identified some health and safety concerns in the kitchen. The proprietor and the manager agreed to address these issues immediately. An audit of the homes fire records confirmed that the required fire prevention checks had been completed. For example, the homes emergency lighting and fire extinguishers had received monthly visual checks. The homes accident records contained the required details. The homes lift and hoisting equipment had been serviced. All gas and electrical appliances had been subject to the required safety checks. Care Homes for Adults (18-65 years) Page 27 of 30 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 Adults (18-65 years) Page 28 of 30 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 1 20 13 There must be appropriate arrangements in place for the recording, handling and safe administration of medicines received. To protect the health and welfare of service users. 15/05/2009 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 6 Devise a new format for the service users care support plans to ensure that each persons holistic care needs can easily be reviewed and evaluated when needed. Re-organise the service users care records, and archive any old and outdated information held. As part of the homes quality assurance system, the home must implement an annual development plan, based on a systematic cycle of planning and review. 2 3 6 39 Care Homes for Adults (18-65 years) Page 29 of 30 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 Adults (18-65 years) Page 30 of 30 - 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!