Inspection on 18/12/08 for Gallagher Residential Care Limited

This inspection was carried out on 18th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gallagher Residential Care... 04/07/06

Gallagher Residential Care... 08/03/06

Gallagher Residential Care... 04/07/05

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Gallagher Residential Care Limited 212 Charnwood Road Shepshed Leicestershire LE12 9NR     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: Keith Charlton     Date: 1 8 1 2 2 0 0 8 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. the things that people have said are important to them: They reflect 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 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Gallagher Residential Care Limited 212 Charnwood Road Shepshed Leicestershire LE12 9NR 01509503113 01509507239 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Gallagher Residential Care Limited care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: None Date of last inspection Brief description of the care home Gallagher Care Residential Home is located on the outskirts of Shepshed, with easy links to Coalville and Loughborough and within easy reach of local facilities. The home is registered for nine adults with a learning disability at the time of inspection. The property comprises of eight single and one shared bedroom located on the ground, first and second floors. On the ground floor there is a lounge, and a dining area. Another lounge is on the second floor. Bathrooms/shower rooms and toilets are sited on all floors. The house has a large rear garden. The range of fees currently charged is #1388 to#1986 every four weeks. Extra charges for services such as hairdresser and chiropodist are made on an individual basis. This information was given on the day of the inspection. 9 Over 65 0 Care Homes for Adults (18-65 years) Page 4 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: 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: This key inspection included a visit to the service. We (the CSCI) visited Gallagher Home on the 18th December 2008. The Registered Provider, Manager, and staff in the home helped us during the visit. The last inspection of this service was completed on the 4th July 2006. 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, - talking to staff and management, Care Homes for Adults (18-65 years) Page 5 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 Gallagher Home. As well as this, we looked at information that had come to our attention since the last key inspection in July 2006. We spoke with six people who live at Gallagher during our visit. People told us that staff were good and helped them. One person said staff are friendly and help me. None of the people spoken with had any complaints about 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 Gallagher Home and wanted to provide excellent care to people living there. Their comments were, We have enough staff and had training to do the job. Everyone is friendly and we get to know the residents as individual personalities. 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: 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 28 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 8 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, 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. People living at Gallagher Home have had their needs properly assessed before moving into the home. Evidence: We case tracked a person living in the home who had moved in to the home. We checked that she had received information to help her with the choice of home, and she said she had received enough information. We also checked that this person now living at the home had her needs properly assessed prior to moving in, to ensure that the staff at the home could meet her needs. Care Homes for Adults (18-65 years) Page 9 of 28 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 individual needs and choices of each person living at Gallagher Home are not all documented so cannot be consistently acted upon by staff supporting people who live there. Evidence: A resident said I like it here, staff are friendly and I can do what I want. A resident who was case tracked said Staff are friendly and help me. We looked at the care records of people living at Gallagher Home. We found detail to support the care given to people who live at the homes, though care plans are not in a format more easily understood by people who live there. They also did not detail the mental health conditions of residents or supply detail to staff as to how to approach any challenging behavior they may meet. If incidents had happened there was no evidence that these had been referred to their Social Workers or other support to discuss a way of handling this behavior. We also have not been informed of such Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: matters. There was no information in a residents care plan as to a risk assessment to deal with such incidents, which is then a risk to residents and staff. We saw that care plans were not reviewed on a six monthly basis and up-dated to ensure they reflected the changing care needs of people living in the home, though the Provider said they could be up-dated to ensure they reflected the changing care needs of people living in the home as there was space on the form for this to happen. During our visit we observed staff being very friendly to residents and explaining what they were doing to reassure residents. There was evidence that residents are able to live their own lives, e.g. going out to places in the community, self medication, choice of meal etc but little evidence that residents are consulted through regular residents meetings, or a representative of the residents being able to contribute to staff meetings and staff recruitment. There was a reference in a care plan that the sanction of not allowing a resident to have her boyfriend to visit if she persisted with a behavior, though no evidence that this had been agreed with the resident/representative. Care Homes for Adults (18-65 years) Page 11 of 28 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. People living at Gallagher Home have opportunities to have a varied life though this needs to be extended . Evidence: We looked at the life plans of people who live at Gallagher Home. These showed us a varied social life was being experienced. People go to the day centre or college to learn life skills, and one person works in a charity shop. They go to outside activities such as pubs and discos and the residents who wanted to go enjoyed a holiday to Mablethorpe this year. There were comments in residents surveys that residents would like more activities - more discos, walking, cooking, pets, 10 pin bowling, shopping etc. We saw that staff are sensitive to the needs of people living at the homes. They were aware of the preferences of people in terms of where they prefer to sit and when they like to have company or be alone. We saw staff talk to and interact well with people who live Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: at the home. Staff also were aware of how to effectively communicate with each person. There was a comment that people who smoke have to go outside in all weathers and this was not fair as they were admitted on the assumption that they could choose to smoke for as long as they wished. The Provider said that a proper shelter was to be provided in the back garden early in January 2009, and later contacted us to say this had now been put in place. We saw tea being served and people living at the home having a healthy meal of roast chicken, with two different types of potatoes and three vegetables with creamed rice pudding for dessert. They said that they enjoyed their meal. The menu provides a balanced and healthy diet. A resident had the choice to buy her own meals outside the home on some days of the week. There was a comment that a resident could not have her boyfriend to stay overnight if she wanted to. The Provider said this issue had never arisen but it would be properly looked into if it becomes an issue in the future. Care Homes for Adults (18-65 years) Page 13 of 28 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. People who live at Gallagher do not always receive excellent support in their personal and healthcare needs. Evidence: We looked at the personal and healthcare records of people who live at Gallagher. We saw that they have access to healthcare services to meet their personal and healthcare needs. However instances were noted when residents had potentially serious injuries following falls and these were not referred to medical services. xxx We looked at medication management and found that staff are administering medication appropriately to people who live at Gallagher. We also looked at how medication is stored and this was stored safely. We saw staff records and these showed us that staff have undertaken training in the administration of medication. We were informed that only trained carers are given permission to administer medication to people who live in the home. There was a reference to an as needed medication not being available in the home and Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: that staff trying to get other staff into trouble over medication - the Manager said that this had not meant that medication was not properly given to residents as a consequence of this matter. Nevertheless this is of concern. Care Homes for Adults (18-65 years) Page 15 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management and staff listen and act upon complaints made though need to evidence how complaints are met. Management do not always follow correct staff recruitment practice to ensure residents are kept safe from unsuitable staff. Evidence: Residents said that they had no complaints but if they did they thought the staff or Manager would quickly get it sorted out. A resident said, I have been here a long time and never had anything to complain about. We saw the complaints record and no complaints for the past year. However on a residents notes there was a complaint about staff not knocking before entering her bedroom but this was not recorded in the Complaints Book, or a note of action taken to rectify this. The complaints procedure does not give the option of going to the Lead Agency (the Social Services Department) as an alternative to going to the home first. 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 of Agencies to report to if the in house procedure failed. Care Homes for Adults (18-65 years) Page 16 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 Gallagher Home. We found records which showed three staff had started work at the home before management had received written references to help them reach the judgement that people were safe to start employment. Care Homes for Adults (18-65 years) Page 17 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, 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 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 Gallagher Home live in a generally homely, comfortable environment. Evidence: Residents said that they liked their bedrooms. I like the way I can have my own things in my bedroom and can use it when I want, one resident said. We looked at the communal areas of the homes and the bedrooms of people who live there. We found the communal areas to be satisfactorily decorated and homely. The bedrooms were decorated to reflect the personalities and preferences of the people using them. Some bedroom doors squeaked very loudly and could disturb residents. The Manager said they would be attended to. The AQAA told us about the maintenance and renewal programme for furniture and fittings in the home. It said that there have been new carpets installed and that the washroom and shower was to be upgraded in the near future. We saw that the home was well maintained in general though the wall near the front ground floor bedroom by the washbasin still needed to be finished off. The Provider later contacted us to say this had been done. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: There were comment in the residents surveys that residents were not warm enough and there were draughts. Care Homes for Adults (18-65 years) Page 19 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, 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. People who live in the home have satisfactory staffing levels and support from a motivated staff team, though staff references and more induction training needs to be in place to fully support residents welfare. Evidence: Residents said that staff provided good care. I like the staff. They do a good job, one resident said. No one, residents or staff, thought the home was short staffed. The staff rota indicated that when residents were in the home, there were a minimum of two staff on duty with an awake staff member at night and on call management staff available if needed. We talked to staff and saw them supporting people who live in the home. We saw very good interaction between staff and people who live in the home, and staff demonstrated a very good understanding of the needs of people living there. Staff staff said they were supported well to do their job, though there was little evidence of induction training, there was evidence of on going training relating to the job they do, but no regular supervision. We were told by the Manager that the Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: approximately half of the staff have either a minimum of a level two National Vocational Qualification in Care or are/will be working towards one and that staff are encouraged to do NVQ 3 training as well.This was confirmed by staff. We looked at a sample of staff records, and saw that not all the necessary checks were made to safeguard people who live at the home as there were no references in place. We looked at training records and this confirmed that staff have undertaken relevant training to help them in their roles. Training included health and safety, medication management, working with challenging behaviour - though it was hard to see that all staff had relevant training. Care Homes for Adults (18-65 years) Page 21 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is not effectively managed to provide an excellent quality of life for people who live there. Evidence: The previous registered manager/owner has moved to a different role in the company. There is a new manager for the home and the owner said an application for this person to become the registered manager is to be sent to the CSCI. There are quality assurance and monitoring systems in place, and we saw the last audit undertaken by the providers. These need to be in a more user friendly format the next time they are used. There were a number of criticisms of the care of the home in relation to activities, lack of staff and warmth of the building, but no evidence of an action plane to meet these issues. The Manager said he would quickly do this. The AQAA informed us of the policies and procedures the service works to, to ensure good health and safety practise in the home. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: However the temperature of water in a bath on the ground floor and a washbasin in a first floor bathroom was measured at 50c, which could scald residents. The owner said that he had hot water regulating valves and would fit them within a day and confirm with us. The Manager said window restrictors have been fitted to some service users bedroom windows for their protection, though this would be reviewed again to ensure these were properly in place. The Manager also said that some of the fire doors do not fit on their rebates, which is a fire risk to residents and staff and these would be attended to to eliminate this risk. Care Homes for Adults (18-65 years) Page 23 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 Adults (18-65 years) Page 24 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 1 6 15 Care plans must contain detail as to how to deal with all situations relevant to the resident and be regularly reviewed and updated. To ensure that staff follow best practice and are consistent in how to deal with situations that occur. 18/02/2009 2 20 13 Medication must be ordered 18/02/2009 in a timely manner to ensure it is always available to residents. To ensure residents medical needs are always met and their physical health is protected. 3 23 19 The Provider must ensure that staff do not commence employment prior to the receipt of two written references. To ensure residents are protected from unsuitable staff. 18/02/2009 Care Homes for Adults (18-65 years) Page 25 of 28 4 42 13 That residents are protected from scalding risks from hot water and that fire doors properly operate to contain an outbreak of fire. To protect the health and safety of residents. 17/02/2009 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 7 That residents are free to deceide their own lifestyles and any restriction to be agreed with them and their advocate, e.g. social worker. That residents participation in the running of the home is extended to contributing to staff recruitment and staff meetings. That activities are extended based on residents choice. Residents need to have the choice of following their own lifestyles regarding personal relationships. That a shelter is made available for residents who wish to smoke to protect them from bad weather. That if residents have potentially serious injuries that a referral to medical services is made. That the complaints procedure is ammended to give complainants the choice of how they wish to complain. To check that all residents are warm enough and take action if they are not. That new staff complete a detailed induction programme in line with the Skills for Care programme, to provide good care skills. Staff need to be provided with regular supervision to support their individual practice to always provide good and consistent care to residents. An application for the Manager to become the Registered Manager needs to be made in the short term to ensure there is proper responsibility for the running of the home. The Quality Assurance system needs to be made more robust so that action is seen to be taken if issues are raised Page 26 of 28 2 9 3 4 5 6 7 8 9 14 15 16 19 22 24 35 10 36 11 37 12 39 Care Homes for Adults (18-65 years) regarding the running of the home. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 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 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. 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!