Inspection on 04/07/05 for Gallagher Residential Care Limited

This inspection was carried out on 4th July 2005.

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

Gallagher Residential Care... 18/12/08

Gallagher Residential Care... 04/07/06

Gallagher Residential Care... 08/03/06

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Gallagher Care 212 Charnwood Road Shepshed Leicestershire LE12 9NR Lead Inspector Jo Vyas Unannounced 04 July 2005 14:00 at 2:00pm 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Gallagher Care C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Gallagher Care Address 212 Charnwood Road Shepstead Leicestershire LE12 9NR 01509 503113 01509 507239 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) Gallagher Residential Care Limited Mr Paul Anthony Gallagher Care Home 9 Category(ies) of LD Learning disability(9) registration, with number of places Gallagher Care C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 7th February 2005 Brief Description of the Service: Gallagher Care Residential Home is located on the outskirts of Shepshed, with easy links to Coalville and Loughborough and within easy reach of all local care and community facilities. The home offers nine places for Adults with a Learning Disability. The home briefly comprises of bedrooms sited on the ground, first and second floors, made up of seven singles and one shared room. On the ground floor there is a large lounge,smaller lounge and dining area. Bathrooms/shower rooms and toilets are sited on the ground and second floor. The house is set in a residential position, with a large rear garden, which is well maintained by a service user. Gallagher Care C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the CSCI is upon outcomes for service users and their views of the service provided. The primary method of Inspection used was ‘case tracking’ which involved selecting three service users and tracking the care they received through looking at their records, discussion with them, care staff and observation of care practices. This unannounced inspection took place between 2pm and 6pm and was carried out as part of the annual plan of inspection. Planning for this inspection included reviewing the previous inspection report, the pre-inspection questionnaire and a comment card from a relative. During the inspection, residents showed the inspector their bedrooms and care records were inspected. What the service does well: What has improved since the last inspection? What they could do better: Although the inspector found that there are currently excellent outcomes for service users at this home, concerns were raised about the lack of staff, numbers, deployment, support and training. Staffing on each shift is low and Gallagher Care C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 6 this may need to be addressed after further discussion. Some medication practices were also a concern to the inspector. 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. Gallagher Care C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection Gallagher Care C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Prospective service users’ needs and aspirations are fully assessed therefore their care needs can be met once they move into the home. EVIDENCE: • • • A full assessment is completed by a social worker in consultation with relatives and carers. Care plans are formulated to meet the needs and aspirations assessed. Records indicate that a range of professionals are involved in the care of individual service users. Gallagher Care C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9, 10 The individual needs and choices of residents are not fully addressed therefore this potentially puts residents at risk. EVIDENCE: • Three care plans were viewed. These gave minimal information, specifically with regard to health care needs but were up to date and used a Person Centred Planning format. A service user talked through his care plan with the inspector confirming the information was relevant and accurate. Risk assessments formed part of the care plan but were not comprehensive and did not cover all the risks identified. Service users do not have formal meetings but service users the inspector spoke to were happy that their views are listened to. One service user stated that he maintains the garden and makes the decisions about what should be done in the garden. The Registered Manager stated that he discusses issues with service users everyday. Care files are kept in an unlocked cupboard in the dining room. • • • • Gallagher Care C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16, 17 Social activities and meals are well managed and provide daily variation and interest for people living in the home. EVIDENCE: • • • • Service users attend day services and colleges. One service user very proudly spoke about the work he does as a volunteer while college is closed for the summer. Staff were observed interacting with service users positively, with respect and upholding their dignity. Service users had free access to the kitchen and helped themselves to drinks. Meals were varied and planned by service users. Service users are also supported to do the shopping. The Registered Manager stated that they will try and accommodate whatever activities the service users want to do. The Registered Manager is currently working with the Breaking the Barriers team to support a service user to gain appropriate employment. Evidence was seen of service users accessing the local community, some independently. At home service users watch TV, listen to music and relax. One service user maintains the garden. C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 11 • Gallagher Care • • • Staff encourage and facilitate family/friends contact. One service user told the inspector that his girlfriend visits him each week and stays for tea. They sit in the small lounge for some privacy. At the time of inspection, five service users were on holiday in Mablethorpe. Meals are relaxed and flexible. Service users said the food was brilliant. Gallagher Care C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 There are good levels of personal and healthcare support to service users. However, there were some shortfalls in some areas relating to the safe handling of medication and these have the potential to place residents at risk. EVIDENCE: • • Service users are registered with a GP and have access to the appropriate healthcare professionals as required. Currently staff dispense medication from the original packaging and the management team write the medication administration records, they are not pre-printed from the pharmacist. At the time of the inspection the keys to the medication cabinet were left in the cupboard lock, which is located in an unlocked cupboard in the lounge. Medication was found on top of the medication cupboard and this was no longer in use. On the medication administration sheet a line is used to indicate that medication hasn’t been taken. Reasons for medication not being taken were neither written on the administration record or in the care notes. All staff except for new staff, had received training for the safe handling of medication. Gallagher Care C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 The inspector was satisfied that staff in the home respond to complaints and concerns adequately but was not satisfied that service users are safe from abuse or neglect. EVIDENCE: • The Registered Manager stated that he listens and responds to service user’s concerns as they occur but does not keep a written record. He said that concerns tend to be minor such as complaints about the food. However, service users stated that they felt their views were listened to. The Registered Manager has not yet acquired the new adult protection procedures and therefore hasn’t trained staff in the new procedures. • Gallagher Care C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29, 30 Gallagher Care is homely, clean, safe and comfortable. EVIDENCE: • • • • • • The home was clean and well maintained. All bedrooms are single except for one shared room and are highly personalised. Adaptations are used where necessary to maintain independence for some service users. There are sufficient toilets and bathrooms. Communal areas are bright and homely. The home is well maintained and decorated. Gallagher Care C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 35, 36 The deployment, number, support and training of staff is poor, which may lead to service users being put at risk. EVIDENCE: • The rota showed that there is usually one member of staff per shift to nine service users who are fairly independent. During the night a member of staff stays awake as two service users tend to get up. Staff can refer to an on-call rota if they require a manager on site. The Registered Manager stated that a manager can usually be at the home within a few minutes. This was indeed the case on the day of the inspection. The Registered Manager stated that if more staff are required to take service users to healthcare appointments etc., he ensures they are rostered on. Staff are inducted using the home’s own induction package but this had only been completed for one week for a member of staff who had been at the home for one month. The new member of staff had little experience of people with a learning disability and had so far not attended any training courses. The Registered Manager stated that this was because of the college summer break and that the new staff were booked on courses in September. The home does not use an external induction package such as Learning Disability Award Framework. C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 16 • Gallagher Care • • One member of staff has completed the National Vocational Qualification level two and another member of staff has started the course but is having difficulties completing it. Staff support is poor. The Registered Manager does not hold staff meetings or carry out staff supervisions. A member of staff stated that she was able to discuss issues with other staff at handover but felt staff meetings and supervision would be useful. Gallagher Care C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39, 41 There is minimal leadership, guidance and direction for staff, which potentially places service users at risk. EVIDENCE: • The Registered Manager does not have a formal qualification but is extremely experienced and knowledgeable. The Assistant Manager is considering enrolling on the National Vocational Qualification level 4 and the Registered Managers Award in September this year. The Assistant Manager has completed a comprehensive qualitymonitoring tool, which is a self-assessment of the National Minimum Standards for younger adults. They also send out questionnaires to relatives, service users and professionals. Information from these are transferred into the service user guide. The Assistant Manager has also produced a comprehensive newsletter this year detailing an inspection report. The Registered Manager uses an on-call system, whereby the Registered Manager and another manager are on-call 24 hours a day, 7 days a week. C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 18 • • Gallagher Care SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 x x Standard No 22 23 ENVIRONMENT Score 2 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 2 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 1 1 x 1 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Gallagher Care Score 3 3 1 x Standard No 37 38 39 40 41 42 43 Score 3 x 4 x 2 x x C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 19 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 20 Regulation 13 (2) Requirement The Registered Person must ensure that there are arrangements for recording, handling, safekeeping, safe administration and disposal of medicines in the care home. The Registered Person must ensure staff have up to date information to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. The Registered Person must ensure that the home is staffed at all times by suitably qualified staff. The Registered Person must ensure that persons working at the care home are appropriately supervised. The Registered Person must ensure the care home has the appropriate number of staff to ensure the health and welfare of service users. Timescale for action 30/7/05 2. 23 13 (6) 30th August 2005 3. 32 & 35 13, 18 1st October 2005 30th August 2005 30/07/05 4. 35 18 (2) 5. 33 18 (1) 6. Gallagher Care C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 20 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. 5. 6. 7. 8. Refer to Standard 6 9 10 & 41 22 35 36 33 33 Good Practice Recommendations It is recommended that care plans are comprehensive and reflect all the needs of the service users. It is recommended that risk assessments are comprehensive and reflect all the risks that affect each service user. It is recommended that all care files are stored in a secure cupboard. It is recommended that all complaints are recorded. It is recommended that staff receive a formal induction package which is specifically focussed on people with a learning disability. It is recommended that staff receive six supervision sessions each year, which should include an annual appraisal. It is recommended that the on-call policy is sufficient to ensure the needs of service users are met. It is recommended that risk assessments are completed for lone working to ensure risks to staff and service users are minimised. Gallagher Care C51 C01 S63965 Gallagher Care V235259 040705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection The Pavilions 5 Smith Way, Grove Park Enderby, Leicestershire LE19 1SX 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. 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