Inspection on 26/08/05 for Gallimore Lodge

This inspection was carried out on 26th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Gallimore Lodge 29/04/08

Gallimore Lodge 08/06/07

Gallimore Lodge 29/11/06

Gallimore Lodge 31/12/05

Gallimore Lodge 02/11/04

Gallimore Lodge 17/02/04

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

CARE HOME ADULTS 18-65 Gallimore Lodge Meesons Lane Grays Essex RM17 5HR Lead Inspector Helen Laker Un-announced 26th August 2005 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. Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Gallimore Lodge Address Meesons Lane Grays Essex RM17 5HR 01375 396174 01375 396174 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) Mosaic Essex Mrs Evelyn Thomson CRH 8 Category(ies) of LD Learning Disability 8 registration, with number of places Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17th February 2005 Brief Description of the Service: Gallimore Lodge is a purpose built double bungalow situated on a private residential road in Grays. Public transport by both rail and bus is available approximately 1 mile away. The home has its own minibus. All bedrooms are single occupancy and the home provides nursing care for 8 adults with learning disabilities. Services provided include personal, psychological, social, emotional and educational care by a multidisciplinary team and enabling the service user to remain as independent as possible. Service users within the home can access a range of formal day care placements and are encouraged to participate in leisure pursuits within the local community. Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine, unannounced inspection which took place over five hours with one inspector in the home. There was a tour of the premises and grounds and an inspection of records and documentation. Time was spent discussing the care of the eight service users. Two members of staff were spoken with. Twenty eight National Minimum Standards were inspected on this occasion, twenty five overall outcomes were met and there were three requirements detailed in the full report. Discussion of the inspection findings took place with the deputy manager in charge at the end and throughout the inspection and guidance was given. The manager at the time of this inspection was rostered on a day off. What the service does well: What has improved since the last inspection? What they could do better: At the last inspection the communal areas of the home were noted to be in need of repair and decoration these are still to be attended to. The proprietor must at all times ensure that any recruitment and training records required are easily accessible and available for inspection. Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 Page 6 These issues were all discussed at the time of the inspection and the intended outcomes of each. 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. Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 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 Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 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) 2,5 The admission procedure does include an adequate assessment which ensures that service users needs can be met. The home provides a caring environment where visitors are made welcome. EVIDENCE: The care plan of a service user recently admitted to the home contained a comprehensive assessment. The assessment also contained information gained from professionals as well as the service users families. The contract was in the process of being reviewed at the last inspection. All service users are issued with pictorial terms and conditions of residence and a tenant’s handbook. This was seen for a recently admitted service user. It was noted at the last inspection that the contract did not offer three months trial period and some were not signed by the service users or their representatives. Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 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) 6,7,9 Each service user has an individual plan and service users are supported to take risks as part of an independent lifestyle via a process of assessment. Due to service users profound learning disabilities they are only able to make limited decisions but staff facilitate this as much as possible. EVIDENCE: Care plans were seen to be comprehensive and reviewed on a regular basis. Care plans included assessments and evidenced involvement of service users and their families/representatives Daily records varied in quality. These were discussed with the deputy manager regarding improvements to ensure they fully reflect the welfare of the service user, how they spend their time and the progress of the care plan. The inspector was informed that the home care planning system has now reverted to Person Centred Planning (PCP). Risk assessments are contained in all service users files. These were seen to be to a good standard and detail how staff are to manage the risk. All were seen to be regularly reviewed. Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 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) 12,13,15,16,17 Social activities take place and service users are generally happy with the choices in routine available to them. Visitors are made welcome and overall the service users rights and responsibilities are recognised in their daily lives. EVIDENCE: The deputy manager informed the inspector that the home encouraged service users to participate in a wide range of activities, including colleges and day centres. However it was not possible to establish fully their views. The home encourages and supports service users to gain access to all the local community facilities. These include cinemas, pub, restaurants, bowling and theatre. Some service users are able to access public transport. Others can use a specially adapted taxi service and the home has its own transport which various staff are authorised to drive. Some service users were going away on holiday for a long weekend to Butlin’s on the day of inspection. The home operates an open visitors policy whereby service users can receive their family, friends and representatives at any time. Service users can see their family, friends and representatives in the privacy of their own bedrooms or in one of the two lounges or sensory room. The deputy manager stated that service users are encouraged to maintain personal friendships where they wish. Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 Page 11 The home has a pictorial menu and menu planner. The meal of the day was displayed in the home. Nutrition records are maintained for each service user and these were seen. All service users are supervised at meal times with three service users requiring assistance with feeding. One service user has their food pureed, drinks and snacks are available throughout the day. Staff shop locally for all the homes food and service users are encouraged to help with the shopping. Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 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 Arrangements are in place to ensure that the health care needs of service users are identified and met. EVIDENCE: Wherever possible service users are encouraged to choose their own clothes and hairstyles. Service users receive specialist input as and when required. Service users are allocated Key workers. Personal care is carried out either in private in service users bedrooms or in the bathrooms. Service users likes and dislikes are recorded in their care plans. Service users are supported to obtain all health care services. Records of visits are maintained in their care plan. The deputy manager reported that no service users had been admitted to A & E since the last inspection. Medication records were found to be accurate. Appropriate protocols were seen to be in place. Only nursing staff administer medication. The deputy manager said all nursing staff had received training in medication administration but no records were available to inspect. Medication administration records were seen to have been completed appropriately and medication stored securely. Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 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 home has an appropriate complaints policy which informs complainants of their rights and assures them their complaint will be taken seriously. Staff are aware of the issues relating to the protection of vulnerable adults. EVIDENCE: The deputy manager stated that no complaints had been received since the last inspection. The home has appropriate policies and procedures in place to meet this standard including a pictorial complaints procedure for the service users. The home has an Adult Protection Policy and copies of the Essex and Thurrock Adult protection procedures. A copy of the document ”No Secrets” was available in a copied format. Staff have attended training in the protection of Vulnerable Adults. Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 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 Gallimore Lodge was clean and bright and provided the service users with homely and comfortable surroundings. Limited improvements have been made to service users rooms and other internal maintenance and decoration issues are still to be addressed. EVIDENCE: Some communal areas of the home were in need of redecoration and this is planned. The bedroom accommodation remains unchanged and ceiling fans have been installed in all bedrooms. All service users bedrooms were seen to be well furnished and personalised to individual needs and tastes. Bedroom doors were lockable but only one service user has made use of this facility. The home provides 6 toilets, 2 bathrooms and 2 shower rooms which met the needs of the service users. Both conjoined bungalows have their own kitchen, lounge and dining areas with one bungalow housing a sensory room. The home has a laundry room with a domestic style washing machine and tumble dryer. Service users have access to the garden but are usually accompanied for safety reasons. The home currently has six service users described as having high dependency needs. The home provides a hoist for use with the less mobile service users. Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 Page 15 The deputy manager advised that any specialist aids for specific conditions would be provided if necessary. The home was found to be clean and tidy throughout and odour free. The homes laundry facilities were sufficient to meet the standard. Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 Page 16 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) 34,35,36 It was not possible to confirm that adequate recruitment policies and practices were in place on this occasion due to the inaccessibility of records. The home has an effective and competent staff team who receive training to the required standard. EVIDENCE: The inspector was unable to inspect staff records as the registered manager was on a day off and is the only person with a key to access them. These records on this occasion were locked away. The deputy manager in charge was advised that any records required for inspection must be easily accessible at all times. Minimal training records were available to inspect and will be inspected in more detail due to inaccessibility problems at this inspection also. A training plan is in place though and was seen. The inspector was informed that supervision is now carried out regularly in a planned way. Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 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) 39,42 There is guidance and direction to staff and the home has in place practices that will promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The deputy manager on duty during the day was aware of health and safety issues in the home. Safety certificates were seen for electricity, gas and fire prevention. Regular weekly tests are maintained as are the homes fire precautions. Fire drills are held on a monthly basis. The deputy manager advised that staff have received COSHH training and the home has appropriate policies and procedures in place. Risk assessments for safe working practises were in place. Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 Page 18 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 x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Gallimore Lodge Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 Page 19 YES 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 24 Regulation 23 (2) (b) (o) 17 (3) (b) Schedule 4 (6) Requirement The registered provider must ensure the premises are kept in a good state of repair internally and externally. Recruitment records required by regulation for the protection of service users and for the effective and efficient running of the business must be maintained, up-to-date and accurate and be easily available and accessible for inspection at all times.. The Registered Person ensures that there is a staff training and development programme which meets National Training Organisation (NTO) workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. Records required by regulation for the protection of service users and for the effective and efficient running of the business must be maintained, up-to-date and accurate and be easily available and accessible for inspection at all times.. Timescale for action 30th November 2005 30th November 2005 2. 34 3. 35 12(1) & 18(1) 17 (3) (b) Schedule 4 (6) 30th November 2005 Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 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. Refer to Standard Good Practice Recommendations Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend on sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Gallimore Lodge I06-I56 S15534 Gallimore Lodge V232561 260805 Stage 4.doc Version 1.30 Page 22 - 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!