Inspection on 31/12/05 for Gallimore Lodge

This inspection was carried out on 31st December 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gallimore Lodge 29/04/08

Gallimore Lodge 08/06/07

Gallimore Lodge 29/11/06

Gallimore Lodge 26/08/05

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 Unannounced Inspection 6th January 2006 09.00 Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 1 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 Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 2 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 Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 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 Provider Web 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 Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Excluding any person who is liable to be detained under the provisions of the mental Health Act 1983 26th August 2005 Date of last inspection 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 DS0000015534.V274716.R01.S.doc Version 5.1 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 three 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. One member of staff was spoken with. Nineteen National Minimum Standards were inspected on this occasion, seventeen overall outcomes were met and there were two 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: 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 DS0000015534.V274716.R01.S.doc Version 5.1 Page 6 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 Outcomes Statutory Requirements Identified During the Inspection Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 7 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 the following standard(s): 1,3,4 Present and prospective service users and their supporters are given adequate information about the home so that they can make informed choices. 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 home has produced its Statement of Purpose and Service Users Guide. It’s format has been specifically designed for the service users and the manager stated that it would be read to them if required and that copies in suitable formats were presently being distributed to all service users. There are additional charges for hairdressing, chiropody, toiletries, personal clothing holiday expenditure, social events, aromatherapy sessions and transport. Service users within the home were noted to have a range of specific needs relating to communication, health, and personal and social care issues. Review of staff training records indicated that most staff were conversant with the needs of the present service user group. The inspector was advised that a number of therapeutic services were used, especially for one service user. One service user communicates using makaton, and 5 residents were more dependant and wheelchair bound. Evidence of practical aids within the home such as hoists were seen. The home has had no new admissions and currently has no vacancies. Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 8 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 the following standard(s): 8,10 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: There was evidence to show that service user meetings were held and that minutes are documented. The Deputy Manager was advised to ensure that service users have the opportunity to participate in staff selection and in the day-to-day running of the home. Policies and procedures are in a suitable format for service users and some policies are in pictorial format. Service users personal files are held within the homes office in a locked filing cabinet to which staff have access. The home was noted to have a confidentiality policy. Staff respect information given by service users in confidence, and handle information about service users in accordance with the home’s written policies and procedures and the Data Protection Act 1998, and in the best interests of the service user. Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 11,14 Social activities take place and service users seem 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: Staff enable service users to have opportunities to maintain and develop social, emotional, communication and independent living skills. Service users have their own televisions, some have music centres and DVD players. All service users enjoyed a holiday of their choice in the summer. Previously a variety of courses were undertaken at colleges, including self communication and expression and music, and promotion of independence, unfortunately both day centres have now closed down and the deputy manager stated that further opportunities were currently being explored. All service users on the day of inspection seemed to integrate well together and staff within the communal areas were noted to be receptive to service user needs. Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 10 Service users interests are pursued and many enjoy listening to music and watching the television and videos and trips out. An activities plan was displayed, and individual service user opportunity plans in appropriate formats were seen in service users rooms. A holiday report is completed by the keyworker, and was seen on service user plans inspected. Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 21 Good arrangements are in place to ensure that the ageing, illness and death of service users and their needs are identified and met should the occasion arise. EVIDENCE: Service users wishes on death and dying have been sensitively obtained and recorded in individual careplans. As the home is a learning disability home and all the service users are quite young deaths in the home are very few and none have happened recently. The Deputy Manager stated that dying and death are handled sensitively and professionally at the home. Policies were seen and are in place within the home to meet this standard Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 12 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 the following standard(s): NOT INSPECTED EVIDENCE: NOT INSPECTED Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 24 Gallimore Lodge was clean and bright and provided the service users with homely and comfortable surroundings. Internal maintenance and decoration issues have been addressed. EVIDENCE: At the last inspection some communal areas of the home were in need of redecoration and this has now been addressed. 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 is generally well maintained inside and out. Routine maintenance is recorded in a book, and upon previous discussion with the manager it was agreed that actions, dates and outcomes be recorded also. Environmental risk assessments were seen and are stored separately. The garden was found to be neat and tidy. The proprietor is to look at a format, which records planned renewal and decoration, carried out at the premises. Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 14 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 The procedures for the recruitment and training of staff have most safeguards in place to offer protection to people living in the home. The home has an effective and competent staff team who receive training to the required standard. EVIDENCE: All staff with the exception of the most recent member of staff working in the home is issued with detailed job descriptions. the deputy manager advised the inspector that these are given to staff upon employment. In previous discussions with care staff some were able to confirm that they had received copies however others were unable to. Service users are appointed a keyworker. The role of the key worker was evident within staff records and most staff appeared clear as to the specific role required. A record of staff training is kept and certificated evidence in some cases was seen. The inspector was advised that the manager is making efforts to ensure that all staff receive regular updated training and training specific to the needs and requirements of the service users within the home including communication, sensory needs, dealing with aggression, epilepsy, dietary and learning disabilities. On the day of inspection the rota verified the staff that were on duty including Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 15 the deputy manager and indicated that the home had sufficient staffing levels as agreed with the previous registration authority required by regulation. Regular agency use was evident and the deputy manager advised that recruitment was ongoing. Two staff employment files were inspected. Both did not contain job descriptions, evidence of induction training, two work references, adequate evidence of criminal records disclosure (CRB), copy of passport or permissions to work. The process regarding volunteer and agency recruitment and CRB checks was discussed. Attention should be paid when recruiting, to work addresses for references, incomplete application forms, comprehensive work history information covering a minimum of last two to three years minimum, NMC pin checks, proof of identity and permissions to work. The deputy manager was advised that staff members should not start work at the home until all relevant recruitment checks have been completed. The Manager previously advised the inspector that she was moving towards ensuring that the home has a training and development plan and all staff have an individual training and development assessment. The Manager was advised that staff working in learning disability services use the Learning Disability Award Framework TOPPS. On inspection of staff supervision records individualised training and development plans were evident and mandatory training in some cases was noted to require some updates but this was being addressed. Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 16 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,40,41,43 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 manager is a qualified RNMH and has experience with people who have learning and physical disabilities. She is the registered manager at Gallimore Lodge and was previously acting manager for several years. The Manager previously advised the inspector that she is currently undertaking NVQ Level 4. She has undertaken a variety of training, some courses were noted to require refresher courses. Although the manager was not present at this inspection some documentary evidence was available for inspection by means of a key being left for the inspector to enable accessibility. This is seen as good practice. The home conducts service user and staff meetings. The last relatives meeting was held on 17th November 2005. Corporate questionaires are sent out. Service users are generally reviewed as required at the home and receive social service reviews in addition. Family involvement was evidenced to clarify Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 17 this. The deputy manager was advised to ensure that service users recommendations from reviews are followed and outcomes are recorded The homes policies and procedures have been developed corporately. The policies are stored within the main office, the Manager advised previously that staff are aware of any changes but require time to read the documents, and all staff have been asked to read them and signatory evidence was available. Policies and procedures relevant to service users are in suitable formats. Records inspected were accessible, in good order and stored appropriately. It is judged that procedures are in place to ensure appropriate management of the business and there was no evidence to suggest that the home is not financially viable. The Proprietor said that there is a business plan, which would be made available if required. Evidence was seen of up to date Insurance Cover. Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 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 Standard No Score 1 3 2 X 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X 3 X 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X 3 3 3 X 3 3 X 3 Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? YES 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 YA34 Regulation 17(3b) Sch 4(6) Requirement Timescale for action 28/01/06 3. YA35 12(1) 18(1).. 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. 28/01/06 12(1) 18(1) 17(3b) Sch 4(6) 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. Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 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. Refer to Standard Good Practice Recommendations Gallimore Lodge DS0000015534.V274716.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection South Essex Local Office 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. 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