CARE HOMES FOR OLDER PEOPLE
Gardner House Brierton Lane Hartlepool TS25 4AG Lead Inspector
John Trainor Unannounced Inspection 17th January 2006 11:50 X10015.doc Version 1.40 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 Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 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 Older People. 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. Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Gardner House Address Brierton Lane Hartlepool TS25 4AG 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) 01429 261023 01429 261023 Community Integrated Care Miss Lisa Newbury Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 6th June 2005 Brief Description of the Service: Gardner House is a care home for older people and is registered to provide care and accomodation for up to 29 older people. The home is well served by bus routes to the town centre of Hartlepool. The home also has a number of lounge areas, dining room, a quieter room. Menus cater for the specific needs of individual residents. Residents are able to personalise their own rooms and relatives and friends are welcome to visit at any reasonable times. The home has 29 individual bedrooms but does not offer en-suite facilities although they do all have wash handbasins. There are an adequate number of bathing and toilet facilities within the home to meet the needs of all residents. The home has a pleasant enclosed garden to the rear with a number of raised flower beds, there are also substantial lawned areas to the side and rear of the building. Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 4 hours during which there was a tour of the building and people were asked about their experience of living in the home. A visiting nurse gave her feedback on the home and felt it was a good home in the area. A relative felt the home met the needs of their mother well and said it was, brilliant, can’t fault the home.” Records were inspected including health and safety records and care plans. The company representative on the day was the registered manager Lisa Newbury. What the service does well: What has improved since the last inspection? What they could do better:
Community Integrated Care must implement the fire safety recommendations of the fire officer in the home in order to ensure the safety of people in the event of a fire. The assisted bath which is broken and beyond repair must be replaced so there are sufficient baths to meet people’s needs and they can have a bath when they wish. This work has been outstanding from previous inspections and needs to be done. It is recommended a dedicated activities co-ordinator be appointed one person who generally spoke well of the home did say they, “just sit and sit for hours until the next meal, more to do would be nice.” Some staff still had outstanding training needs in health and safety and the manager needed to develop a plan as to how this would be done. Fire safety training needed to be improved so staff would have refreshers 6 monthly. Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 6 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. Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6. People had their needs met if they were staying in the home as an interim measure to returning home. EVIDENCE: The home does not have an intermediate care unit. Hartlepool social and health services provide a mobile rehabilitation team so if people are resident in the home for a short time whilst they receive rehabilitation this is part of a package where the rehabilitation is provided by the mobile rehabilitation team and the home simply provides accommodation and personal care. Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 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 at this inspection. EVIDENCE: Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12. Improvements to activities provision would enhance people’s individual social and occupational needs. EVIDENCE: There were some activities taking place and external entertainers came to the home from time to time but some people felt there were not enough activities to keep them occupied. A dedicated activities co-ordinator would be able to focus attention on this area. Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 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 at this inspection. EVIDENCE: Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19. Though the home was clean and tidy, bathing facilities needed improvement. EVIDENCE: The home was generally clean, tidy and pleasant for people. The Arjo bath identified at the previous inspection needed to be replaced as it was beyond repair. Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 and 30. People’s safety is potentially compromised because staff training needs to take place in health and safety matters. EVIDENCE: There have been improvements to staff training and the majority of staff are qualified to NVQ 2 or above. Some work is still needed on ensuring all staff receive health and safety training and protection of vulnerable adults training for the few staff who have not yet received it. The manager needs to develop a training plan to ensure all these training needs are met. Fire safety refreshers need to take place 6 monthly. Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 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 and 38. The home is managed competently in the interests of the service users though improvements were needed to health and safety matters to ensure peoples safety in every eventuality. EVIDENCE: The manager had almost completed her NVQ4 in care management though needed it to be signed off by an assessor. People felt the manager was approachable and helpful. Fire drills were now taking place weekly and equipment was checked regularly. However the recommendations in the fire officer’s letter of 17th November 2005 must be implemented to ensure the safety of people in the event of a fire current provision is inadequate. Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 15 Some water temperatures were a little low and should be regulated to 43°C though service users when asked had no problems with the water temperature. Legionella procedures were in place to minimise risks from legionella. Hoists were serviced regularly. Gas safety and Electrical Hard Wiring certificates were not available for inspection and so the safety of the installations could not be verified. It was required these be sent to the Commission for Social Care Inspection. Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 1 X X X X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X 1 Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 17 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 OP19 Regulation 23 (2(c) Requirement The ARJO bath which has been identified in previous reports which is broken and irreparable must be replaced in order that there are sufficient assisted bathing facilities. (Previous timescale of 6th September 2005 not met.) The registered person must make adequate arrangements for detecting, containing and extinguishing fires in line with the recommendations from the fire officer in his letter dated 17/11/05. Electrical Hard Wiring and Gas safety certificates were not available for inspection and so the safety of the installations could not be verified. These certificates must be forwarded to the Darlington office of the Commission for Social Care Inspection before 27th January 2006. Timescale for action 31/05/06 2 OP38 23 (4) 31/05/06 3 OP38 13 (4(a)) 27/01/06 Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 18 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 OP12 Good Practice Recommendations The provision of activities should be improved to better meet people’s social and occupational needs. A dedicated activities co-ordinator would ensure focus on this area is maintained. The registered manager should develop a programme to ensure staff training deficits are met within a defined timescale. The registered manager should continue her efforts to finalise and complete the NVQ 4. 2 3 OP30 OP31 Gardner House DS0000021739.V257870.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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