Inspection on 11/10/06 for Gate Cottage

This inspection was carried out on 11th October 2006.

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 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

Gate Cottage 29/09/08

Gate Cottage 14/02/06

Gate Cottage 01/09/05

Gate Cottage 06/01/05

Gate Cottage 15/09/04

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

CARE HOMES FOR OLDER PEOPLE Gate Cottage Bazehill Road Rottingdean Brighton East Sussex BN2 7DB Lead Inspector Merle Blakeley Key Unannounced Inspection 11th October 2006 09:30 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 Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 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. Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gate Cottage Address Bazehill Road Rottingdean Brighton East Sussex BN2 7DB 01273 301890 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) Mr Michael Martin Sodeau Mrs Brenda Georgina Sodeau Mrs Brenda Georgina Sodeau Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The number of service users accommodated must not exceed eleven (11). The service users accommodated will be aged sixty-five (65) years or over on admission. 14th February 2006 Date of last inspection Brief Description of the Service: Gate Cottage is registered to provide care and accommodation for up to eleven older people who do not have high dependency needs. The home is located in a quiet residential area of Rottingdean and it is close to public transport, local shops, amenities and the seafront. The home is an attractive two-storey property built on a slight incline and comprises of eleven single en suite rooms, lounge and dining area, a conservatory and very pleasant garden areas. A lift is available to the first floor. The property is furnished and maintained to a very high standard and provides a very warm, caring and friendly environment for residents. The current fees range from £535.00 to £625.00 per week. Additional charges are made for chiropody, hairdressing and newspapers. Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out over a period of six and a half hours on the 11th October 2006. As well as this site visit information was also gained from a returned pre-inspection questionnaire, eight returned resident survey forms, informal talks with six residents, three staff and a family member who is the business manager of the home. The inspector also joined three residents for lunch. The site visit consisted of a tour of the premises, looking at the needs of four particular residents, document reading and observing staff interactions with residents. What the service does well: What has improved since the last inspection? What they could do better: The home must ensure that medication sheets are completed correctly as several discrepancies were found on the day. Any out of date medicines need to be correctly disposed of. The home must also ensure that adequate staff are Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 6 on duty at all times to meet residents current needs as some stated that they did not always feel that enough staff were on duty during certain times of the day/night. Some of the staff recruitment files were missing information such as references, current CRB checks and proof of identity. The home will need to address this and make sure that all staff have the information as set out in Schedule 2 of the National Minimum Standards. It should also be noted that CRB checks are not transferable between care homes. The homes quality assurance programme needs to be expanded to include written feedback from not only residents but also family members and friends. 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. Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 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 Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 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): 3 Standard 6 is not applicable Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Formal written assessments are now carried out on all prospective residents. EVIDENCE: During the last inspection a requirement was made for the home to formally record all assessments carried out on prospective residents and this is now being done. This assessment should then become part of the resident’s plan of care. Four new residents have moved into the home and their written assessments were viewed. Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 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): 7, 8, 9, & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are updated and reviewed. Resident’s healthcare needs are being met. Not all medications had been signed for. Residents were seen to be treated with dignity and respect. EVIDENCE: Five care plans were viewed and they appeared informative and up to date. All residents are registered with a doctor and they have access to visiting professionals such as district nurses, diabetic nurse, chiropodist and dentist. All residents who were spoken to generally felt that their healthcare needs were being met by the home. Some resident’s healthcare needs have recently increased. Medication records were checked and some discrepancies were found. Some medication records had not been signed for on the day that they were administered. Also it was noted that the current medication cupboard appears too small for the amount of drugs that are stored in there. Staff did state that on occasions it was difficult to remove the monitored dosage system cards. There were also two items in the cupboard, which were out of date. Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 10 During the day interactions with staff and residents was observed and staff were seen to treat residents in a friendly yet respectful manner. Residents stated that they were treated well by staff and that their privacy and dignity was always respected. Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 11 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, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy the lifestyle the home has to offer. Visitors are always made welcome. Residents have control over certain aspects of their lives. The home offers a well-balanced and nutritious diet. EVIDENCE: Residents were asked about the lifestyle the home offered and all said they were happy with their daily lives. Some activities are offered such as weekly drives and the occasional outing out. Some of the residents are independent and go out by themselves during the week. One person did mention that they would perhaps like more to do in the afternoons. Visitors are made very welcome in the home at most times of the day. The visitor’s book indicated that the home has quite a lot of visitors who come in to see relatives. Visitors are also welcome to stay for meals with their relative or friend. The home encourages residents to maintain family links. Residents were also asked as to whether they felt they had control and choice in their lives and all responded that within reason they did have control and Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 12 choice about certain aspects of their lives. They also stated that they could make their own decisions. The long-term cook has now retired and a new cook has been employed. The new cook was able to spend some time in the kitchen with the outgoing cook who has shared her knowledge about residents likes and dislikes and the weekly menus and this has helped with a smooth handover. Continuity of menus has been maintained, which the residents are all happy about. Overall resident’s comments about the meals provided were very positive. There appears good choice in the menu with various other options available. The inspector was able to join three residents for a very enjoyable lunch. Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 13 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): 16 & 18 Quality in this outcome area is good. The home has a complaints policy and procedure. The home is aware of its legal responsibilities regarding the protection of vulnerable adults. EVIDENCE: The home has produced a complaints policy and procedure, which is made available to all residents. The home was asked to maintain a complaints book, which they have done. One complaint had been made and dealt with. A policy and procedure about the protection of vulnerable adults has been compiled and staff have attended training in this subject. There are no current adult protection alerts within the home. Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 14 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is safe and well maintained. The home is kept very clean and tidy EVIDENCE: Gate Cottage has a very pleasant and relaxing environment and the home is maintained to a high standard. There are eleven single bedrooms all with en suite facilities. Call systems are located in each room and there is a lift to the first floor. Resident’s bedrooms are comfortable and homely. The home is kept very clean and tidy. Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 15 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): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A number of new staff have joined the home. 80 of the staff team have obtained NVQ qualifications. Staff are receiving adequate training. EVIDENCE: Since the last inspection in February 2006 two of the long-term staff have retired. The home has employed five new staff many of which have worked in care homes before. Residents were asked how they felt about the new staff members and some stated that they were ‘very good’ and ‘fitting in well’. The new staff were spoken to and they stated that they were happy working in the home and felt it had a very friendly and caring environment. For the morning shift one care worker was on duty plus the cook and a domestic/carer. Residents were also asked as to whether they felt there were enough staff on duty during the day. Some residents did feel that on occasions there was not enough staff on duty at certain times of the day/night. The home needs to be aware that if residents needs increase then the staffing ratios also need to be addressed to meet those needs. The home has achieved a good level of staff qualifications with eight staff obtaining either NVQ Level 2 or Level 3. Two of the staff team are also qualified RGN’s. Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 16 Staff recruitment files were viewed and some of them did not contain all the required information as set out in Schedule 2 of the National Minimum Standards. Some had CRB’s, which had been transferred from previous employers, some were missing proof of identity and one did not contain any references. The home must ensure that CRB checks are applied for directly from the home; CRB checks are not transferable between homes. The remaining files also need to be updated with the required information. Staff are receiving a good level of core skills training and recent courses staff have attended include medication training, fire safety awareness, adult protection, infection control, food hygiene and manual handling. Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 17 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, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owner/manager has many years experience in running a service for older people. The homes quality assurance programme needs to be expanded. Residents manage their own finances. No health and safety concerns were found. EVIDENCE: The home continues to be run by the owner/manager and as stated in the last inspection report the home will have a new manager when one of the senior staff members completes her nursing qualification. The owner does not intend to apply to study for the Registered Managers Award. The owner/manager was not present during this inspection but the inspector was able to talk to her via the telephone during the day. The home has now commenced holding more formal residents meetings this year, however to meet the quality assurance standard the home must organise Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 18 feedback surveys from residents, relatives and visiting professionals. This will provide the service with a broader range of feedback about how the home is running. This should be carried out at least twice a year. The home does not deal with any of the resident’s finances as these are dealt with either by the resident themselves or a family member. A health and safety check was carried out. The home tries to ensure that where possible the health and safety of residents and staff is maintained. Fire drills are carried out and staff have received fire training. All staff have attended core skills training in the subjects set out in the National Minimum Standards. Hot water temperatures are checked weekly. Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 19 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? NO 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. 2. Standard OP9 OP29 Regulation 13(2) Schedule 2 Requirement Timescale for action 11/10/06 3. 3. OP27 OP33 18(1)(a) 24(1) That all medications administered are correctly signed for by staff. That all staff recruitment files 11/11/06 contain the required information. That the home is aware that CRB checks are not transferable between care homes. The home ensures that adequate 11/10/06 staff are on duty to meet the current needs of service users. That the home expands its 11/01/07 quality assurance programme to include written feedback from service users, relatives and visiting professionals. 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 OP9 Good Practice Recommendations That the home look into the storage of the monitored dosage system to ensure that medications are easily DS0000014200.V297098.R01.S.doc Version 5.2 Page 21 Gate Cottage accessible to staff. Gate Cottage DS0000014200.V297098.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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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