CARE HOMES FOR OLDER PEOPLE
Gate Cottage Bazehill Road Rottingdean Brighton East Sussex BN2 7DB Lead Inspector
Merle Blakeley Announced Inspection 14th February 2006 10:00 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.V274102.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 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.V274102.R01.S.doc Version 5.1 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.V274102.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The number of people accommodated must not exceed 11 The people accommodated will be aged 65 years or over on admission Date of last inspection 1st September 2005 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. Gate Cottage DS0000014200.V274102.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This Announced Inspection was carried out over a period of five hours on 14th February 2006. The inspection process included a returned pre-inspection questionnaire, eight service users comment cards, twelve relative and professional visitors comment cards, informal talks and lunch with several residents, speaking with the owner/manager and staff on duty, document reading and a tour of the premises. The responses from the returned comment cards were overall very positive. Residents stated that they enjoyed living in the home and they felt well cared for by the staff team. Relatives comments were also very positive with some stated that the home was ‘wonderful’ and that staff were very caring. Comments from visiting professionals were also positive towards the care the home provides. What the service does well: What has improved since the last inspection?
The home has carried out all the requirements that were made during the last inspection. Residents care plans and risk assessments are regularly reviewed and dated. All staff have attended medication training. Residents are being consulted to ascertain the types of activities they would like to be involved with. Staff are now receiving supervision sessions at least six times a year. Fire exits are now kept free of obstructions and the correct fire signage has been installed. The home has achieved a very good level of NVQ training for staff. By July 2006 all staff will have obtained an NVQ qualification. Gate Cottage DS0000014200.V274102.R01.S.doc Version 5.1 Page 6 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. Gate Cottage DS0000014200.V274102.R01.S.doc Version 5.1 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.V274102.R01.S.doc Version 5.1 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): 1, 2 & 3 The home has produced a service user guide and statement of purpose. The owner/manager must formally record all assessments carried out on prospective residents prior to them moving into the home. EVIDENCE: The home has produced a service users guide, which contains information about the homes statement of purpose, residents charter of rights, financial arrangements and fees, contracts, services provided and complaints procedure. The home provides residents with a written contract, which includes information about termination of residence. This information must be clearly outlined to residents and their families, as recently there was some confusion about periods of notice that were given to one particular resident. Any changes to termination of residency must also be discussed with the residents funding authority if applicable. Gate Cottage DS0000014200.V274102.R01.S.doc Version 5.1 Page 9 The manager assesses prospective residents before they move into the home and they are either visited at home or in hospital. The assessment is to ascertain as to whether the home can meet the persons current and ongoing needs. These initial assessments must be recorded, as they will form part of the residents care plan. The home is not currently following this practice. Gate Cottage DS0000014200.V274102.R01.S.doc Version 5.1 Page 10 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): 8, 9 & 10 Resident’s health care needs are met. Risk assessments must be carried out on all residents who self medicate. Staff provide residents with privacy & dignity. EVIDENCE: All residents are registered with local doctors and they have access to a variety of other health professionals such as district nurses, diabetic nurse, chiropodist and dentist. All residents who were spoken felt that their health care needs were being met by the home. There are currently two residents who are being visited by district nurses. Medication records were checked and were found to be in order. Any resident who self medicates must have a specific risk assessment carried out, which is signed and regularly reviewed. The home feels it provides residents with privacy and dignity by knocking on their doors before entering, calling them by their preferred names and allowing them to see health professionals and visitors in private. Residents stated that they were treated with respect by staff. Gate Cottage DS0000014200.V274102.R01.S.doc Version 5.1 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): 13 Visitors are made welcome in the home. EVIDENCE: Visitors are welcome in the home at any time and they are able to stay for lunch or dinner with their relative or friend. If there is a spare room available visitors are also able to stay overnight. During the inspection a relative was seen having lunch with his mother. Relatives/friends returned comment cards indicated that all visitors felt very welcome in the home. The home encourages residents to maintain contact with their family and friends. Gate Cottage DS0000014200.V274102.R01.S.doc Version 5.1 Page 12 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 The home has a complaints policy and procedure. EVIDENCE: The home has produced a complaints policy and procedure, which includes information about how residents can contact the CSCI. One verbal concern had been made to the manager but this had not been recorded anywhere. The home must ensure that any concerns or complaints are properly recorded in an appropriate format. Gate Cottage DS0000014200.V274102.R01.S.doc Version 5.1 Page 13 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, 21, 23 & 26 Gate Cottage provides a comfortable and well-maintained environment. All bedrooms have en suite facilities. Bedrooms are homely and comfortable. The home is clean and hygienic and maintained to a high standard. EVIDENCE: Gate Cottage is a small family-type care home with bedrooms located over two floors. Call systems are located in each room and there is a lift to the first floor. The home is surrounded by an attractive landscaped garden with easy access for wheelchair users. The environment is friendly and relaxed. Each of the eleven bedrooms has en suite facilities with either a bath or a shower. There is an additional assisted bath in the home. Bedrooms are very homely and comfortable and decorated to a high standard. Residents are able to bring with them small pieces of furniture and personal possessions, which helps to make the rooms even more personalised. The home is very clean and tidy and maintained to a very good standard.
Gate Cottage DS0000014200.V274102.R01.S.doc Version 5.1 Page 14 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 & 29 Staff are progressing well with their NVQ qualifications. The home is maintaining the correct staff recruitment information. EVIDENCE: In March 2006 four staff will have completed their NVQ Level 3 training and in July 2006 another four staff will have also completed this qualification, which is an excellent outcome for the home, as 100 of the staff will then be trained. The home has put a lot of effort into providing NVQ training for staff. There are currently two RGN’s employed by the home with one of them training to become an A1 Assessor. Another part-time staff member is currently completing her Registered Nurse training. All staff recruitment files were viewed and were found to contain all the correct documentation as set out in Schedule 2 of the National Minimum Standards. (NMS) Gate Cottage DS0000014200.V274102.R01.S.doc Version 5.1 Page 15 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, 32 & 33 The manager has many years experience of running a care home. The management style of the home appears relaxed. Residents meetings need to be recorded and held more frequently. EVIDENCE: The current owner/manager has sixteen years experience of running Gate Cottage. During this inspection the owner/manager has stated that she is hoping to step down as the manager and introduce one of the staff as the new manager. This person is currently completing her nurses training and would hope to become the registered manager once this training is completed. She has been working at the home for several years. The current manager will continue to have proprietorship of the home along with her husband and they will continue to be involved with the home on a day-to-day basis. Gate Cottage DS0000014200.V274102.R01.S.doc Version 5.1 Page 16 The home has a friendly and relaxed atmosphere and residents stated that they felt quite happy to approach the owner/manager or any staff member if they had any concerns or issues to raise. The home has not produced a formal system of quality assurance and this standard will need to be expanded in the future. Residents meetings are held infrequently and there are no records kept. The home must ensure that regular residents meetings are held and that these meeting are formally recorded. The home needs to evidence that they are formally including residents in the decision making of the home and that any concerns or suggestions that are brought up can be responded to. Gate Cottage DS0000014200.V274102.R01.S.doc Version 5.1 Page 17 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 3 3 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 3 X 3 X 3 X X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X X X X X Gate Cottage DS0000014200.V274102.R01.S.doc Version 5.1 Page 18 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 OP3 Regulation 14, Schedule 3 1(a) 22 24 Requirement That a formal assessment tool is produced to record all initial assessments of prospective service users. That the home formally records all residents concerns or complaints. That residents meetings are held on a more frequent basis. Records of these meetings must also be maintained. That risk assessments are carried out and regularly reviewed on all service users who self medicate. Timescale for action 30/04/06 2. 3. OP16 OP33 14/02/06 30/04/06 4. OP9 13(2) 14/02/06 Gate Cottage DS0000014200.V274102.R01.S.doc Version 5.1 Page 19 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. Refer to Standard OP2 OP37 Good Practice Recommendations That service users, relatives and funding authorities are very clear about the homes policy regarding termination of residence. That the homes accident record sheets are correctly filed. Gate Cottage DS0000014200.V274102.R01.S.doc Version 5.1 Page 20 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
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