Inspection on 15/11/05 for Gateford Hill Care Home

This inspection was carried out on 15th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Gateford Hill Care Home 21/11/07

Gateford Hill Care Home 18/05/06

Gateford Hill Care Home 30/06/05

Gateford Hill Care Home 10/12/04

Gateford Hill Care Home 06/05/04

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Gateford Hill Care Home Worksop Nottinghamshire S81 8AF Lead Inspector Karmon Hawley Unannounced Inspection 15th November 2005 10:00 X10029.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 Gateford Hill Care Home DS0000024640.V267685.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 and 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. Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gateford Hill Care Home Address Worksop Nottinghamshire S81 8AF 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) 01909 475402 01909 500179 Ashbourne Homes Ltd Mrs Diana Cameron Care Home 66 Category(ies) of Old age, not falling within any other category registration, with number (36), Physical disability (30) of places Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29/06/05 Brief Description of the Service: Gateford hill provides both nursing and residential care for the older person and younger disabled adult. The care home is owned by Ashbourne health care and is divided into four separate units. The Milner unit which caters for 9 older people nursing care, Cavendish unit which caters for 18 younger disabled nursing, Machin for 27 older people residential and Lindrick which caters for 12 younger disabled residential, in total 66 placements. The home has 64 single and one double room, 62 rooms are fitted with ensuite facilities. Each of the units has a lounge, dining room, assisted bathing facilities and kitchen facilities. The home, which has thirty-three acres of land is located in a quite area at the edge of a residential estate in Gateford, Worksop. Access is mainly by car, although a regular bus service is available to the perimeter of the housing estate. Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place in one day and was performed by one inspector. The main method of inspection was case tracking, this is a method of sampling the records of six randomly selected service users to ascertain if the needs of service users are appropriately assessed and identified needs are being catered for by the home to maintain optimum health and wellbeing of the service user. Seven service users were spoken with so as to give the inspector an insight into the conditions and standards within the home. Those service users spoken with were happy with the care received and the standards within the home. The manager assisted in the inspection process and four members of staff were spoken with. Staff were able to demonstrate a good understanding of service users needs and promoted a caring atmosphere. What the service does well: What has improved since the last inspection? Plans of care continue to develop ensuring a holistic approach is maintained. Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 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. Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Not assessed during this inspection. Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): 7,10, Service users needs are set out in a plan of care to ensure their needs will be met. Risk is negotiated to ensuring all service users have had input into this practice, thus do not feel their lives are unduly restricted. Service users are treated with respect and their right to privacy is upheld and they receive personal care and support in a way they prefer. EVIDENCE: Service users undergo various assessments with regards to mental health, incontinence, nutrition, manual handling and the daily activities of living, which underpin the plan of care. Care plans in place were extremely personalised, in Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 10 depth, reflected complex needs, preferences and choices and worked towards promoting independence; with the exception of one plan which only contained limited information in the plan of care despite having had complex needs identified. There was evidence to demonstrate that service users and their family had been involved in the care planning process. Risk assessments were also in place for identified risks and adequate management plans with the exception of one case file where a risk of falls had been identified. Daily records were maintained and significant events were recorded. All staff undertake resident welfare training to ensure service users respect and dignity is maintained, there was evidence of this occurring in working practices observed and staff were able to discuss core values and principles. Service users also substantiated that staff respect them and maintain privacy. All consultations are carried out in the service users own room. One service user spoken with stated she had her own telephone and received her mail unopened. Service users are able to choose what time they get up and go to bed and how they spend the day, depending upon risk assessments, which are drawn up with compromise and balance. Service users are enabled to make their own choices and these were noted within plans of care. Service users are able to choose who attends to their needs as able. Service users when spoken with were able to substantiate this. All care staff undergo training in the safe administration of medicines. Service users if able and after an assessment may administer their own medication and a lockable cabinet is provided. Fridge and room temperatures were recorded daily. Medications were check against the prescription sheet, on one prescription, medication had been administered for the whole month but had not been signed for and on another chart medication had been signed for and not given on several occasions. Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Service users receive a wholesome appealing balanced diet in pleasing surroundings. EVIDENCE: A four weekly menu is followed, there is also a younger disabled persons option to uplift the portion to ensure adequate portions and choices are offered. The menu demonstrated that a wholesome and appealing diet is on offer and that service users are offered choice at each meal. Service users may also make their own drinks in the kitchen area within each unit; some service users if able make their own breakfast. Specialist diets are catered for and Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 12 liaised with the catering manager. Service users spoken with substantiated that meals are of a good standard and that choice is offered. Records kept within the kitchen were observed. The cleaning rota demonstrated that cleaning had taken place, however there were gaps in signing for this, the explanation given was that it was not applicable or due. All other records were maintained. Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Service users are protected from abuse. EVIDENCE: Relevant policies and procedures are in place with regards to adult abuse and staff spoken with were able to discuss these appropriately. All members of staff have current criminal record bureau checks in place and protection of vulnerable adult checks where required. Staff are instructed of the policy of gifts and wills and sign to state they have received the staff handbook. There is a dedicated whistle blowing line should staff feel the need to use this method. Staff training is at a good standard and staff spoken with were able to discuss core values and principles and service users needs. Where required additional support is gained form the divisional nurse, psychologist and mental health team who provide guidance and advice to staff, there was evidence to demonstrate this had occurred and staff stated that they had benefited from this practice. Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) 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 Service users live in a safe well-maintained environment. EVIDENCE: A routine maintenance programme and annual development plan is utilised and there was evidence of ongoing redecoration taking place. Although there is currently no CCTV in place this is being considered due to the increasing size of the residential area next to the home. The environmental health officer visited Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 15 the home recently and no requirements were set. The fire authority visited in February 2004 and the requirements set have been actioned. Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the 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 The numbers and skill mix of staff meets service users needs. Service users are in safe hands at all times. Service users are supported and protected by the homes recruitment policies and practices. EVIDENCE: Staff rotas were observed and demonstrated that sufficient staff are employed to meet service users needs. Staff spoken with stated staffing levels were satisfactory and service users stated staff were available to meet their needs. There was evidence available to demonstrate that staff have been seen by outside national vocational qualification assessors. Six members of staff have attained the level two national vocational qualification in care whilst another fourteen have been registered. The Ashbourne induction programme is at a recognised level and evidence was observed that staff have completed this. The manager has requested sexual behaviour training, as the staff team have not been comfortable on occasion. Staff are also working together to improve the induction programme and research additional information on service users conditions to enable a whole picture to be gained. Staff are employed following Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 17 rigorous interviews, which take into account the needs of service users and promoting independent, and quality lives. There was evidence of interview notes within staff personnel files to substantiate this. Five staff files were observed and contained all the required documentation to meet this standard. Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,35 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 her responsibilities. Service users financial interests are safeguarded. EVIDENCE: Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 19 The manager is awaiting registration; she has been working at the home as the acting manager for the last three years and has sufficient experience in management and care. She is currently working towards the national vocational qualification level four and managers award. She also remains up to date as required with mandatory training Staff spoken with spoke highly of the manager and stated that she was approachable and amenable and endeavoured to listen to any concerns and rectify them. Service users also spoke highly of the manager and stated they were well looked after. Service users are able to control their own money if able. Six service users personal allowances were checked and corresponded with the banking transaction. There was evidence of receipts and two staff members had signed for all transaction. Staff stated that service users plan ahead for the weekend and draw money out in anticipation, however should a service user require any money and they had not done this there is an emergency fund available. Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 20 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 X 2 X 3 X 4 X 5 X 6 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 ENVIRONMENT Standard No Score 19 3 20 X 21 X 22 X 23 X 24 X 25 X 26 X STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 X 34 X 35 3 36 X 37 X 38 X Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 21 No 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 OP7 Regulation 13(4,c) Requirement Timescale for action 22/12/05 2 OP7 15 3 OP9 13(2) Appropriate information is required to be available within risk assessments to fully ensure service user safety. Service users reviews are 22/01/06 required to be service user focussed in order to reflect care and condition. The registered person shall make 22/12/06 arrangements for safe handling and administration of medicines. 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 OP15 Good Practice Recommendations To amend the cleaning rota to clearly demonstrate which cleaning is applicable and when cleaning is to be carried out. Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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. Gateford Hill Care Home DS0000024640.V267685.R01.S.doc Version 5.0 Page 23 - 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. 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