Inspection on 21/11/07 for Gateford Hill Care Home

This inspection was carried out on 21st November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 18/05/06

Gateford Hill Care Home 15/11/05

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 Jayne Hilton Unannounced Inspection 21st November 2007 08:00 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.V354605.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 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.V354605.R01.S.doc Version 5.2 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 gateford.hill@ashbourne.co.uk Ashbourne Homes Ltd Mrs Catheryn Burgum 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.V354605.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th May 2006 Brief Description of the Service: Gateford Hill provides older people nursing, residential care for older people, younger disabled nursing unit and a residential unit for younger people. Southern Cross home now owns the care. The care home is divided into separate units: 9 older people nursing, (Milner Suite) 18 younger physically disabled nursing, (Cavendish) 27 residential older people, (Machin) and 12 younger people residential (Lindrick), 66 placements in total. The home has 65 single rooms, 62 rooms are fitted with en-suite 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 quiet area at the edge of a residential estate in Gateford, Worksop. Access is mainly by car, a regular bus service is available to the perimeter of the housing estate. The current weekly fees are between £334 and £600 dependent on needs and exclude any additional1-1 care agreed individually based upon service users needs. Service users are expected to fund their own newspapers, chiropody and hairdressing The Statement of Purpose, Service User Guide and copies of previous inspection reports are available in the main entrance area of the home. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This inspection took place over 7.5 daytime hours and was unannounced. The main method of inspection used was called ‘case tracking.’ This involves selecting five service users and looking at the quality of the care they receive by talking to them, examining their care files and discussing how support is offered to them by staff members. Not all service users who were “case tracked” were able to help by giving an opinion about the care provided. Six members of staff, five service users and the manager were spoken with as part of this inspection, documents were read and medication inspected to form an opinion about the quality of the care provided to service users. Prior to completing this visit the inspector assessed the homes previous inspection reports, the service history including complaints and adult protection referrals. The Annual Quality Assurance assessment completed by the manager was also used in assessing evidence of the quality of service and twenty service users returned surveys in the preceding months of the inspection. What the service does well: A kind and caring ethos was prevalent throughout the home and a comfortable rapport was evident between service users and staff. Service users spoken with were very happy with life within the home and care received. They stated that staff, were kind, caring and respectful. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 6 Staff spoken with, were extremely compassionate with regards to service users needs and ensuring a quality of life is maintained and service users are given the utmost respect. Care plans were of a holistic nature encompassing whole person needs and respecting equality and diversity. The lifestyle within the home offers the opportunity for service users to live a life of their choice and expectations ensuring a quality life is experienced. People who use the service are able to make complaints and are confident these are dealt with appropriately. Safeguards are in place to protect the people who use the service, should they need them and access to external agencies or advocacy services is actively promoted. The home is run in the best interests of service users, by a competent staff team supported by a dedicated and focused manager, ensuring that service users heath safety and well being is promoted at all times. The service is proactive in its staffing recruitment and training, with planning for the potential needs of people currently using it and for anyone who may use the service in the future, thus delivering highly effective person centred care. Service users live in a well-maintained, safe, clean, pleasant and hygienic environment. The environment was observed, to be, well maintained and the home is decorated to a good standard. Service users spoken with stated that the home and the surroundings were beautiful and service users are able to bring in their own possessions should they wish. A marquee facility is used for fetes and events and is used for themed activities. Service users and relatives comments included: “All staff are marvellous and help in anyway they can”. “I have been treated with respect and made to feel welcome at any time this is appreciated”. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 8 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.V354605.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2 3 and 4 [Older People] and 1, 2,3 and 5 [Adults 18-65] Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Service users have the information they need about the home and are assured their needs will be met. The home does not currently provide an intermediate care service EVIDENCE: The main entrance area is posted with an abundance of information about the home, including the staff training matrix, complaints procedure, newsletters, photographs of events and programmes of various activities. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 10 Staff use innovative methods to make information meaningful and interesting such as leaflets, photographs and videos. Many of these are posted throughout the home. Service users clearly contribute to the home and evidence was seen in resident meeting minutes of this for example the devising of a new four weekly menu and warming plates on the trolley to help served food remain hot. The Statement of Purpose, Service User Guide and copies of previous inspection reports are clearly available. Service users are provided with contracts and information about fees and any changes to these, but not specifically stated in the Service user Guide. Service users needs are fully assessed prior to moving into the home and staff were able to demonstrate how they reassure individuals and help them feel welcome. Service users spoken with confirmed that the care provided was of a high standard in their opinion. There was evidence that significant time and effort is spent making admission to the home personal and well managed. There is a high value on responding to individual needs for information, reassurance and support. The assessment and care plan format used is Southern Cross Corporate documentation and is used for both older people and younger adults. It is recommended that Person Centred Planning formats be introduced for younger service users, which would be easier to map to the Younger Adults, National Minimum Standards in line with standard 2.3. The home follows Southern Cross Equality and Diversity policies. Training is provided in the topic and staff demonstrated knowledge about individual service users needs. Further development of the diversity needs of service users within the assessment process should be explored. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards, 7, 8, 9 and 10 [Older People] and 6, 9, 16,18, 19 and 20 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Service users personal, social and healthcare needs are fully met, they are treated with respect and their privacy upheld. EVIDENCE: Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 12 The care plans and risk assessments viewed were well written, kept up to date and reviewed regularly. Service users and /or their representatives sign that they agree to the care plans and for use of bedrails. Where limitations are imposed on the service user, such as in the use of monitor alarms, this was recorded in the individuals care plan, however staff need to ensure that signed authorisation for this is obtained from the service user or their representative prior to its implementation, even if only on a trail basis and that staff are provided with clear guidance in respect of this. People using the services receive personal and healthcare support by a person centred approach, however this would be further enhanced by developing the care plan format to the wider need of younger adults. It is recommended that healthcare sections be incorporated, which include action/management plans for chiropody, annual well person checks and a section for managing finances etc also included. Service users said that staff respect service users preferences and privacy and observation of practice on the day of inspection confirmed this. Suitable aids and equipment is provided and independence is promoted and staff undertake training in pressure are care, continence management, diabetes etc. Events of falls are well monitored, as are nutrition and any nursing interventions. Service users spoken with confirmed that their personal, social and healthcare needs were met and that staff, assist access to healthcare professionals as required. Care plans demonstrated, that where service users may choose alternative healthcare practices and refuse traditional methods, this is fully and appropriately documented. There is an efficient medication policy in place and staff undertake training both in house and by distance learning. The manager on a regular basis also undertakes audits. A recent pharmacy audit identified some areas for improvement, such as signatures on handwritten prescriptions and dating liquids upon opening. These were noted, to be dealt with and satisfactory practice observed on the day of the inspection. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 13 Although fridge temperatures were monitored the general storage temperatures of medication were not and this is therefore recommended. One person case tracked self medicates and appropriate documentation and facilities are in place to ensure this is safe. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 and 15 [Older People] 12,13,15 and 17 [Younger Adults] Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service are able to enjoy a full and stimulating lifestyle, with a variety of options to choose from. Routines are very flexible and service users are able to make decisions in major areas of their life. EVIDENCE: Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 15 Service users are enabled to live an ordinary and meaningful life, both in the home and the community appropriate to their peer group and diversity of needs. The routines, activities and plans are service user focused, regularly reviewed and meeting individuals needs choices and wishes. Service users confirmed that they were able to make decisions about their lifestyle and that routines were flexile, getting up times, bedtimes, etc On the day of the inspection, one younger adult service user went out to the local pub, another to the shop, clearly integrated into community life. An older service user was allocating [identifies the order and writes the room number] the delivered newspapers to the correct room newspapers and another service user delivers the newspapers to the correct rooms Others get involved in setting tables etc One service user had made her own matching curtains bedspread and cushions for her room. The home is hive of activity, providing a variety of options to choose from, ensuring service users are able to enjoy a full and stimulating lifestyle. Some service users attend college/and/or do voluntary work in the community. One service user said he did administration work for the local church. What is evident in the home is that staff go the extra mile, for example on the day of the inspection staff were discussing with the manager ideas for unusual, creative table displays, decoration of the Christmas Marquee and innovative activity ideas. Staff also said they felt it extremely important to facilitate service users relatives, particularly at Christmas time and provide for example, private space for couples who didn’t want to be part of a larger group. The service is also running a ‘Make a Wish for Christmas’ draw, with service users being asked to think about something they would like, be it for example hot air ballooning or a trip somewhere special. The main kitchen provides meals, but service users confirmed they could make snacks/drinks should they wish to and participate in bread making etc. Meals are very well balanced and cater for varying dietary needs of the people who use the service. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 16 All service users spoken with said they enjoyed their food and confirmed that they were able to select their choice from the many options on offer. The manager and a staff member are currently working on a benchmarking project for good practice activity provision in conjunction with the College of Occupational Therapists and NAPA [National Association for Providers of Activities for Older People] Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 [Older People] and 22 and 23 [Adults 18-65] Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People who use the service are able to make complaints and are confident these are dealt with appropriately. Safeguards are in place to protect the people who use the service, should they need them and access to external agencies or advocacy services is actively promoted. EVIDENCE: People are supplied with a complaints procedure that they can understand, copies of the procedure are clearly displayed around the home. Service users spoken with said they felt able to make any concerns to staff or the manager and that they were confident they would be listened to and dealt with. Four complaints have been made since the previous inspection, these include issues about, wet laundry being left in a service users room, a missing bottle of perfume and care practices, three have been resolved and one is still not Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 18 finalised. All others were substantiated or partly substantiated and resolved within an appropriate timescale. The home has up to date policies and procedures for safeguarding the people who live in the home and 98 of staff have been trained in the topic and staff spoken to were knowledgeable about what constitutes poor practice and how to report this should they witness any. There has been one safeguarding adults referral in the previous twelve months, which no further action was deemed necessary. Individual assessments are undertaken for use of bedrails etc and the home has a policy for use of restraint. Service users if able handle their personal finances, however if unable to do so assistance is available to ensure the safekeeping of this. It is recommended that the policy for the management of service users finances be expanded to include the use of advantage cards when shopping on behalf of service users. Staff are issued with the General Social Care Councils Code of Conduct and audits are undertaken on key workers knowledge of individuals in their care. It is recommended that staff undertake training in sexuality and relationships to further enhance any support for people, already in place. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,2 24 and 26 [Older People] and 24, 26, and 30 [Adults 18-65] Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Service users live in a well-maintained, safe, clean, pleasant and hygienic environment. EVIDENCE: Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 20 The environment was observed to be well maintained and the home is decorated to a good standard. Service users spoken with stated that the home and the surroundings were beautiful. A marquee facility is used for fetes and events and is used for themed activities; for example, staff and service users explained that recently the marquee was decorated out for Halloween Night. The hairdressing room and staff room are in need of redecoration but the manager has identified this and discussed her plans for the rooms. The gardens and ground are well cared for and present an attractive view and facility for service users and visitors. There is sufficient domestic staff employed to ensure the cleanliness of the home. The home was clean, pleasant and hygienic on the day of the site visit. There were no infection control or health and safety issues identified at this inspection and all records pertaining to the management of the buildings and environment were well documented and up to date. The manager undertakes regular audits of the building and in respect health and safety. A new training area for staff is currently being developed. Service users are able to bring in their own possessions should they wish. There are doorknockers on all service users rooms to ensure staff continue to respect privacy and knock before entering. Staff spoken with were able to discuss the core values and principles and how privacy and dignity is maintained. All service users spoken with stated that staff, were respectful and privacy is maintained. Observation of practice on the day also supported this. All consultations are carried out in service users own rooms and there is a private lounge available on the Lindrick unit if required. There is a public telephone and Internet connection service users may use and some service user have their own telephones. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 [Older People] and 32, 33, 34 and 35 [Adults 1865] Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The service is proactive in its staffing recruitment and training, with planning for the potential needs of people currently using it and for anyone who may use the service in the future, thus delivering highly effective person centred care. EVIDENCE: The staffing rotas were observed and demonstrated that sufficient staff are employed to meet service users needs. Staff spoken with substantiated this and service users spoken with stated that staff are available when needed. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 22 The unit managers draw up the duty rota and take skill mix into consideration when doing so; the nurse manager and general manager then oversee this. The induction programme remains in depth and there was evidence available to demonstrate that new staff have undertaken this procedure. Six members of staff have attained the National Vocational Qualification level 2 and 15 staff are in the process of working towards this qualification. One staff member reported that she has NVQ level 3 and achieved the advanced carers award. Four staff files were observed and contained the required documentation. All staff have individual training files. Mandatory training continues to be at a good standard and additional training is arranged in line with the training standards employed by Southern Cross. Staff confirmed and evidence was seen that formal supervision is undertaken, however it is recommended that all staff receive at least six sessions a year each. Most staff have undertaken training in resident welfare and customer care. Training is provided for specific conditions, however it is recommended that training in Multiple Sclerosis is accessed as a priority. The manager reported that she is currently arranging training specialist training to help staff deal with any challenging behaviours presented by service users. The manager and staff spoken with were able to discuss the issues of equality and diversity and how it is maintained within the home. Observation of staff practice on the day demonstrated that they provide a friendly, homely and inclusive atmosphere for people residing in the home. Staff and service users were observed to have a good rapport and staff reported good team working. Staff at Gateford are commended for going the extra mile to ensure service users quality of life is as good as possible. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32,33, 34, 36, 37 and 38 [Older People] and 36, 37, 38, 39, 41 and 42 [Adults 18-65] Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 24 The home is run in the best interests of service users, by a competent staff team supported by a dedicated and focused manager, ensuring that service users heath safety and well being is promoted at all times. EVIDENCE: The manager is registered with the Commission for Social Care Inspection. She has completed the National Vocational Qualification level four and Registered Managers award and Certificate of Environmental Health. The deputy manager is a registered nurse and is currently undertaking a first line management course. On speaking with staff they spoke very highly of the manager and stated that the home was well run. The manager is able to describe a clear vision of the home-based on the organisation’s values and or corporate priorities and communicates a clear sense of direction for herself and the staff team. She is able to evidence a sound understanding and application of ‘best practice’, operational systems, particularly in relation to continuous improvement, customer satisfaction and quality assurance. Service users spoken with also were happy with the way in which the home was run and managed. The manager carries out in depth audits on a monthly basis, these cover a wide range of areas and is validated by the operations manager once completed. Following completion an action plan is devised to ensure any negative issues are resolved. The regional manager visits the home monthly and completes the required regulation 26 feedback forms. These were evidenced and were satisfactory. Service users complete satisfaction questionnaires annually and the results of these are reported in the newsletter. Minutes were viewed of service user/relative meetings and demonstrate that service user views are listened to and acted upon. Four service users personal finances were checked and these corresponded with the accounting record. Individual accounts are maintained and receipts Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 25 are available for all transaction. For those service users who are able to handle their own finances a lockable facility is available. [See also Outcome Complaints and Protection] All maintenance and servicing checks and related health and safety documentation, such as fire system testing and accidents records were observed and were satisfactory. No issues were identified in respect of health and safety at this inspection. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 26 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 4 2 3 3 4 4 4 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 ENVIRONMENT Standard No Score 19 4 20 X 21 X 22 X 23 X 24 4 25 X 26 4 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No Score 31 4 32 4 33 4 34 3 35 X 36 3 37 4 38 4 Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 27 N/A 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. Standard Regulation Requirement Timescale for action 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 YA2 YA6 YA19 Good Practice Recommendations Introduce Person Centred Care Planning formats for younger service users, which would be easier to map to the Younger Adults, National Minimum Standards, particularly in line with standard 2.3. Develop the care plan format to the wider needs of younger adults for example: Healthcare sections should be incorporated, which include action/management plans for chiropody and annual well person checks and include a section for managing finances etc. Where limitations are imposed on the service user, such as in the use of monitor alarms, staff need to ensure that signed authorisation for this is obtained from the service user or their representative prior to its implementation, even if only implemented on a trail basis. Staff should also be provided with clear guidance in Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 28 2 YA7 3 YA20 OP9 YA23 OP18 respect of this. The storage temperatures of medication should be monitored and recorded. The policy for the management of service users finances should be expanded to include the use of advantage cards when shopping on behalf of service users. 4 5 YA35 OP30 Staff should undertake specific training in sexuality and relationships and multiple sclerosis to further enhance any support for people, already in place. Gateford Hill Care Home DS0000024640.V354605.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V354605.R01.S.doc Version 5.2 Page 30 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!