CARE HOME ADULTS 18-65
Gateholme Old Bradford Road Carr Gate Wakefield West Yorks WF2 0QW Lead Inspector
Tony Railton Unannounced Inspection 10th November 2005 11:00 Gateholme DS0000006181.V261503.R01.S.doc Version 5.0 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 Gateholme DS0000006181.V261503.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 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. Gateholme DS0000006181.V261503.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Gateholme Address Old Bradford Road Carr Gate Wakefield West Yorks WF2 0QW 01924 880918 01924 872705 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) J C Care Ltd Care Home 31 Category(ies) of Learning disability (31) registration, with number of places Gateholme DS0000006181.V261503.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 6th May 2005 Brief Description of the Service: Gateholme provides accommodation and personal care for 27 adults who have a learning disability. The home consists of three buildings, one large unit and two smaller units. Set back in its own grounds the home is surrounded by very large gardens with a very large lawn to the front. There is also a very large drive with parking to the front. Each unit operates independently having its own lounges, kitchens, bathrooms and toilets. The home only provides single accommodation. Bedrooms are personalised and homely. Most residents attend care services, however, activities are organised on a regular basis for those who wish to participate. Some residents are very able and can travel independently. The home is close to a main bus route and is only a few minutes journey from the centre of Wakefield and all services and amenities. The home is also close to the M1and M62 motorways. Gateholme DS0000006181.V261503.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a very positive and enjoyable unannounced inspection. There was the opportunity to speak to a number of residents, senior support worker and other care workers. There was also the opportunity to inspect most of the building and examine some residents’ case notes and daily records. This particular inspection concentrated on seeing how the home recorded residents’ choices and preferences. This ‘themed’ inspection was possible because all of the core standards were considered at the last inspection. It was noted that the home continues to meet all statutory requirements and most minimum standards. However, on the day of the inspection some remedial work to the building noted. The inspector would like to take the opportunity to thank residents and support workers for their hospitality and co-operation throughout the inspection. What the service does well: What has improved since the last inspection?
There are two main areas of improvement noted since the last inspection. Firstly there have been massive improvements to the physical environment. There is a new lounge and kitchen provided on the first floor and this presents very well and is furnished and decorated to a good standard. The senior support worker aid that everyone is pleased with the new lounge and kitchen as this means that more able residents can relax in their own lounge and not be disturbed by others. The senior also said that more able residents have the opportunity for personal development for example choosing and getting their own breakfast.
Gateholme DS0000006181.V261503.R01.S.doc Version 5.0 Page 6 Some residents are very able and can do most things for themselves, having their own lounge and kitchen will help promote and maintain their independence. The new walk in shower room is near completion. This presents very well and the complete refurbishment of this room is a great improvement and will benefit those residents who prefer to have a shower. The second improvement is the way descriptive words are used in the daily records to reflect and indicate individual residents choices, preferences, likes, dislikes and when residents choose to do something different. Having descriptive words in the daily records is very important as it shows that residents have a say in what happens to them and what they do. On the day of the inspection there was consistency in the standard of daily recording which is commendable and which benefits residents and those looking after them. It was noted that the home in collaboration with the health authority are piloting a new ‘Healthcare Assessment’ which is made up of words, pictures and symbols. This joint working/ partnership with other healthcare professionals is to be commended and should benefit residents and those who support them. 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. Gateholme DS0000006181.V261503.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gateholme DS0000006181.V261503.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Prospective residents have their personal care and healthcare needs assessed before they are admitted to the home. EVIDENCE: Residents’ records including assessments show that all residents benefit from having a comprehensive assessment of their care needs before they are admitted to the home. Two residents had ‘Integrated Case Management Assessments’ carried out by two different placing local authorities. On the day of the inspection it was noted that staff in the home were working closely with the local health authority in piloting a new ‘Healthcare Assessment’ comprising of pictures, symbols and words. Residents will benefit from this joint working by the home with other healthcare professionals. Despite providing a Complaints procedure in an alternative format it was noted that the home has not provided a similar format for the Service User Guide to promote a better understanding by residents of where they live. Gateholme DS0000006181.V261503.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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&9 Residents are encouraged and supported to make decisions about their lives and are also supported to take risks as part of an independent lifestyle. EVIDENCE: Residents records and in particular the daily records show that they have improved greatly. Descriptive words are now used to reflect residents’ choices, preferences, likes and dislikes. The daily records also show when residents have made a decision about what they do and how they live their lives, for example where they would like to go on holiday. Residents records also show that there are risk assessment and care plans put in place to make sure that they are not at risk from making decisions about their daily lives and living an ordinary lifestyle. Some residents’ records show that their care plans are looked at on a regular basis to make sure that they are still relevant or need changing. However, some relatively new care plans had not been reviewed. Gateholme DS0000006181.V261503.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15, 16 & 17 Residents are encouraged to live an ordinary lifestyle and are supported to take advantage of ordinary community based leisure services. Residents’ rights are also respected and responsibilities recognised in their daily lives. EVIDENCE: The senior support worker said that the opening of the new lounge and kitchen upstairs has had a great impact on the residents’ lifestyle. He said that those who are more able have opportunities for personal development and for maintaining their independence. Residents records and in particular programme of activities and daily records show that residents have a wide and varied experience of activities. These activities include attending local authority run day services, shopping trips to Wakefield, trips to the cinema, trips out for meals, outings to the coast and holidays. The daily records show that residents’ choices and preferences with regards to activities are considered and recorded Photographs of holidays and outings show that residents enjoyed holidays in Blackpool and Skegness.
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The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Residents receive the care and support they need and require and their physical and emotional healthcare needs are also met. EVIDENCE: Residents’ case files including assessments, risk assessments, care plans, reviews and daily records show that their personal health and care needs are planned for. The medical records including records of visits to the doctors, dentist and chiropodist and of their medicines show that residents’ healthcare needs are met. The daily records are good as they reflect residents’ choices, preferences, likes and dislikes with regard to how their healthcare needs are met. Gateholme DS0000006181.V261503.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The home provides a complaints policy and procedure which is available and accessible to residents and their relatives. EVIDENCE: On the day of the inspection the senior support worker said that the home has not received any complaints since the last inspection. He went on to say that most residents are able to and have the opportunity to communicate their views to staff and also have regular residents meetings to air their views. The home continues to provide a complaints policy and procedure in an alternative format, which is more accessible to residents by using pictures, symbols and words. The home also continues to provide a copy of Wakefield Social Services and Health Multidisciplinary Adult Abuse and Protection Policy and Procedure which forms part of the training for new staff. The senior support worker said that all staff undertake Protection of Vulnerable Adult training and it was noted that on the day of the inspection four care staff from the home were attending a POVA course. Gateholme DS0000006181.V261503.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27, 29 & 29 Residents live in a home which is homely and comfortable and clean, however, there is some minor remedial work required. EVIDENCE: Inspection of the home showed a number of improvements for the benefit and comfort of residents. One of the biggest improvements is having a new lounge and kitchen on the first floor. The new lounge is decorated and furnished to a good standard is homely and comfortable. The senior support worker said that the residents living upstairs are more able and can do quite a lot for themselves. He went on to say that they are very happy with their new lounge and appear more relaxed and comfortable. There is also a new small fully fitted kitchen which is used by residents to prepare simple meals. There I alo a brand new medicine cabinet provided. The shower room downstairs has been totally refurbished and presents as new. All residents will benefit from having a shower room fitted and decorated to such a good standard. It was noted that all of the corridors have been decorated and generally look good. However, some wheelchair damage was noted on the downstairs corridor. Residents’ bedrooms are personalised, homely and comfortable and all areas of the home are clean and free from unpleasant odours.
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The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 & 36 Residents would benefit by being cared for by support staff who were appropriately supervised and by having more qualified staff. EVIDENCE: Unfortunately on the day of the inspection the senior support worker did not have access to staff records, including references, CRB Checks, supervision and appraisal records. However, the senior support worker said that there are only five staff with a National Vocational Qualification Level 2 or above. He went on to say that another five support staff are currently registered on NVQ. The senior support worker said that as far as he is aware the manager has not started annual staff appraisals, however, he did say that some staff supervision had been completed but there was still some to do. Staffing rotas show that there has been an increase in the amount of staff working in the home. The senior support worker said that the manager has increased the staffing levels to reflect the changing needs of service users. These actions are to be commended and show an insight and awareness by the manager of the home. Gateholme DS0000006181.V261503.R01.S.doc Version 5.0 Page 15 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 40,41 Residents’ benefit from the ethos, leadership and management approach of the home and their rights and best interests are safeguarded by the policies and procedures. EVIDENCE: Residents financial and medicine administration records and case files show that their rights and best interests are safeguarded by the homes record keeping policies, procedures and practices. The senior support worker said that the manager has an open door policy is accessible and will listen to what staff and residents have to say. On the day of the inspection both staff and residents appeared to be relaxed and spoke feely about their home and their work. The senior support worker was not sure if residents and relatives’ quality assurance questionnaires had been completed this year. He also said that he was not aware of anyone asking visiting professionals their views on the quality of care provided by the home. Gateholme DS0000006181.V261503.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 X X x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 2 X 3 x Standard No 24 25 26 27 28 29 30
STAFFING Score 2 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X X X 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Gateholme Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 X 2 3 3 X X DS0000006181.V261503.R01.S.doc Version 5.0 Page 17 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. 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. 2 3 4 5. 7. 8 Refer to Standard YA1 YA7 YA24 YA32 YA36 YA36 YA39 Good Practice Recommendations All residents should be provided with a service user guide which is in an appropriate format for that persons level of understanding. Residents would benefit by having all of their care plans reviewed on a regular basis which should include a date and signature. The minor remedial work on the ground floor corridor should be addressed as soon as is practicable. A minimum ratio of 50 of care staff should have a NVQ Level 2 or above. All care staff should have 6 planned line management supervision sessions per year and a record kept for inspection. All staff should have an annual appraisal with a record maintained for inspection. The information gathered from residents their families and other visiting professionals as part of quality assurance questionnaires should be collated by the manager and a report provided for residents. Gateholme DS0000006181.V261503.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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