Inspection on 26/04/07 for Gateholme

This inspection was carried out on 26th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gateholme 29/09/06

Gateholme 10/11/05

Gateholme 06/05/05

Gateholme 25/08/04

Gateholme 21/04/04

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

CARE HOME ADULTS 18-65 Gateholme Old Bradford Road Carr Gate Wakefield West Yorks WF2 0QW Lead Inspector Tony Railton Unannounced Inspection 26th April 2007 08:00 Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 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.V337390.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 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.V337390.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gateholme Address Old Bradford Road Carr Gate Wakefield West Yorks WF2 0QW 01924 871137 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) www.craegmoor.co.uk J C Care Ltd Care Home 31 Category(ies) of Learning disability (31) registration, with number of places Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th September 2006 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 large lawn to the front. There is also a large drive with parking to the front. Each unit operates independently having their 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. On 26th April 2007 the providers said that the range of fees for living in the home was between £373.00 and £872.00 per week with separate cost for hairdressing (£4.00), chiropody (£5.00) and horse riding (£7.00). The Statement of Purpose containing additional information about the service provided for prospective residents and their relatives is available from the home or from the providers website, www.craegmoor.co.uk Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to the service commenced at 08.00 and ended at 13.00. There was discussion with a number of people using the service, the manager, support workers, domestic staff and a visiting independent advocate. A sample of six staff records were seen and records of six people who use the service. The record of complaints was seen along with eight of the homes quality assurance surveys, service user guide, staff rota, and staff training records. A tour of the premises was undertaken and included lounges, dining room, shower room, bedrooms and garden. The inspector would like to take the opportunity to thank people for their hospitality and co-operation throughout the visit. What the service does well: People using the service have their personal and healthcare care needs assessed so that staff know what to do to meet their individual needs. People benefit from having a Service User Guide, which uses pictures, and symbols and words to tell people what services will be provided. People benefit by having a complaints policy and procedure, which uses pictures, words and symbols to make it easier for people to understand. People benefit from living in a comfortable, homely and well-maintained environment. People have their bedrooms how they want. One person said that they “liked their bedroom” and that they had “chosen their bedding and curtains”. Another said that they liked their Robbie Williams posters. People are supported and encouraged to use ordinary community based education and leisure services. One person said that they liked “going to college” but that they liked “staying at home to do their washing” as well. People are protected and safeguarded by the way staff are recruited and selected. Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 6 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. Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 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.V337390.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 People living in the home have their personal and healthcare needs assessed. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: The manager said that everyone coming to live in the home has their personal and healthcare needs assessed to make sure that they get the care and support that they need. This was confirmed by looking at a sample of six people’s records, which included assessments and risk assessments. All people living in the home have been given a Service User Guide telling them about the service provided. The Service User Guide uses pictures and symbols and words to make it easier to understand. The independent advocate raised no issues about the needs or choices of people living in the home. Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 People have their personal care needs written down to tell staff how they need to be cared for, but staff need to look at these more often to make sure people get the care and support agreed. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: A sample of six peoples care plans showed that some had not been looked at for over a year, which means it was not clear that these plans would be meeting peoples current needs. However, some people have had their care needs reviewed by them, their relatives, Social Workers and Advocates. Reviewed plans held updated information to show staff their current care needs, explained how these will be met and recorded the person is happy with the services provided. There was discussion with the manager about the need to check that all peoples care plans and risk assessment are looked at regularly to make sure that peoples personal care needs are being met. Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 10 The daily records show that people using the service have the opportunity to make choices on a day-to-day basis about how they live their lives, and staff were observed offering choices to people using the service. The minutes of the residents meetings and the returned quality assurance surveys show that people have the opportunity to comment and be involved in every aspect of the running of the home. One person using the service said that they have chosen to go to Blackpool this year for their holidays. Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 People benefit from living as ordinary a lifestyle as possible and from being encouraged and supported to use ordinary community based education and leisure services. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: On the day of the visit some people were seen getting ready to go to college, some to local authority run day services, others to go shopping. Activities are encouraged and one person using the service said that they liked going shopping, whilst another person said that they like going to work to meet all their friends. One person said that they “enjoy going to college” but that they also like staying at home “doing the washing”. Another person said that they were waiting to “see their Advocate” and another that they “like going to the centre” as they “have friends there”. Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 12 The daily records show that some people go home with relatives for the weekend, others enjoy holidays aboard, outings to the seaside and regular visits to local shops and public houses. The manager said that the philosophy of the service is based on ordinary living principles and people are encouraged and supported to use ordinary leisure services. The daily records confirmed this. Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People’s healthcare needs are met, and they are safeguarded and protected by the way medicines are given and recorded. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: Peoples medical records show that they are encouraged and supported to use ordinary community based healthcare services. Records also show that people also supported by the local Community Learning Disability Team and hospital –based consultants. People’s medical records and reviews confirmed this. Staff training records show that people giving out medicines are trained in how to do it safely and to make sure that people get prescribed medicines at the prescribed time with clear record keeping. Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People have the opportunity to comment on the running of the home and their concerns are listened to and acted upon. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: People are protected by the Safeguarding Policy and Procedures and by being supported by staff that have training in how to prevent adult abuse. The service history shows that there have been two Safeguarding referrals since the last inspection, and discussion with the manager and the minutes of the Safeguarding meetings show that these were appropriately dealt with. The independent advocate raised no issues in this area. People know how to make a complaint and there is a copy of the complaints procedure for people to see on the notice board. The complaints procedure uses pictures and simple words to make it easier for people to understand. The manager said that the home has not received any complaints this year, and the record of complaints confirmed this. Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26 and 30 People enjoy living in a comfortable, homely, well decorated and wellmaintained environment that promotes their independence. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: People enjoy living in a home where they are comfortable and safe. This was confirmed by a tour of the premises and discussion with people living in the home. One person said that they “liked their bedroom” and that they had “chosen their bedding and curtains”. Another said that they liked their “Robbie Williams posters”. Others were observed enjoying a walk in the extensive gardens. The manager said that one bedroom has been completely re-decorated following a recommendation made in a previous report. Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 16 A tour of the home found that people using the service live in a well decorated, well maintained home that is comfortable and promotes their independence. Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 17 Staffing 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 and 36 People using the service benefit from being cared for by a sufficient number of staff to meet their needs. However, staff development, to meet people’s needs, would be improved by more staff achieving qualifications in care. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: The training records show people are cared for and supported by staff that have had training; and most staff are trained in First Aid, Moving and Handling, Infection Control, Fire Prevention, Food Hygiene and in how to give medicines safely. The staff training Matrix shows that other training is planned for this year, although currently the majority of staff have not yet obtained a qualification in care. Although there was a recommendation at the last inspection discussion with the manager found that there is no annual appraisal record to show that staff have the skills to meet peoples need. The staff rota shows an increase in the number of staff employed, and there is enough staff on duty to meet people’s care and support needs. One person spoken to said that they “liked the staff” and that they are “great”. One support worker said that they “felt supported” in the work they do and the Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 18 staff supervision notes show that people benefit from being cared for by staff that are trained and supervised. The returned relatives surveys show that they are generally happy with the care and support provided. Staff records show that people are protected and safeguarded from abuse by the staff selection and recruitment policies and practices and staff training records show that all staff have received vulnerable adults safeguarding training. Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 People benefit from living in a well run home where their best interests are protected and promoted. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: There was discussion with the manager about the need for the person managing the home to seek registration, to ensure that there is a full clearance and assessment of how they can manage the home and meet peoples needs. The manger said that she has not completed or sent her application to become the registered manager to the Commission for Social Care Inspection. The rules say that all registered services must have a registered manager. Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 20 There was also discussion about the manager making sure that care plans and risk assessments are reviewed to make sure that peoples current care and support needs are met. The homes returned quality assurance surveys show that people using the service and their relatives are happy with the care and support provided. The independent advocate, visiting a person at the home, did not raise any issues in this area. The manager said that the information gathered from the quality assurance surveys is collated centrally and a report provided to reflect the views of people using the service and their families. The minutes of the staff and service user meetings show that people have the opportunity to comment on the running of the home and have a say in what happens to them and the way they live their lives. Staff training records show that people’s health and well-being is promoted and protected as staff are trained in First Aid, Moving and Handling, Health and Safety, Fire Prevention, Food Hygiene and Infection Control. Two staff said that they feel they have the appropriate training for the work that they do and that they feel they are supported to meet peoples needs. Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 21 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 Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15 (2) (b) Requirement To make sure peoples current needs are met peoples care plans must be reviewed on a regular basis. Outstanding from the previous inspection 26.9.2006 To ensure people living in the home receive a service that is well managed the person managing the home must apply to be registered. Outstanding from the previous inspection 26.9.2006 Timescale for action 01/07/07 2 YA37 8 (1)(a) 01/07/07 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 YA32 Good Practice Recommendations A minimum ratio of 50 of care staff should have a NVQ Level 2, or commensurate, qualification. DS0000006181.V337390.R01.S.doc Version 5.2 Page 23 Gateholme 2 YA36 All staff should have an annual appraisal with a record maintained for inspection. Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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 Gateholme DS0000006181.V337390.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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