Inspection on 06/05/05 for Gateholme

This inspection was carried out on 6th May 2005.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gateholme 26/04/07

Gateholme 29/09/06

Gateholme 10/11/05

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 WF2 0QW Lead Inspector Tony Railton Unannounced Inspection 6th May 2005 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 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 Stationary 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 J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Gateholme Address Old Bradford Road Carr Gate Wakefield WF2 0QW 01924 880918 01924 872705 Telephone number Fax number Email 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 Limited Fiona Tate Acting Manager Care Home 31 Category(ies) of Learning Disability 31 registration, with number of places GATEHOLME J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 28 August 2004 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 inependantly having its own lounges, kitchens, bathrooms and toilets. The home only provides single accommodation. Bedrooms are personalised and homely. Most residents attend care care services, however, activities are organised on a regular basis for those who wish to participate. Some residents are very able and can travel independantly. 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 J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector arrived early on this unannounced inspection to meet residents and see what daily morning life in the home is like. The inspector also saw how residents and support workers were together. This was a good inspection and a number of improvements were noted. The inspector was given a warm welcome by residents and care staff and would like to take the opportunity to thank everyone for their hospitality, patience and co-operation throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: The new acting manager should send her application to become registered to the commission as soon as is practicable as the law says that the home must have a registered manager. Some care plans need to be updated and reviewed as a priority, and the new acting manager needs to complete this. The daily records also need to use descriptive words to show residents choices and likes and dislikes. Records of supervision and staff annual appraisals should be made to show how staff are being trained to care for residents. Residents views are sought on what it is like living in the home and what changes residents would like, but this needs to be put together in so residents and families can a see a report on how what they say affects what happens in the home. GATEHOLME J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 Page 6 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 J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection GATEHOLME J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 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 standard(s) 1,2.3,4& 5. People wanting to live in the home have the information they need to make a judgement about what is provided although service users would benefit from a service guide adapted to meet their communication skills. EVIDENCE: The acting manager said that although the Statement of Purpose includes all the information required, the Service User Guide should be personalised to meet individual residents needs by more appropriate and alternative formats. GATEHOLME J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 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 standard(s) 6,7,8,9 &10 To ensure that residents receive the appropriate care and support they require their care plans should be updated and reviewed. Outcomes for residents’ including their wishes and choices should be reflected in the daily records. EVIDENCE: Examination of the care plans, assessments, risk assessments, and daily records found that care plans needed to be updated and reviewed. The acting manager said that she is currently reviewing all residents’ care plans. She said that she is aware of the need to reflect residents’ care and support needs in their care plans and also the need to date and sign the reviews. There was sufficient evidence in case notes, daily and medical records to conclude that residents’ personal and healthcare needs are being met, although the home doesn’t provide documented evidence in reviews to support this. Through discussion and observation the inspector found that residents’ do make decisions on a day-to-day basis about what they do and how they live their lives. However, the daily records do not show the use of descriptive words to reflect residents choices, likes and dislikes. GATEHOLME J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 Page 10 GATEHOLME J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16 & 17. Residents benefit from the ethos and philosophy of the home and in particular that of living of an ordinary lifestyle. Residents enjoy being supported to be part of the local community and having a positive community presence. EVIDENCE: Records seen and discussion with ten residents showed that residents are encouraged and supported to take advantage of locally provided day care services, and there are opportunities provided for personal development. The manager and support workers said that residents are also encouraged and supported to do as much for themselves as possible and maintain their independence. However, there is an absence of descriptive words in the daily records seen to reflect residents’ preferences and choices with regard to activities and how they live their daily lives. GATEHOLME J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 & 21. The care planning systems and in particular the reviewing system should be improved to ensure that residents’ are getting the care and support they need and prefer. EVIDENCE: Residents care plans seen, needed to be updated and reviewed. The new manager said that she is currently in the process of reviewing and changing all residents’ care plans as most of them are out of date. The inspector saw that some of the care plans inspected had not been reviewed since May 2004. GATEHOLME J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 Page 13 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 standard(s) 22 & 23 The home has a satisfactory complaints system with some evidence that service users feel that their views are listened to and acted upon. EVIDENCE: The inspector was pleased to note that the home has a copy of Wakefield Multidisciplinary Social Services and Health Adult Abuse and Protection Policy and Procedure. Which is used as training for staff and to protect residents from abuse. The complaints procedure is produced in an alternative format using pictures and symbols to aid and assist residents understanding. The manager said that the home has not received any complaints since the previous inspection. Discussion with staff showed a positive attitude towards residents regarding complaints and they had a good knowledge of the adult abuse and protection policy. Staff training records showed that adult abuse and protection forms part of the induction training for new staff and ongoing training for existing support workers. GATEHOLME J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 Page 14 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 standard(s) 24.25,26,26,27,28,29,30. The standard of the environment within the home is good providing residents with an attractive and homely place to live. EVIDENCE: A number of improvements to the environment were seen to have occurred since the last inspection. The main lounge has been decorated and provided with a new carpet. The main dining room has also been decorated, has new curtains, new dining tables and chairs. There are six new bedrooms with ensuite facilities, a new kitchen and small lounge/ dining room. These improvements have raised the standard of environment considerably and are to be commended. The home has recently employed a new domestic and all areas of the home were found to be clean and free from any unpleasant odours. The care staff and in particular domestic staff are to be commended for their efforts in maintaining such a high standard of cleanliness throughout the home. Residents were happy to show the inspector their bedrooms which are personalised, comfortable, homely and promote their independence. GATEHOLME J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36. The staff have a good understanding of residents support needs. This is evident from the positive relationships, which have been formed between the staff and residents. EVIDENCE: Care staff said that they feel supported in the work that they do. They said that they are more confident and happier in their work since the appointment of the new manager who offers them support and clear leadership. The acting manager said that she offers informal supervision to all staff, but not keeping written records, nor providing a record of annual appraisals. Records indicate that all staff are currently registered on National Vocational Qualifications at Levels 2, 3 & 4. to progress towards the home having a minimum of 50 of care staff trained to NVQ Level 2 or above. There was a positive attitude from the staff team towards residents and the and staff appeared comfortable, confident and open. GATEHOLME J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,41,42 & 43. The acting manager has a clear development plan and vision for the home, which she has effectively communicated to residents, care staff and other stakeholders. Residents’ benefit from the ethos, leadership and management of the home. EVIDENCE: The home is currently without a registered manager, however, the management systems examined within the home are very good. The acting manager is very experienced and residents and care staff benefit from living and working in a well run home. The acting manager said that she has an application form to become the registered manager, however, she has still to send this to the CSCI. Residents’ rights and best interests are safeguarded and promoted by the homes financial, record keeping, accounting and health and safety policies procedures and practices which upon inspection appear to work well. GATEHOLME J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 Page 17 Appropriate records were seen of safety checks including fire and health and safety and water temperatures. Staff training records show that appropriate training is provided for staff including, Moving and Handling, First Aid and Basic Food Hygiene. GATEHOLME J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 Page 18 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 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 2 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 2 3 3 3 Standard No 31 32 33 34 35 36 Score 3 2 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 GATEHOLME Score 2 3 3 3 Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 3 3 J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 Page 19 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6.1 Regulation 15 (2)(b) Requirement All residents care plans need to be updated reviewed on a regular basis Timescale for action Ongoing 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. Refer to Standard YA1.1 YA 7.4 YA14.1 YA18.1 Good Practice Recommendations All residents should by provided with a service user guide which is in an appropriate format for that persons level of understanding. The daily records would beneft rom the use of descriptive words to reflect and indicate residents choices and preferences. Residents choices and preferences with regard to leisure activities should be recorded Documented evidence should be provided to demonstrate that residents are in control of their own lives and decisions should be recorded in residents day to day records. 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 J51J01_ s6181_gateholme_v220569_ 060505.doc Version 1.30 Page 20 5. 6. 7. YA32.6 YA36.4 YA36.6 GATEHOLME 8. YA37 maintained for inspection. The acting manger should send her application to register to the CSCI as soon as is practicable. 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