Inspection on 11/12/06 for Gatesgarth

This inspection was carried out on 11th December 2006.

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

Gatesgarth 17/12/08

Gatesgarth 31/01/06

Gatesgarth 24/10/05

Gatesgarth 25/02/05

Gatesgarth 01/06/04

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

CARE HOME ADULTS 18-65 Gatesgarth The Green Little Broughton Cockermouth Cumbria CA13 0YG Lead Inspector Cath Wilson Unannounced Inspection 11th December 2006 09:30a Gatesgarth DS0000022574.V314957.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 Gatesgarth DS0000022574.V314957.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. Gatesgarth DS0000022574.V314957.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gatesgarth Address The Green Little Broughton Cockermouth Cumbria CA13 0YG 01900 828487 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.c-i-c.co.uk Community Integrated Care Mrs Hilary Stamper Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places Gatesgarth DS0000022574.V314957.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 4 service users to include: up to 4 service users in the category of LE (Learning disabilities under 65 years of age) up to 4 service users in the category of PD (Physical disabilities under 65 years of age) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 31st January 2006 2. Date of last inspection Brief Description of the Service: Community Integrated Care are the Responsible Company for Gatesgarth and provide care and services for up to four people with a learning and physical disability. They operate a number of similar facilities both in Cumbria and other parts of the Country. Gatesgarth is located in a quiet residential area in the village of Little Broughton, several miles from the town of Cockermouth. It blends into the other residences in the local community. Car parking facilities are to the front of the home and garden areas to the back and side. The detached premises have a ground and first floor. Service users only use the ground floor. There is a lounge, dining room, kitchen, shower, bathroom and toilet facilities, utility room and four private bedrooms and an office. All rooms used by service users have level access. There is also a designated open area off the corridor that is used for a relaxing sensory facility. Specialised aids and adaptations are provided. Access into and around the home is level and appropriately designed for people who use wheelchairs. Private transport is provided to facilitate access to local amenities, facilities and appointments. Gatesgarth DS0000022574.V314957.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection to the home that was undertaken during the morning period. During this visit I was able to meet residents, the registered manager and staff. Relatives of service users and health care personnel had completed comment cards regarding the provision of care. The registered manager had completed a pre-inspection questionnaire prior to this visit. This assisted me in verifying information throughout the inspection. A tour of the premises was undertaken. Staff, resident’s records and administration files were assessed. What the service does well: What has improved since the last inspection? The home continued to ensure that the identified needs of people in the home are met. This involved the expertise and guidance of other personnel in order that the most appropriate outcomes are achieved for people and are diligent in doing this on an ongoing basis. The recording system used in the home continues to be improved so that outcomes are effectively recorded. Gatesgarth DS0000022574.V314957.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Gatesgarth DS0000022574.V314957.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 Gatesgarth DS0000022574.V314957.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has procedures, paperwork and care practices in place to ensure individual need is assessed, promoted and appropriately acted upon. EVIDENCE: The information available to prospective guests, their family or representatives is well documented. The manager is fully informed of the criteria for needs led assessments and incorporates this information comprehensively in meeting individual need. People are provided with choice and being provided with opportunities to visit the home allows an informed and supported decision to be made. The Statement of Purpose and Service User Guide are accessible and available to family and representatives also. Both these documents are currently under review so that people can always be informed of up-to-date information. Gatesgarth DS0000022574.V314957.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, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and staff are focussed on achieving the individual outcomes for people. EVIDENCE: There are individual care plans for people that contain comprehensive details and information. The manager and staff are continuing to look at ways to further strengthen the records to show the achievements of outcomes for people. There was also evidence to clearly indicate that staff are constantly seeking ways to further enhance people’s lives and enlist other professional personnel for advice and training. This is very good practice. The manager and staff are very well informed of people’s needs and these include their cultural and religious preferences. Not all care planning documentation is up-to-date and the registered manager had a programme in place to ensure this work is undertaken. People’s personal information is confidentially stored. Gatesgarth DS0000022574.V314957.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s rights are very much promoted and their individuality respected. Mealtimes are catered for on an individual basis taking choice and balance into account. EVIDENCE: People’s leisure and community involvement is detailed in their records and staff supported people to attend these. These include people’s cultural and personal beliefs. This had been achieved in a manner that respected people’s individuality and wishes. The manager and staff have great interest and enthusiasm in encouraging people to have meaningful and enjoyable experiences. Seeking opportunities to further people’s choice and participation in everyday events. Family members are encouraged to have and maintain contact. Mealtimes are arranged to meet individual need. Gatesgarth DS0000022574.V314957.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health care matters are well managed and documented and advice and guidance from professional personnel is included in this process. EVIDENCE: Staff are very knowledgeable of peoples needs including their health care arrangements. The staff team work very positively with the local health care professionals to offer a responsive and supportive approach in assisting people to maintain and receive the right attention. Specialist assistance and guidance is incorporated into the home’s approach and practices and actions regularly monitored by the manager. Training has been provided to staff regarding medicines management in the home. Policies and procedures for medicines handling are in place and are appropriate for the home. Whilst care plans are under review at present records did however indicate that there is much work being achieved in supporting people in their health care needs and individuality is sensitively attended to ensure that people’s dignity is upheld. Gatesgarth DS0000022574.V314957.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s complaints system is available to both service users and their family and arrangements for vulnerable adult procedures are well managed. EVIDENCE: Information is available regarding complaints and relatives or representatives have access to this. This information is being updated. Staff are informed of the policies and procedures relating to adult protection matters and how to safeguard the health and welfare of people in the home. The manager and staff are familiar with the multi-disciplinary guidance and this includes arrangements for training to be appropriately renewed. Gatesgarth DS0000022574.V314957.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place for the general health and safety of people in the home and for their environment. EVIDENCE: Guidelines are generally followed regarding environmental health and fire safety. Specialist equipment is regularly serviced and the home has access to advice and guidance regarding environmental matters. People have their own bedroom and these are individualised and personalised. Arrangements are in place to upgrade and replace furnishings and the décor when needed. The flooring and décor in and around the shower room however, needs to be attended to. The arrangements in place to complete this work need should now be implemented as soon as possible. The doors leading to people’s bedrooms are showing signs of wear and tear and require upgrading, as do the door guards. Gatesgarth DS0000022574.V314957.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are very motivated and committed to meeting the comprehensive needs of people in the home. EVIDENCE: Staff are provided with a good training and development programme including their involvement and achievements in National Vocational Qualifications. Staff are well informed of the needs of people and certainly have great commitment to placing their needs first and provide them with life enhancing experiences New staff completed a programme of induction into the home and they are appropriately supervised during this. Their training needs are identified and they are supported and encouraged in their work. The home follows the recruitment procedures of Community Integrated Care. Staff had all the appropriate checks and references completed prior to taking up their post and all appointments are subject to a probationary period. There had been occasions when some staff had not received regular supervision. A programme has been implemented to correct this and will be regularly monitored by the registered manager. Gatesgarth DS0000022574.V314957.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from a service that places their personal need first and where they are valued as individuals. EVIDENCE: There are good systems in place that attend to and support the comprehensive needs of service users. These will be further enhanced when all care planning documents are up-to-date. Staff are generally focussed on meeting the needs of people and to seeking ways to enhance their lives. Community Integrated Care monitors the delivery of services and care and their operations manager carries out quality assurance checks on regular unannounced visits to the home. The Commission for Social Care Inspection is notified of the outcome of these visits. The registered manager also informs the Commission for Social Gatesgarth DS0000022574.V314957.R01.S.doc Version 5.2 Page 16 Care Inspection of important events that happen in the home. The home are developing and strengthening their methods of Quality Assurance. General health and safety matters are attended to. The records examined on the day of the inspection were however, well ordered and confidentially stored. Gatesgarth DS0000022574.V314957.R01.S.doc Version 5.2 Page 17 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 2 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 2 26 3 27 2 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 3 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 4 4 3 X 3 X 3 3 X 3 X Gatesgarth DS0000022574.V314957.R01.S.doc Version 5.2 Page 18 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. Refer to Standard Good Practice Recommendations Gatesgarth DS0000022574.V314957.R01.S.doc Version 5.2 Page 19 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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. 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