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Inspection on 30/08/05 for Gattison House

Also see our care home review for Gattison House for more information

This inspection was carried out on 30th August 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 but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users were clearly the focus for the whole staff team; who all demonstrated good interpersonal skills. Service user care needs were clearly known and anticipated; interactions were conducted both skilfully and professionally. Staff were busy occupying and involving service users in decision-making. Staff were heard and observed to offer individual service users choices, of meals, drinks and activities. The Staff group were enthusiastic and positive, keen to develop the care and services provided, and to personally train and develop their knowledge and skills.

What has improved since the last inspection?

The Authority has continued with the programme of updating and refurbishing the premises. The progress is however slow. Visitors and residents whose rooms had been redecorated and refurbished were happy with the outcome and having choice in colours used.

What the care home could do better:

DMBC`s restrictive policy and the poor management of the recruitment and appointment of staff is presenting serious problems for standards of care at the home. Vacancies often are unfilled for periods of up to 6 months. This is limiting the care staff abilities to provide more than basic care. Resident`s activities, outings, holidays and individual time with care staff have been severely restricted or are no longer provided. Staffs training opportunities have been restricted as they "cover" the vacancies by working many additional hours to provide care and support their colleagues. This has serious implications for the care of residents and the well being of the staff team. The catering and house keeping services continue to be compromised by lack of permanent staff. DMBC must ensure a timely and effective response to recruit and employ staff to meet "Residents Care Needs" and improve their quality of life in accordance with The Care Standards Act 2000 and Regulations. The bathing and toilet facilities are in need of updating and upgrading since they were installed in 1981, they are worn and the needs of the user group have changed.

CARE HOMES FOR OLDER PEOPLE GATTISON HOUSE GATTISON LANE DONCASTER SOUTH YORKSHIRE DN11 0NQ Lead Inspector Ian Hall Unnanounced 30 August 2005 08:30 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 Older People. 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. GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service GATTISON HOUSE Address Gattison Lane, Gattison Lane, Doncaster, DN11 0NQ 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) 01302 864993 01302 866520 Doncaster Metropolitan Borough Council Mrs Norma Cooke Care home only 36 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (18) of places GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Support for a variety of day care centres must not impact on the staffing needs of Gattison House. There must be no removal of staff from rota. 2. Wheelchair dependent service users must be allocated private accommodation that has 12 square metres of useable floor space. 3. To allow a 64 year old client respite care within the elderly mentally infirm unit. Date of last inspection 30-Nov-2004 Brief Description of the Service: Gattison House is a care home offering personal care and accomodation for thirty six older persons. This total includes a maximum of eighteen persons who have mental health needs that include dementia. The home is owned and managed by Doncaster Metropolitan Borough Council. The home is located in Rossington a village approximately six miles from Doncaster. It is readily accessed by a frequent bus service. There are shops, a post office and a public house nearby. The home is a single storey building set within its own grounds with a car park at the front. Additionally there is ample on street parking available to the front of the home. All residents are accomodated in single bedrooms. The home is divided into two distinct areas providing care for elderly persons with residential care needs and mental health needs. Both areas are accessed via the main entrance from Gattison Lane. There is a choice of both lounge and dining areas. The home has landscaped gardens, the rear gardens are fully enclosed with lawned areas, shrubs and flowers. GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection took place over 7 hours and was the first of the cycle of inspections for year 2005/6 and followed a risk assessment carried out with the CSCI risk assessment tool It was the Inspectors first visit to the home; consequently an emphasis was placed upon meeting residents, relatives, visitors and the staff team. The Officer toured the whole site to understand the range of services provided there. The officer case tracked 3 resident’s files, and the records maintained. The conditions of registration in regard to item 1 and 3 no longer apply and will be removed in due course by the Commission. What the service does well: What has improved since the last inspection? The Authority has continued with the programme of updating and refurbishing the premises. The progress is however slow. Visitors and residents whose rooms had been redecorated and refurbished were happy with the outcome and having choice in colours used. GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 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. GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3, 4, 5. Residents and their advocates are involved in choosing the home. The management clearly consider the needs of others residing at the home when making this assessment; thus ensuring that all existing and prospective residents needs are met. EVIDENCE: Case records examined contained copies of individual service user care assessments, plans and written contracts stating terms and conditions. Visitors and residents confirmed that they had been involved in the choice of care home and were aware of the facilities and care that would be provided by Gattison House. Intermediate Care is not provided at Gattison House; respite care is provided following assessment and by arrangement with the Manager GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10. Residents and their families are involved in the social, physical and psychological care planning and provision. Staff are demonstrably focussed upon meeting residents needs and those of their family members. Access to health care professionals and health care services is provided for the benefit of residents. Staff interactions with service users were skilful, professional and with obvious empathy for the individual concerned. EVIDENCE: Care records of 3 service users were inspected; they contained individual “needs” assessments and plans for staff to follow to meet the identified needs. The records were maintained correctly, describing the service users response to the care and services provided. Changes to plans and reassessment of physical and psychological needs were ongoing. None of the service users were responsible for their own medication although the facility to enable this is in place. Staff had received additional accredited GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 10 training for the administration of medicines. Staff were observed dispensing medications and assisting service users to take them. Service users and visitors to the home confirmed that staff were caring and helpful and that nothing was too much trouble, they were always willing and keen to help. GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15. The Manager and her team continue to work hard to provide a homely, welcoming and inclusive care setting. The residents are encouraged and enabled to exercise choice in their lives. Links with the Community are positively encouraged and facilitated. EVIDENCE: Service users had a choice of midday meal and snacks. Staff were observed to assist and encourage appropriately. The “diets” have been compiled with the assistance of the dietician, special diets were available for those persons requiring that service. Service users and their visitors confirmed that nourishing drinks and fluids were provided throughout the day and night time if needed. The home has had a vacancy for a cook for six months. Care staff (with Food Handling Qualifications) have worked many additional hours cooking for residents. There were numerous visitors to the home throughout the day, they confirmed that they were able to visit at any reasonable hour and that shift workers could visit at other times by arrangement. GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 12 The home does not employ an activities organiser. Staff, undertake activities when staffing levels permit. There have been few opportunities for staff to accompany residents to places of local interest. Staff had given up their own time to fund raise and celebrate events such as VE day. GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16. Staff were confident and competent able to respond to concerns or complaints effectively. EVIDENCE: Visiting relatives and some residents were able to describe how they would raise concerns with staff. They stated that any matters raised however trivial they may seem were acted upon promptly by staff and that they were satisfied. GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26. The home both appeared clean and smelled fresh. The staff, work hard to both maintain and improve the residents environment. EVIDENCE: Service users and their visitors expressed their overall satisfaction with the cleanliness and maintenance of the home. Individual day areas and bedrooms appeared both homely and comfortable. A number of bedrooms continue to require redecoration and replacement of carpets and armchairs that show evidence of wear. Two bathrooms have been updated and refurbished, the remaining bathing facilities require updating to meet the changing needs of the service user group. Crazed tiles within the pantry area make cleaning difficult. GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 15 The Lounge area within the EMI Unit requires redecoration. Dining tables and chairs require upgrading. Armchairs are all the same height and size, this does not meet the individual needs of residents, Physiotherapy and Occupational therapy assessments must be undertaken to ensure equipment meets residents needs. GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28,29, 30. The staff group are a well-motivated and positive team. Their commitment and support for residents and fellow team members continues to be stretched and tested by the persistent failure of DMBC to fill staff vacancies in a timely manner. EVIDENCE: The staff group were well motivated and enthusiastic about their work. They confirmed that they were well supported by the manager and encouraged to train and update their skills. This has been difficult for the manager and her staff to achieve due to the number and persistent ongoing staff vacancies. Recruitment problems have caused Gattison House to be reliant upon the care team to work many hours in excess of their contracted hours. The prolonged period and number of vacancies has a detrimental effect upon staff morale. The dependency level of the current service user group and their needs has continued to increase; this has placed additional pressures upon staff. Staff are unable to meet much more than basic care needs. Holidays, days out, one to one quality time is seriously restricted. Staff are clearly unhappy and disappointed, they are keen to improve the standards of care and service offered. There is no Activities Person employed, this is a key component of maintaining independence and personal skills. The DMBC policy and procedures for advertising, recruitment and time taken to offer employment continues to cause serious problems for the staff team GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 17 providing a quality service. Basic needs are met. Care staff work in the kitchen cooking due to a long term recruitment problem. Advertising is slow to initiate, it is limited to one monthly local authority free paper and the internet. It does not adequately specify the place of employment, role/job description, hours, terms and conditions. Periods in excess of six months to fill a vacancy are not unusual. GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, 37, 38. The Homes Manager’s enthusiasm and positive approach to elder care has clearly influenced the whole team and benefited service users. The staff had performed risk assessments to identify areas of concern and maintain user safety. The building although in need of improvements was a “happy” care environment. EVIDENCE: The management Team had recently been strengthened by the appointment of a shift manager. Responsibilities are shared between the senior members of the team. Visitors to the home remarked that they had ready and easy access to management and were confident in them. There is always a senior member of staff on duty at the home, with advice and support readily available. The Gattison House management team are responsible for the Day Care provision. This is not registered or inspected by the CSCI. GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 19 DMBC has failed to advertise and recruit catering, housekeeping and care staff to respond to the needs of service users. GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 1 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 x 3 3 3 x x 3 2 2 GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 21 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 25 Regulation 23 Requirement The registered person should upgrade and refurbish the identified bathroom facilities The registered person must redecorate and refurbish the lounge and corridor areas on the EMI wing The registered person must employ sufficient numbers of catering and domestic staff to meet residents needs, previous deadlines 1st November 2004, 1st April 2005 The registered person must ensure that the DMBC employs adequate numbers of staff, care staff, activities staff, housekeeping, laundry and catering to meet the service users care needs. Timescale for action 1st April 2006 1st April 2006 2. 25 234 3. 27 18 1st October 2005 4. 29 18 1st October 2005 GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 22 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 Good Practice Recommendations GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 23 Commission for Social Care Inspection First Floor Barclay Court Heavens Walk Doncaster South Yorkshire DN4 5HZ National Enquiry Line: 0845 015 0120 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 GATTISON HOUSE 20050830 Gattison House X00015 UI Stage 4 S32092 V186913 J55.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!