Inspection on 07/12/05 for Gattison House

This inspection was carried out on 7th December 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.

Other inspections for this house

Gattison House 04/01/08

Gattison House 15/01/07

Gattison House 30/08/05

Gattison House 30/11/04

Gattison House 22/07/04

Gattison House 12/03/04

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

CARE HOMES FOR OLDER PEOPLE Gattison House Gattison Lane Rossington Doncaster DN11 0NQ Lead Inspector Ian Hall Unannounced Inspection 7th December 2005 08:40 X10015.doc Version 1.40 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 Gattison House DS0000032092.V268471.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 DS0000032092.V268471.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gattison House Address Gattison Lane Rossington Doncaster DN11 0NQ 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) 01302 864993 01302 866520 Doncaster Metropolitan Borough Council Mrs Norma Cooke Care Home 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 DS0000032092.V268471.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 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. Wheelchair dependent service users must be allocated private accommodation that has 12 square metres of useable floor space. To allow a 64 year old client respite care within the elderly mentally infirm unit. 30th August 2005 Date of last inspection Brief Description of the Service: Gattison house is a residential care home for both elderly service users and elderly mentally infirm residents above the age of 65; it is owned and operated by Doncaster Metropolitan Borough Council. The home can accomodate up to 18 elderly mentally infirm residents and up to 18 elderly residents; it also provides up to 6 day-care places. The day care service is neither registered nor inspected under existing legislation. Gattison House is a purpose built home. Access to the separate EMI unit is via the main house. There is level access throughout the home. All private accomodation is in single bedrooms. There are a range of seating areas that vary in size; two have their own sink units and tea and coffee making facilities. The enclosed gardens provide enjoyment, one having raised flowerbeds that are maintained with a variety of shrubs and flowers. Gattison House DS0000032092.V268471.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection took place over five and a half hours within the cycle of inspections for year 2005/6 and followed a risk assessment carried out with the CSCI risk assessment tool The emphasis of the inspection was placed upon meeting residents, relatives, visitors and the staff team. Areas of concern had been identified that were investigated during the inspection. The Officer toured the whole site to observe the redecoration and refurbishment that had been performed since the last inspection. The officer case tracked 3 resident’s files, and the records maintained. The final draft of this report was delayed to include the findings and recommendations of an investigation by the DMBC into concerns raised by former members of staff. The concerns were unfounded however management have responded promptly and positively to issues raised providing training for the staff team and amending documentation, policies and practise as required. 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 DS0000032092.V268471.R01.S.doc Version 5.0 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 DS0000032092.V268471.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Gattison House DS0000032092.V268471.R01.S.doc Version 5.0 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 the following standard(s): 1, 2, 3, 4, 5, 6. 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 DS0000032092.V268471.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9, 10. Residents and their families are involved in the social, physical and psychological care planning and provision. Staff were 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 DS0000032092.V268471.R01.S.doc Version 5.0 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 DS0000032092.V268471.R01.S.doc Version 5.0 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 the following 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. Opportunities for activities are limited by the minimum staff levels currently provided. 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. 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 DS0000032092.V268471.R01.S.doc Version 5.0 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. Gattison House DS0000032092.V268471.R01.S.doc Version 5.0 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 the following standard(s): Staff were confident and competent able to respond to concerns or complaints effectively. Former members of staff had highlighted a variety of concerns. A detailed and in depth investigation was undertaken by Management of DMBC. The investigation conclusion was that concerns were unfounded. However policies and procedures at the home were examined, amended appropriately with additional training being provided for staff. EVIDENCE: The Inspector discussed highlighted concerns with the manager and her senior staff team. The manager had already implemented positive changes to address the concerns. Additional training had been planned and the importance of the “whistle blowing” policy and procedure. Staff had received training in abuse recognition and prevention; this was to be repeated for the complete staff team. 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 DS0000032092.V268471.R01.S.doc Version 5.0 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 the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26. The home both appeared clean and smelled fresh. Staff work hard to both maintain and improve the residents environment. The authority has continued to redecorate and refurbish the home. 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. The Lounge area within the EMI Unit has been redecorated. 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 DS0000032092.V268471.R01.S.doc Version 5.0 Page 15 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following 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 with this ongoing situation, 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. Gattison House DS0000032092.V268471.R01.S.doc Version 5.0 Page 16 The DMBC policy and procedures for advertising, recruitment and time taken to offer employment continues to cause serious problems for the staff team providing a quality service. Basic needs are met. 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 DS0000032092.V268471.R01.S.doc Version 5.0 Page 17 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The Homes Manager’s enthusiasm and positive approach to elder care has clearly influenced the whole team and benefited service users. Service users personal finances had not all been regularly audited. Receipts had not been promptly returned and entered within the running total/records of some individual’s files. The system has been reviewed and positive changes implemented to avoid a repetition of this problem. DMBC must ensure that these accounts are externally audited annually as a minimum requirement. The Care Standards Act 2000 and its associated regulations require that DMBC must notify the CSCI of any event that may effect care and service provision promptly. 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. Gattison House DS0000032092.V268471.R01.S.doc Version 5.0 Page 18 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. Service users personal finances had not all been regularly audited. Receipts had not been promptly returned and entered within the running total/records of some individual’s files. The system has been reviewed and positive changes implemented to avoid a repetition of this problem. The Care Standards Act 2000 and its associated regulations require that DMBC must notify the CSCI of any event that may effect care and service provision promptly. This regulation was clarified during the Inspection. Gattison House DS0000032092.V268471.R01.S.doc Version 5.0 Page 19 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 2 2 Gattison House DS0000032092.V268471.R01.S.doc Version 5.0 Page 20 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 OP29 Regulation 18 Requirement The registered person must ensure that the DMBC employs adequate numbers of staff ( care staff, activities, housekeeping laundry, and catering staff) to meet the residents needs. The registered person shall maintain in respect of each service user up to date and accurate records of financial transactions conducted on behalf of the service user. The registered person shall give notice to the Commission without delay of any of the occurrences listed in regulation 37 and its subsections. Timescale for action 01/03/06 2 OP37 17 01/03/06 3 OP38 37 01/03/06 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 Gattison House DS0000032092.V268471.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster 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 DS0000032092.V268471.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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