Inspection on 09/05/06 for Gernon Manor

This inspection was carried out on 9th May 2006.

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 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

Gernon Manor 25/07/07

Gernon Manor 28/09/05

Gernon Manor 14/06/05

Gernon Manor 25/01/05

Gernon Manor 11/05/04

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

CARE HOMES FOR OLDER PEOPLE Gernon Manor Dagnall Gardens Haddon Road Bakewell Derbyshrie DE45 1EN Lead Inspector Denise Bate Key Unannounced Inspection 9th May 2006 09:15 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 Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 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. Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Gernon Manor Address Dagnall Gardens Haddon Road Bakewell Derbyshrie DE45 1EN 01629 788411 01629 778419 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) Derbyshire County Council June Richardson Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th September 2005 Brief Description of the Service: Gernon Manor was built in 1980 and is a care home with 33 places, registered to accommodate older people. This Derbyshire County Council home provides permanent care, short-term care and day care. It is situated close to the centre of Bakewell and accommodation is provided on one level with 33 single occupancy bedrooms. All bedrooms are equipped with washbasin, built in wardrobe, TV point and a link to the call system. There are several lounge and dining areas. The home is set around a pleasant enclosed garden area, which is easily accessible. Services include personal laundry, meals, and personal care designed to meet individual needs. A range of leisure and social events are organised. Fees are £364 per week for permanent service users, but a range of prices for short term care service users. Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over six hours. During the inspection 7 service users, 2 relatives, and 2 staff members were spoken with. The manager was present throughout the inspection and provided assistance and information. Written information was provided prior to the inspection. A tour of the part of the building took place. A number of records were examined, including risk assessments and care plans, health and safety documentation, staff files, medication records and Regulation 26 visit records. An assessment was also made of the progress by the registered persons to address requirements made at previous inspections. Four service users were case tracked. What the service does well: What has improved since the last inspection? Care planning documentation has improved significantly and the service development plans were very good. New staff have been recruited and have undergone induction training. Some decoration has taken place and new furniture, carpets and curtains purchased for communal areas. Progress is being made in NVQ2 training levels with further staff due to commence training later in the year. Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 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. Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 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 Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home have a system for assessing residents’ needs to ensure that the care provided can meet residents’ needs appropriately. EVIDENCE: Assessments are carried out in the community by social workers and care managers. Potential new residents are invited to spend a day at the centre with their relatives, and this visit is used to verify assessment information, provide the service user with information and choice, and undertake any further assessments. Service users and relatives confirmed that they had been given written information about the home and visited prior to admissions. The home does not provide an intermediate care service and standard 6 is therefore not applicable. Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans relating to personal and social care needs of residents are detailed. Residents are encouraged and supported to be independent and to exercise choice in all aspects of the home and are treated with dignity and respect. This contributes to the enhancement of residents’ everyday lives. EVIDENCE: All case tracked residents had detailed personal development plans, monthly updates, daily logs, daily routines and various risk assessments, monthly summaries, and monitoring forms e.g. detailing activities, contact with relatives and one to one time spent between service users and key workers. Information recorded on care plans was presented clearly and was informative. Residents had signed documentation indicating that care plans had been discussed with them. Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 Page 10 The administration of medication was inspected and records found to be up to date. The home has a separate medication room with the medicines trolly, fridge and controlled medication cupboard. Night staff have not been trained in the administration of medication, but the inspector was informed that all medication is administered by suitably trained staff before they leave; that night staff have been trained in house in administering and recording homely remedies; and that no pre-dispensing takes place. Some service users are able to administer their own medication, which is kept securely in their rooms. Service users spoke very positively about staff and said they were treated with dignity and respect. Confirmation was given that they are given choice and are able to follow their own routines. Information about likes and dislikes, and preferred routines is recorded on personal development plans. The home have an equal opportunities policy and staff and the manager had an understanding of disability and gender issues. Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities are provided that generally suit the expressed preferences of residents. Regular outside contacts are encouraged and supported. This assists in contributing to a pleasant atmosphere and the overall high level of satisfaction for residents. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets residents’ tastes and choices. EVIDENCE: Regular activities include ‘First Taste’, outings in the summer, in house entertainment, bingo, crafts, film nights, and some residents attend local clubs in the town. Service users interviewed reported that they felt the home provided some suitable activities and catered for their interests, although this area had been highlighted for development by the quality assurance exercise. Several people commented that there was very convenient access to the town which was beneficial. There is a section in the care planning documentation that details service users involvement in activities. Appropriate staffing levels are seen as crucial in enabling this development of in house activities. Some Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 Page 12 service users prefer to spend time on their own, and this is respected. There is a regular residents meeting and the minutes of the last meeting were made available. This was well attended and indicated that service users were given the opportunity to give their views on a variety of topics relating to the day to day running or the home. The home have well established contacts with the local communities, including local churches and chapels. Several service users confirmed that they were able to attend local religious services and they greatly appreciated these opportunities. There are a variety of local clubs that service users attend on a regular basis. Service users indicated that they feel staff are approachable and any problems can be discussed with them or with one of the managers. All indicated that they are able to exercise choice about aspects of their daily lives. Service users spoken to were generally complimentary about the standard of catering, and the choice of menus that are available. Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 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): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are systems in place which promote the protection of residents from abuse and neglect. A complaints procedure is in place. EVIDENCE: There is a complaints procedure in place, although most relatives and service users prefer to raise issues on a more informal basis. Several examples were given by service users and relatives of how problems had been dealt with promptly and appropriately. The manager and staff are viewed as approachable and responsive. One complaint issue was discussed with the inspector. A discussion took place with the manager, who is aware of adult protection issues. Staff have had training in adult protection. Staff spoken to showed an awareness of adult protection issues and would pass any concerns on to their line manager. Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 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, 21, 24, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Apart from the bathroom and laundry area, the home was suitable for its stated purpose and generally provided a comfortable, homely environment for residents. However, the delay of the improvements to the home has adversely affected the facilities offered to residents. EVIDENCE: The building provides service users with a comfortable and homely place to live with a variety of communal spaces situated in the front area of the building, offering a choice of seating arrangements for residents. The building has continued to be generally maintained to a good standard overall, and the decoration and refurbishment of the lounge and dining areas is attractive and comfortable. Some minor redecoration is needed as part of a rolling programme. Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 Page 15 Bedrooms were personalised according to service users preferences. Some improvements may be made in due course to the built in wardrobes. Refurbishment of one bathroom and the laundry area have been outstanding requirements for some time. Work on the bathroom was due to commence a few days after the inspection to turn it in to a shower room. There is no date yet for the refurbishment of the laundry area. As this is now a major refurbishment an extended timescale was agreed. The home have been asked to inform CSCI in writing when these improvements have been carried out. The outside garden area is accessible to service users, several of whom have expressed an interest in planting flowers, etc. which will be done with the assistance of staff. Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 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 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A trained and competent workforce are in place which meet the dependency needs of service users currently accommodated within the home. EVIDENCE: The staff rotas were discussed and found to provide adequate staffing to meet service users’ needs at the current time, although staff were often very busy. New staff have been recruited and plans are in place to recruit more relief staff. Continued vigilance will be needed to ensure that staffing levels continue to meet service users’ needs as current service users become more dependent and the home’s occupancy levels rise. It is anticipated that staffing rotas will be looked at again at future inspections. The manager said that generally staff worked constructively together and new staff had integrated well. Staff spoken to were responsible and competent, and were observed being responsive to service users’ needs. There is generally a team approach to work. Staff said they feel well supported by both their colleagues and their managers. Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 Page 17 Staff files seen had evidence of CRB checks, copies of contracts and references. Derbyshire County Council has a thorough and detailed recruitment and selection procedure. Discussion with staff indicated that they felt they were offered good training opportunities and all staff spoken to were keen to make use of these. Some staff are in the process of trained to level NVQ2 and it is anticipated that the target level of 50 will be reached early in 2007. New members of staff felt well supported and had had detailed induction training. Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 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 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): 31, 32, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager provides clear leadership throughout the home with staff demonstrating an awareness of their roles and responsibilities ensuring that the home is run in the best interests of the residents. EVIDENCE: Service users and staff spoke positively about the manager and the management team. The unit manager has overall responsibility for the planning and development of the home. Three deputies have responsibility for daily operations and have their own areas to manage with regards to staff supervision, care planning and development, activities, and ‘hotel’ Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 Page 19 management. This is a relatively new management team with one deputy only recently appointed. The manager has a clear programme of consolidation and improvement based on the results of the quality assurance programme and requirements and recommendations made at previous inspections. The home is visited regularly by a representative of the registered person and Regulation 26 visit reports were made available to the inspector. These indicated that matters of day to day management are dealt with, and service users and staff spoken to on a regular basis. There had been a quality assurance exercise which indicated that the majority of elements of the service provided at Gernon Manor had been rated as good or excellent. The results of the survey had been made available to service users, and had been put on tape for service users with sight problems. Areas for improvement had been clearly identified, as referred to earlier in this report, and these matters had been incorporated into plans for the coming year. The inspector was informed that the home has a computerised system for managing residents’ finances, which appears to work satisfactorily. Information on a variety of health and safety records was provided and found to be satisfactory, apart from there being no up to date 5 year electrical hard wiring certificate. Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X x 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 Standard No Score 16 3 17 x 18 3 3 X 2 X X 3 X 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 X 3 X x 3 Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 Page 21 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 OP21 Regulation 13(3) Requirement The second bathroom on Lathkill wing must be upgraded and CSCI informed of completion. (Previous timescales of 31/08/05 and 28/02/06 not met). The wall finish in the laundry must be readily cleanable (washable paint peeling) and CSCI informed of completion.. (Previous timescales of 31/08/05 and 28/02/06 not met). An up to date electrical hard wiring certificate must be made obtained. Timescale for action 28/07/06 2 OP26 13(3) 28/10/06 3 OP38 32 (2) (b) 28/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP38 Good Practice Recommendations There should be training dedicated to the subject of infection control, including MRSA prevention and containment measures. Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 Page 22 2 3 4 OP27 OP12 OP28 More relief staff should be recruited to ensure staffing levels remain appropriate to meet service users needs. The activities, entertainment and outings programme should be developed further. Progress should continue to be made to meet the target of 50 staff trained to NVQ2 Gernon Manor DS0000035737.V290396.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. 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