Inspection on 08/08/06 for Gibraltar Road Nursing Home

This inspection was carried out on 8th August 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gibraltar Road Nursing Home 17/07/07

Gibraltar Road Nursing Home 09/03/06

Gibraltar Road Nursing Home 31/10/05

Gibraltar Road Nursing Home 23/02/05

Gibraltar Road Nursing Home 27/07/04

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

CARE HOME ADULTS 18-65 Gibraltar Road Nursing Home 35 & 64 Gibraltar Road Halifax West Yorkshire HX1 4HE Lead Inspector Liz Cuddington Unannounced Inspection 8th August 2006 3:00 Gibraltar Road Nursing Home DS0000001052.V299192.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 Gibraltar Road Nursing Home DS0000001052.V299192.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. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gibraltar Road Nursing Home Address 35 & 64 Gibraltar Road Halifax West Yorkshire HX1 4HE 01422 352418 01422 322552 linda.gibson45@ntlworld.com 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) Mayfield Trust Mrs Lynda Gibson Care Home 13 Category(ies) of Learning disability (13), Learning disability over registration, with number 65 years of age (13) of places Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 9 service users accommodated between 35 and 64 Gibraltar Road, Halifax HX1 4HE 4 service users accommodated between 334 and 336 Hopwood Lane, Halifax, HX1 4HE 9th March 2006 Date of last inspection Brief Description of the Service: The houses at Gibraltar Road provide both nursing and personal care to service users with learning disabilities. The houses are domestic dwellings, situated within the local community. Both the houses have accommodation over two floors. 35 Gibraltar Road has a passenger lift. The houses are on bus routes and are within easy reach of Halifax. There is ample on street parking near both houses. The weekly fees are between £384.78 and £391.45. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group, for example ‘Choice of Home’, and ‘Personal and Healthcare Support’. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers these outcomes to the people who use the service. The judgement categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded in the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk Over an inspection year care homes usually have one or two inspections; these may be announced or unannounced. One inspector carried out the site visits over three days, which lasted a total of nine hours. The methods I used to gather information included conversations with residents and staff, case tracking, examining records and touring 35 Gibralter Road. I also sent out questionnaires for residents and their relatives to complete. The purpose of this inspection was to assess a selection of the National Minimum Standards for Care Homes for Adults (18-65). I looked at twenty-four of the forty-three standards. At the last inspection in March 2006 I made three good practice recommendations and no requirements. One requirement and three good practice recommendations have been made been made following this inspection. Although there are still a few areas for improvement the home continues to make significant improvements. The outcomes for residents in two of the eight outcome groups were judged to be “excellent”. The remaining six groups were judged as “good”. This means that the overall judgement for Gibralter Road is “good”. I would like to thank the ladies and gentlemen who live at Gibralter Road, and all the staff, for their welcome and hospitality during the inspection. What the service does well: The care plans are clearly set out and show how each person’s needs are being met. Regular reviews are carried out. Staff are aware of each individual’s needs and preferences, which are respected and supported. Residents’ privacy and dignity is maintained. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 6 Visitors are welcomed to the home. Residents and their relatives confirmed that the care and support they receive from the staff at Gibralter Road is very good. They spoke highly of the staff and the welcoming atmosphere in the home. My own observations of the interaction between residents and staff confirmed this view. The progress made in improving the health of residents, supported by comments made to me, confirm my own observations that the healthcare offered to the people at Gibralter Road is of a high standard. All the comments I received from relatives and residents spoke highly of the care and support offered by the staff. One person wrote that they felt their relative was “getting the best of care from all at Gibralter Road”. Another relative said how pleased they are with the way their relative is looked after. Residents confirmed that their choices and wishes are respected. One person said that they are supported in anything they wish to do and that they are treated with dignity and respect. The meals are good and varied and any assistance needed is offered discreetly, following the pace of the resident. Residents and relatives are aware of how to make a complaint. The home has suitable adult protection policies and procedures. The staff are well qualified, with seven of the fifteen care staff having achieved a recognised care qualification. The manager is also sufficiently qualified and experienced to run the home effectively. Enough staff are employed to meet the needs of the residents and the home. Criminal Records Bureau (CRB) checks have been carried out for staff. What has improved since the last inspection? Improvements to the décor and furnishings have been started since the last inspection. The new carpet and paintwork looks very nice. Staff are now signing on each occasion, to confirm that a dose of medicine has been given. A quality assurance system has been adopted and is being put into practice. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 7 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. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 8 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 Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using the available evidence, including a visit to the service. All necessary pre-admission assessments are carried out. EVIDENCE: Calderdale Social Services pre-admission assessments are carried out for new residents. The manager and staff work hard to make sure they can meet the needs of someone who is moving into one of the Gibralter Road houses. One person confirmed that they had visited the house before deciding to move in. As these two houses offer nursing care there is a registered nurse on duty at all times. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is excellent. This judgement has been made using the available evidence, including a visit to the service. The care plans detail each individual’s needs and how any changes are to be met. The daily records reflect the plans and record significant events. EVIDENCE: Each resident has their own detailed care and support plan showing exactly how each person wants their needs to be met. The plans also reflect the individual’s changing needs and clearly show how they are to be supported. The plans show that the resident is fully involved in making any decisions about their care and support, their goals and how they like to spend their time. I looked in detail at three plans. They all included a ‘futures’ plan which had written information, illustrations and charts of the person’s life, goals, likes and dislikes, as well as the important people and things in their life and an action plan. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 11 How these choices and decisions had been reached was clearly shown. The plans also showed how people managed their finances and the amount of support they may need. The plans included risk assessments. A new format has been developed but the information has yet to be transferred. Each resident has a daily record book, which the staff complete. This shows significant events of the day and reflects the actions agreed in the care plans. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using the available evidence, including a visit to the service. The residents are supported to lead active and interesting lives. They maintain their independence and freedom of choice. People’s privacy and dignity is respected and the meals are good, with discreet assistance offered where needed. EVIDENCE: The individual plans show how people want staff to support them to follow their choice of daily activities. People choose to go out individually, with staff such as Outreach Workers, or with other people. Some of the people who live at Gibralter Road told me what they had been doing that day. Everyone had recently been away on holiday to places they had chosen. One resident took me around the garden at number 35. She showed me what they had been doing and the improvements they had made. The garden has a productive fruit and vegetable area as well as lawns, flowerbeds and a patio. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 13 The individual plans detail the goals each person wants to achieve. I was told by some of the residents how they were achieving their goals, which are often different every month. The daily records also confirm their progress. Where they want them to be involved, the resident’s family and friends are part of the person’s daily life. The plans show how the staff support the residents to maintain contact with their families and friends. Comments made to me by residents and staff, and my own observations, confirmed this. During the two visits I made to Gibraltar Road it was clear that staff respect and maintain the residents’ privacy, dignity and choice. All the bedroom doors have locks, which some people choose to use. My own observations confirmed that people are completely free to choose to spend their time alone or in the company of others. The residents are involved in deciding what meals they will have. Everyone seemed to enjoy their dinner and where assistance was needed the staff offered assistance discreetly and at a pace to suit the resident. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using the available evidence, including a visit to the service. Independence is promoted and any adaptations and advice needed are obtained. Residents’ healthcare is given a high priority and any necessary equipment and mobility aids are available. Medication is securely stored and accurate records are kept. The stock and ‘brought forward’ records are not always consistently kept. EVIDENCE: Promoting independence is the primary concern of the staff when they support the residents’ different mobility needs. The home obtains any specialist advice that is needed and there are adaptations around the house, such as grab rails and a hoist, to help people. The plans I looked at included completed OK Health checks. Each person’s health is monitored and records of healthcare appointments and the outcomes are kept. Any changes are noted in the person’s care plan and the staff I spoke to knew how to meet residents’ health needs. I saw and heard evidence of improvements in residents’ health brought about with considerable input from the staff at Gibraltar Road. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 15 The medication is securely stored and the records of medicines received and administered are accurate. The ‘brought forward’ systems for any medicines still being used when the next recording chart is started are not always consistent. Details of quantities of most of the medicines in stock are kept on separate sheets, although some are recorded on the Medicines Administration Record (MAR) chart. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using the available evidence, including a visit to the service. There are suitable complaints and adult protection procedures in place. Most residents and relatives know how to make a complaint. EVIDENCE: The information about making a complaint is in the home’s policies and procedures. It has also been written in straightforward language, with illustrations, to make the information more accessible to residents. There is a hardback complaints recording book for details of any complaints received. Most relatives and residents said in the questionnaires I sent out that they knew how to make a complaint if they needed to. The home has adult protection and ‘whistle blowing’ policies and procedures in place. All the policies and procedures were reviewed in April 2006. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 29 & 30 Quality in this outcome area is good. This judgement has been made using the available evidence, including a visit to the service. The programme of refurbishment is underway. High standards of cleanliness and hygiene are maintained. Adaptations to support independence are fitted unobtrusively. EVIDENCE: During this inspection I only visited number 35 Gibraltar Road. The house is clean and comfortably furnished. Since the last inspection in March 2006 new carpets have been laid in the hallway and good progress has been made on the re-decoration work. One of the lounges, the hall, stairs and some other parts of the house have been painted and the overall appearance is much improved. Residents and staff told me that new carpets have also been fitted at number 64 Gibraltar Road. There is a shaft lift at number 35 and all the communal rooms are accessible to wheelchair users and others who need extra space for mobility. None of the adaptations to support independence and safety are obtrusive. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 18 The laundry has a washing machine with an integral sluice programme. The house is hygienically maintained throughout. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using the available evidence, including a visit to the service. The staff are motivated and knowledgeable. Individual supervision is taking place. The recruitment and training files need to be kept up to date. The support staff have almost reached the minimum standard of 50 who have a relevant qualification. EVIDENCE: Each time I visited there were sufficient staff on duty to meet the needs of the residents and the home. The staff mix includes nurses, support workers and outreach staff. Everyone I spoke with showed an excellent understanding of the needs and wishes of the residents. The interaction between residents and staff was friendly, open and relaxed. Seven of the fifteen support staff have achieved a National Vocational Qualification (NVQ). The staff recruitment files are held centrally. When I examined a selection of them some did not have sufficient, suitable references. Since this applies to long-serving members of staff it is not possible to put this right now. A more recently recruited staff member had a complete file, with application form and references. All the files showed that Criminal Records Bureau (CRB) checks had been completed. Two of these were obtained in 2004, before the Protection of Vulnerable Adults (POVA) register checks were introduced. The organisation is Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 20 looking into updating the CRB checks, which will then include POVA checks. They are also in the process of updating all the staff files to make them easier to use. The staff training and development files are kept at the home. They include a training and development plan, but these had not all been kept up to date. A senior member of staff told me that the moving and handling and other mandatory training was soon to be updated. There were some certificates and records in the files, although they did not appear to contain information about all the training staff had completed. The staff files held at the home showed that individual supervision sessions are taking place between staff and their line manager. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using the available evidence, including a visit to the service. The home is managed by a qualified and experienced manager. The quality assurance system has been implemented, but needs further development and analysis in order to gain more in depth information. Health and safety and good hygiene practices are in place. EVIDENCE: The registered manager is a qualified nurse and has the experience and qualifications needed to manage the home effectively. Since the last inspection a quality assurance system and quality manual have been developed. This includes feedback questionnaires for visitors and carers. There is also a satisfaction questionnaire for residents, which is illustrated and written in straightforward language. More of these need to be completed to gain a wider picture of the residents’ views. We discussed extending the survey to the staff and other stakeholders. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 22 During the inspection I noticed that staff were using safe moving and handling practices. The kitchen is clean and food is stored and prepared safely. The premises are well maintained and safe. The training files showed that staff had undertaken fire safety training. The fire safety officer had recently visited the premises. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 23 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 X 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 X 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 24 NO 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 YA34 Regulation 19 & Schedule 2 Requirement All staff files must show that sufficient suitable references and other pre-employment checks have been carried out. Timescale for action 31/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA20 YA32 YA35 Good Practice Recommendations Records of medicines in stock and amounts ‘brought forward’ need to be consistent in order to promote accuracy. More staff need to complete a suitable NVQ course in order to meet this standard. The staff training and development files need to be kept up to date. Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Gibraltar Road Nursing Home DS0000001052.V299192.R01.S.doc Version 5.2 Page 26 - 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. 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