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Inspection on 09/03/06 for Gibraltar Road Nursing Home

Also see our care home review for Gibraltar Road Nursing Home for more information

This inspection was carried out on 9th March 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.

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

The standard of support and care offered at the Gibraltar Road houses is high, and each individual`s needs are met in the way they prefer. Independence is promoted and the staff make sure each person can pursue their own goals and take part in activities, which they choose and enjoy. Service users` healthcare is given a high priority and comments from a relative confirmed the excellent quality of health and personal care offered by the staff. The staff are well trained and motivated and all seemed very aware of each individual`s needs and preferences.

What has improved since the last inspection?

The medication administration system has improved and although a little more accuracy is needed, the systems used are safe and meet the guidance. The storage of frozen foods has now been improved and all the packages of food are now labelled with name of food and date of freezing. Opened food packages are kept sealed.

What the care home could do better:

The medication administration record sheets were not always signed by staff to show when a service user had been offered medication. The programme of redecoration and renewal of carpets could be speeded up. It has not progressed much since the last inspection in October 2005. The quality assurance system needs to be implemented and the results analysed and used to assist in further improving the quality of the services available.

CARE HOME ADULTS 18-65 Gibraltar Road Nursing Home 35 & 64 Gibraltar Road Halifax West Yorkshire HX1 4HE Lead Inspector Liz Cuddington Unannounced Inspection 9th March 2006 14:00 Gibraltar Road Nursing Home DS0000001052.V255501.R01.S.doc Version 5.1 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.V255501.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 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.V255501.R01.S.doc Version 5.1 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.V255501.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 9 service users accommodated between 35 and 64 Gibraltar Road, Halifax HX1 4HE Date of last inspection 31st October 2005 Brief Description of the Service: The houses at Gibraltar Road provide both nursing care 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. Gibraltar Road Nursing Home DS0000001052.V255501.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Over an inspection year from April until March, care homes have a minimum of two inspections; these may be announced or unannounced. This was the second unannounced visit to the home. There have been no further visits to the home until this inspection. One inspector carried out the inspection and spent approximately five hours at the home. The purpose of this inspection was to assess the home against a predetermined selection of the National Minimum Standards for Adults aged 18-65 years. The methods used in this inspection included conversations with five residents, one relative and four staff, examination of records, and a tour of the ground floor area of the house. This was a short inspection to assess the remaining key standards, which must be inspected during the year, and assess progress in meeting the two requirements and two recommendations from the last inspection. The other key standards were assessed at the last inspection in October 2005. Three good practice recommendations have been made following this inspection. This was a good inspection, which confirmed the high quality of care and support offered to the ladies and gentlemen who live at Gibraltar Road. I would like to thank everyone who lives, works and visits there for their welcome and hospitality during the inspection, and for taking the time to talk to me and share their views. What the service does well: The standard of support and care offered at the Gibraltar Road houses is high, and each individual’s needs are met in the way they prefer. Independence is promoted and the staff make sure each person can pursue their own goals and take part in activities, which they choose and enjoy. Service users healthcare is given a high priority and comments from a relative confirmed the excellent quality of health and personal care offered by the staff. The staff are well trained and motivated and all seemed very aware of each individual’s needs and preferences. Gibraltar Road Nursing Home DS0000001052.V255501.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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.V255501.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gibraltar Road Nursing Home DS0000001052.V255501.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2 & 3 were assessed in October 2005. None of the other standards were assessed at this inspection. EVIDENCE: Gibraltar Road Nursing Home DS0000001052.V255501.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7&9 Standards 6 & 8 were assessed in October 2005. Independence and choice is promoted and any risks are assessed and minimised. EVIDENCE: The people who live at Gibraltar Road are supported by staff, where needed, to make their own decisions about all aspects of their lives. An independent advocacy service is available if service users or their relatives would like the help of an advocate. Most people need some support with their finances and records show that this is done accurately. I saw evidence to confirm that the staff support people to achieve their goals, however straightforward or complex the goals are. Risk assessments were seen in the individual plans of care and support. It was clear that the home takes steps to minimise risks to service users, while still supporting people to maintain their independence with as few restrictions as possible. Gibraltar Road Nursing Home DS0000001052.V255501.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 & 17 were assessed in October 2005. None of the other standards were assessed at this inspection. EVIDENCE: Gibraltar Road Nursing Home DS0000001052.V255501.R01.S.doc Version 5.1 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Standard 20 was partially assessed in October 2005. Staff offer personal and healthcare support in accordance with service users wishes. People’s healthcare needs are well looked after and the medicines administration system has been improved. EVIDENCE: Everything that happens at the houses on Gibraltar Road is in accordance with the service users preferences. Any assistance needed with personal and nursing care, and movement around the home, is offered sensitively and the service users are treated with respect and consideration by the staff. If a service user needs any specialist advice or equipment it is made available. The individual plans document how the health care needs of each individual are being met. The evidence in the plans showed that the home’s healthcare practices meet the necessary standard and provide good outcomes for service users. The care offered to one highly dependent service user was seen to be of a very high standard. This was confirmed by the service user’s relative who visits regularly and praised the staff for the care and support they offered. The medicines administration systems were checked. Although there were some signatures missing from the record sheets, the rest of the records were Gibraltar Road Nursing Home DS0000001052.V255501.R01.S.doc Version 5.1 Page 12 accurate. Medicine stocks are checked and ordering records are accurately kept. Refresher training is available for all staff who administer medications. Gibraltar Road Nursing Home DS0000001052.V255501.R01.S.doc Version 5.1 Page 13 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): 23 Standard 22 was assessed in October 2005. Service users are protected by the policies and procedures of the home. EVIDENCE: There are robust procedures for handling any allegations or suspicions of abuse or neglect. The safety and protection of service users is promoted and given a high priority by the manager and staff. Gibraltar Road Nursing Home DS0000001052.V255501.R01.S.doc Version 5.1 Page 14 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 Standards 24, 29 & 30 were assessed in October 2005. The programme of re-decoration and the replacement of carpets has been started. EVIDENCE: The programme of refurbishment at 35 Gibraltar Road has begun but there is still work to be done to complete the re-decoration which is planned, and some carpets still need to be replaced. Gibraltar Road Nursing Home DS0000001052.V255501.R01.S.doc Version 5.1 Page 15 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 Standards 33, 35 & 36 were assessed in October 2005. Due to recent changes within the organisation standard 34 was not assessed this time. It will be assessed at the next inspection. Staff are knowledgeable about the service users’ needs and spend time with them. EVIDENCE: The staff at Gibraltar Road are offered a variety of training courses to keep their skills and knowledge up to date. They are supported to take professional qualifications. From my observations, and from talking to service users and staff, it is clear that the staff are aware of the needs of all the service users and how best to offer support. The staff always seem to have time to spend with service users and are able to respond to an individual’s changing needs. Gibraltar Road Nursing Home DS0000001052.V255501.R01.S.doc Version 5.1 Page 16 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 Standards 39 & 42 were assessed in October 2005. The home is well managed and staff follow safe working practices. The quality assurance system needs to be implemented. EVIDENCE: The registered manager is a qualified nurse and also has the experience and qualifications to manage the home. The quality assurance system the home is starting to use is based upon a model already used within Mayfield Trust. The home needs to implement it and use the questionnaires to gain feedback from all stakeholders. This can then be analysed and the information obtained will help support service quality improvements. During the inspection I observed the staff using safe working practices for moving and handling, infection control and safe storage of food. Staff are aware of fire safety procedures. The premises are well maintained and secure. Gibraltar Road Nursing Home DS0000001052.V255501.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 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 X 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 3 X Gibraltar Road Nursing Home DS0000001052.V255501.R01.S.doc Version 5.1 Page 18 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA20 YA24 YA39 Good Practice Recommendations When staff administer medication they must sign the record sheets for each dose offered. The programme for renewal of carpets and re-decoration needs to progress with minimal delay. The quality assurance system should be implemented and the outcomes analysed. Gibraltar Road Nursing Home DS0000001052.V255501.R01.S.doc Version 5.1 Page 19 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.V255501.R01.S.doc Version 5.1 Page 20 - 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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