Random inspection report
Care homes for adults (18-65 years)
Name: Address: Gilby House Care Home High Street Winterton Scunthorpe North Lincolnshire DN15 9PU two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Wilma Crawford Date: 1 9 0 5 2 0 0 9 Information about the care home
Name of care home: Address: Gilby House Care Home High Street Winterton Scunthorpe North Lincolnshire DN15 9PU 01724734824 01724734824 info@prime-life.co.uk info@prime-life.co.ukwww.prime-life.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Prime Life Ltd care home 22 Number of places (if applicable): Under 65 Over 65 1 mental disorder, excluding learning disability or dementia Conditions of registration: 22 One named service user over the age of 65. This individual can continue to be accommodated in the home until there is a change in their individual circumstances which means the home can no longer meet their assessed needs. Date of last inspection Brief description of the care home Gilby House is registered to provide nursing care to adults who experience mental health problems. The home is a converted Victorian building in the centre of the village set in its own grounds The home is situated in Winterton, a village close to Scunthorpe. Its location gives service users good access to local shops, pubs and other facilities within the village community. There is also a regular bus service into the town of Scunthorpe. The home has a web site and email address that has been included in this report.
Care Homes for Adults (18-65 years) Page 2 of 10 What we found:
There was evidence in peoples care records to confirm that their needs are properly and thoroughly assessed prior to being offered a place in the home. Individual care plans are detailed and outline the level of support that care each person requires in ensuring their health and welfare needs are being met and reviewed. All people spoken to confirmed their satisfaction with the care and services provided by the home. Comments from individuals included The staff are all lovely and kind, Im very pleased with the care and Im very happy here, the staff are wonderful and always have time for us. During the visit, systems for the storage and administration of medications within the home were checked, this showed that safe systems are in place. Discussions with people, observation and checks on records show that people are able to make their own choices about how they spend their time and are offered a range of activities. Mealtimes at the home were observed to be a positive experience and many people told us how much they enjoy the meals and that there is always a good choice. If people have concerns with their care, they or people close to them know how to complain. People spoken with told us that the staff and management are very approachable. Improvements need to be made to ensure that people are offered a good standard of environment.The financial procedures in the home are not being followed, meaning that peoples finances are not safeguarded, nor are the staff who have responsibility for the finances.There were sufficient numbers of staff on duty at the time of this inspection to meet the needs of the people living in the home. Discussions with staff and evidence from records identify that staffing numbers are regularly reviewed in line with any changes in dependency levels. All staff spoken with said that they now receive regular supervision and regularly meet up with their manager to discuss ways of working, checks of records confirmed this. Checks on staff files show that the recruitment procedures in place promote the protection of people who use the service. What the care home does well: What they could do better:
A random inspection was completed on 08/07/2009 to establish if the sytems were in place to ensure the monies of people living in the home were being managed effectively
Care Homes for Adults (18-65 years) Page 3 of 10 and safeguarded. Arrangements had been made by the organisation that only the two named nurses, with support from the manager and administrator from Stoneleigh (a sister home), had responsibility for all financial transactions within the home. However, on the day of the visit the nurse in charge, was unable to explain the system fully and follow this through. She was also unable to access either manual or computerised financial records for the people living in the home.There were no individual records available to record personal expenditure. A large number of cigarettes had been purchased for communal use, but there were no details of whom these had been charged to. Monies were held jointly, so that the balance of individuals monies could not be determined. An attempt was made to contact the manager of Stoneleigh and the Administrator, neither of whom was available on that day. The company accountant was then contacted, who explained that they would be visiting the home the next day, to reconcile the accounts and complete a paper recording system for the nurses to use. Fortnightly visits were being made by the accountant and on all but one of the visits the monies in the home had reconciled. The inspector raised all of the issues that had been found and explained that the current systems did not demonstrate that individuals finances were being managed safely. The company accountant said that they would ensure there was a complete paper system in place by the end of the next day. A further visit to the home was made on 10th July 2008, and found: Individual finance sheets and wallets containing bankcards and receipts were in place for each person living in the home. Details of all transactions made and when the person had been given their card to withdraw monies were in place, with recorded dates and signatures of both the nurse and the person. A full written procedure was available for the nurse to follow, giving clear instructions for dealing with the cash and detailing their own responsibility when managing and recording financial transactions. All transactions for each individual were detailed (with accompanying receipts), including which individuals had been invoiced for cigarettes (the cigarettes were also labelled). The monies held in the home were counted and found to balance to the records maintained and available. The only bankcards kept in the home and managed by the nurses were for four people who managed their own finances, but kept their bankcards in the safe for safe keeping. A balance of finances was made at each shift handover by the two nurses and signed for. Those arrangements were considered to be satisfactory at that time. The inspection visit on 19/05/2009 found that a record of monies and cigarettes taken by any individual was in place between the dates of 15/05/2009 to 19/05/2009, the nurse on duty stated that the company accountant would then charge the individual for the cigarettes at the next audit visit. The accountant had made an audit visit on 07/05/09. This inspection visit found no record of individuals monies available within the home and only statements for a joint bank account, into which all finances were made. There was no way of establishing whether people had adequate monies in their account to allow daily withdrawals of money or if the monies they were withdrawing, belonged to other people living in the home. When the nurse was asked if they would be able to give information to someone living in the home or their relative, about how much money they had available on that day, they replied no. They were also unable to say how much money was being held in the home for people, as no records of daily transactions in the home or a daily reconciliation of monies were being maintained. Only one person has a lockable facility within their room to store valuables. However the safe is available for the storage of valuables for all other people living in the home. The previous systems put in place by the home involved two nurses having responsibility for finances of the people living in the home, including a daily reconciliation at every
Care Homes for Adults (18-65 years) Page 4 of 10 handover. This system was not in place on the day of the visit as one of the nurses was on leave, but instead of one person maintaining daily reconciliations, none were being maintained. Requirements were made in respect of the following Regulations: 17 (2) Schedule 4 (9), 16(2)(l) ,20 (1) (a) and 20 (3). Areas within the home were found to be dirty, particularly carpets in corridors and behind the shutters of windows and window ledges. When this was raised with the manager the domestic cleaned behind the shutters immediately. There were a number of damp areas noted in the upstairs corridors and bedrooms. Plasterwork around windows was also in need of repair. Where repairs had been attempted, these had not been completed to a good standard of repair, or in keeping with the nature of the home :eg the front door had been broken down by the fire brigade in a recent incident and a panel of MDF board used to cover the damage, rather than restore it to its original state. Damage to the door surround had not been repaired. The windows to the square downstairs had been identified as needing repair at the last key inspection and at that time was apparently scheduled for refurbishments. Many of the bedrooms were in need of repair and repainting, but this had not been completed. Bedroom windows were also in need of repair, leaving curtains with water stains on them. A further requirement was made in respect of this. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 5 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 23 13(6), The registered person shall 10/07/2008 make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. Care Homes for Adults (18-65 years) Page 6 of 10 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 23 17 Regulation 17(2)Schedule(4) 22/05/2009 item 9.The registered person shall maintain in the care home the records specified in Schedule 4. A record of all money or other valuables deposited by a service user for safekeeping or received on the service users behalf, which shall state a date on which the money or valuables were deposited or received, the date on which any money or valuables were returned to a service user or used, at the request of the service user, on his behalf and where applicable, the purpose for which the money or valuables were returned to a service user or used, at the request of the service user, on his behalf and where applicable, the purpose for which the money or valuables were used :and People living in the home will have their finances appropriately managed, with accurate records maintained Care Homes for Adults (18-65 years) Page 7 of 10 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action , protecting them from potential financial abuse. 2 23 20 Regulation 20(1)a. Subject to paragraph(2) the registered person shall not pay money belonging to any service user into a bamk unless-the account is in the name of the service user, or any of the service users, to which the money belongs. People living in the home will have their finances appropriately managed, with accurate records maintained, protecting themfrom potential financial abuse. 3 23 16 Regulation 16(2)(l)The 22/05/2009 registered person shall having regard to the size of the care homeand the number and needs ofservice users-provide a place where the money and valuables of service users may be deposited for safekeeping, and make arrangements for service users to acknowledge in writing the return to them of any money or valuables so deposited. People living in the home will have their finances appropriately managed, with accurate records maintained , protecting them from potential financial abuse. 4 24 23 Regulation 23(2)(d)The registered person shall 28/08/2009 22/05/2009 Care Homes for Adults (18-65 years) Page 8 of 10 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action having regard to the number and needs of the service users ensure that- all parts of the care home are kept clean and reasonably decorated. People living in the home will benefit from a clean and comfortable environment. 5 24 23 Regulation 23(2) b The 22/05/2009 registered person shall having regard to the number and needs of the service users ensure that-The premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally. People living in the home will benefit from a well maintained and comfortable environment. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
