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: Eileen Engelmann Date: 3 1 0 7 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 8 What we found:
The reason for this visit was to look at the arrangements for the financial management of monies that belong to residents, and monitor compliance of the home in meeting Regulation 17(2) Care Homes Regulations (2001) . The last report of 19 May 2009 included a requirement in respect of regulation 17(2). The outcome is as follows: Two inspectors carried out this inspection and at the start of our visit one inspector explained the reason for this visit to the registered manager Thomas Magaorokosho. Also present during our visit was Bene Dawson (Director of Adult Services) and Maggie Fenney (Funding Co-ordinator for Prime Life). The arrangements for the management of the finances within the home were confirmed to us by the registered manager, the funding co-ordinator and the Director for Adult Services during this visit (31 July 2009). These safeguarding arrangements will stay in place until the outcome of a court hearing is known. It was stated that Mr Magaorokosho continues to have no involvement in any of the homes finances, he is supernumerary to the registered nurses on duty and he does not hold any keys to the medication systems or the safe in the managers office. Debbie Mogg, the manager of Stoneleigh, with the assistance of the funding co-ordinator for Prime Life continues to oversee finances at Gilby House. The registered nurses at Gilby House manage the day to day finances of people living in the home, and the company accountant visits the home regularly to audit all financial records. The registered manager told us that there are five or six nurses employed by Gilby House and that any one of them could deal with the finances of people living in the home. There are two safes in the administration office, one is obsolete and the combination lock is not operational as no one has the numbers. The other is a small safe, mounted on the work top and is accessed by key. The nurse in charge holds one key, Debbie Mogg and Maggie Fenney have their own key which they keep with them at all times. We looked in the operational safe. There were receipt books which are no longer used, a petty cash tin, the residents fund tin and five dormant bank accounts. On the day of our visit (31 July 2009) Maggie Fenney was carrying out an audit of the finances and bringing the computerised records up to date. The key held by the nurse in charge is kept in the Controlled Drugs cabinet. We were shown the envelope with the safe key in. It was a standard envelope which was dated and included the name of the nurse who was on shift. This did not provide safeguards against anyone else using the key. The nurse in charge signs a sheet at the change over of shift to say she has taken charge of the medication keys. On examination there was no separate sheet for the safe key and there was no note on the signing sheet to show this included the safe key. We recommended that the sealed envelope holding the safe key between shift changes should be signed across the seal to protect against tampering by unauthorised people; also the practise of signing for the medication key should be extended to include a sheet to sign when the nursing staff takes charge of the safe key. On a daily basis, the nurse in charge is given a pre-arranged amount of money which is held in a locked cupboard in the medication room. This is then given out as and when requested by service users and a daily log is completed showing; who has received
Care Homes for Adults (18-65 years) Page 3 of 8 money or given money to the staff, any cigarettes or tobacco purchased from the company by a service user, and the signatures of two members of staff. We were given a blank sheet to show how the information is recorded. Subsequent entries are then made to the computer spreadsheet to account for the use of the money and a secondary form is completed to show the separate entries. Maggie Fenney told us that daily reconciliation sheets are printed off by Debbie Mogg or herself The home encourages people to keep their money in their own bank accounts. Where this is not possible there is a joint account for service users. This does not pay people any interest on their money. We recommended that this information is put into the service user guide so individuals are aware of this and can make up their own mind about what to do with their monies. We looked at the spreadsheets on the computer and saw that each service user, for whom the home looks after their money, has an individual page showing all the transactions of purchases, money out and money in. These entries are then coded to tally with receipts for purchases, fees paid and bank statements received periodically by the home. Maggie Fenney told us that no monies are brought into the home without being accounted for. If respite service users are admitted they are given a spreadsheet on the computer so that all transactions can be recorded and tracked. A number of service users have their own post office or bank accounts and we saw evidence from the computer records that individuals take money from their own accounts and put money into the joint service user account. One person pays their own fees in this way and we were given a copy of their spreadsheet to see how the monies were accounted for. Other service users have their own bank cards, which are kept in the safe until the individual wishes to use it. Bene Dawson and Maggie Fenney assured us that only the individual knows their Personal Identification Number (PIN). Each person is asked to sign a record sheet when they take their bank card out of the safe, and again when it is returned. We looked at one example of how the system works; when the individual makes a withdrawal they bring the receipt to the office and this is saved in their personal allowance file and an entry made of an income on the spreadsheet. We checked the information kept about the dormant bank accounts for five service users. The amounts held in the accounts ranged from a few pence to substantial amounts of money. These did not appear to have been discussed with the individual or social services during the yearly care reviews. We recommended that arrangements should be made to update the accounts and establish what is in the best interests of the service users, bearing in mind each individuals capacity to make decisions and where appropriate involving advocates such as social workers where required. What the care home does well:
Since the last visit on 19 May 2009 the home has met the requirement for Standard 23, Regulation 17(2), and ensured that the home is managing peoples monies in an effective and safe manner. Policies and procedures are in place around the management of peoples monies and financial affairs and these are given to all staff on start of employment. Written guidance is made available to the nurses in charge so they understand the systems in use and what is expected of them. The nurses in charge, director of adult services and funding co-ordinator were able to explain the systems in use and we were given free access to all records. Records taken were given to the inspectors to demonstrate the practices in place. Care Homes for Adults (18-65 years) Page 4 of 8 What they could do better: 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 8 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 8 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 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 1 23 The registered person should ensure that the sealed envelope holding the safe key between shift changes, is signed by the nurse in charge across the seal to protect against tampering by unauthorised people The registered person should ensure that the practise of signing for the medication key should be extended to include a sheet to sign when the nursing staff takes charge of the safe key. The registered person should ensure the information about the shared residential account is put into the service user guide so individuals are aware that this account does not pay them interest and enable them to make up their own mind about what to do with their monies. The registered person should ensure that arrangements are made to update the dormant bank accounts belonging to service users, and establish what is in the best interests of the service users, bearing in mind each individuals capacity to make decisions and where appropriate involving advocates such as social workers where required. 2 23 3 23 4 23 Care Homes for Adults (18-65 years) Page 7 of 8 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 8 of 8 - 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!
