Inspection on 14/11/05 for Gilling Reane

This inspection was carried out on 14th November 2005.

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

Gilling Reane 09/06/08

Gilling Reane 17/01/07

Gilling Reane 19/01/06

Gilling Reane 09/03/05

Similar services:

Littledale Hall Therapeutic Community

Padgate House

Westcliffe House

Richards House

Turning Point (Hoole Road)

Stanfield House

Little Acre Care Home

Inward House Projects

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

CARE HOMES FOR OLDER PEOPLE Gilling Reane Gillinggate Kendal Cumbria LA9 4JB Lead Inspector Ray Mowat Unannounced 14 and 15 November 2005 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 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. Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Gilling Reane Address Gillinggate Kendal Cumbria LA9 4JB 01539 731040 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Pearl Care Julie Ann Smith Care Home 33 Category(ies) of 33 OP - Old Age registration, with number 11 DE(E) - Dementia over 65 of places 1 MD - Mental Disorder Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 33 service users to include: up to 33 service users in the category of OP (Older people) up to 11 service users in the category of DE(E) (Dementia over 65 years of age) one named service user under sixty five years of age in the category of MD (Mental disorder) 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 3. Sufficient staff must be on duty at all times to meet the specialist needs of service users in the categories identified. Date of last inspection 09 March 2005 Brief Description of the Service: Gilling Reane is a privately owned and run residential care home for thirty three older people, eleven of whom may have dementia. The owner and responsible individual is Mr Danny Markovic. The registered manager for the home is Ms Julie Smith. The home is situated in a quiet residential area of Kendal, Cumbria, within walking distance of the amenities of the town centre. The home has its own mini-bus to meet all its transport needs. The home is set back off the road in its own grounds. There is car parking to the front of the building, which is bordered by well-kept flowerbeds. There is a large fenced, private garden to the rear, which is accessed by a ramp from the conservatory. In addition there is a pleasant patio area with seating. The home is on two floors, the second floor being accessed by a large staircase or alternatively there is a lift. The home has a number of lounges and seated areas including a conservatory and dining area. It has an innovative approach to supporting people with dementia by fully integrating them in all aspects of home life. Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two days. I visited the home on the evening of 14th November, to enable me to see the evening routines of the home and meet with different members of staff. I spoke to many of the residents during the evening, in addition to speaking to the senior carer and three care staff on duty. I returned to the home on the morning of the 15th to examine records and meet with the manager and senior staff on duty. What the service does well: What has improved since the last inspection? What they could do better: The record of medication administered, must be kept up to date at all times, with medication signed for by staff as they administer it. The front driveway was covered with moss/algae, which must be removed as it is a slip hazard when it is wet. Chemicals that are hazardous to health were not being securely stored at all times. It is recommended when staff serve a drink and biscuits that they offer people a choice. Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 6 It is recommended if someone tells the home they are concerned about something, it should be written down and a reply sent to the person, explaining what has been done to resolve it. 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. Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 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 standard(s) 2,3,4,5. The admission process provides people with adequate information to make an informed choice about moving into the home. EVIDENCE: Since the last inspection the service user guide and statement of purpose have been reviewed and updated to ensure they contain relevant and up to date information. These include the terms and conditions of residence. On admission to the home a contract of terms and conditions is issued to the new resident and agreed and signed by them or their representative, a copy of which is retained on individual files. The home had a comprehensive pre-admission assessment, which was completed by the manager and deputy, for all new service users. There was evidence of the home working closely with a range of community health services and other specialist services, to meet the specialist needs of individual residents. From these initial assessments, comprehensive care plans are developed. Incorporated in the care plan, the home had developed an activity plan for each individual. This included people’s preferred activities and social interests and a record of the date and the type of activities undertaken. Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 9 Prospective new residents are invited to visit the home with their family or representative, this could then lead to a series of visits or overnight stays, enabling people to make an informed choice about moving into the home. Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 10 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 standard(s) 7, 8, 9, 11. Health and personal care needs are well documented with staff having good knowledge of individual needs and preferences. Recording of medication administration was inconsistent. EVIDENCE: The home has developed comprehensive care plans for all the residents. These include an informative social history, which gives staff a valuable insight to a person’s life and achievements and therefore a greater understanding of their personality and uniqueness. They also included detailed information regarding all aspects of personal and healthcare needs, such as a medical history, preferred interests and hobbies and personal care needs. A senior member of staff has been identified to take a lead role in the development and review of care plans, which ensures a continuity of care, is maintained. She had recently introduced a new risk assessment tool to focus on fracture prevention. This involves the completion of a “falls diary”, for individuals who have been identified as being at risk. This detailed assessment looks at underlying reasons and factors for falls and results in the development of a detailed risk assessment. I examined the medication records against the contents of the medication cabinet. Although there were the correct amount of drugs, it was evident Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 11 medication had been administered and not signed for on several morning shifts. This is subject to a requirement. It is also recommended training or refresher training, in the management and administration of medication is provided for all relevant staff. Individual’s needs and preferences upon illness or death are recorded in care plans, with input from family or legal representatives as appropriate. This includes details such as preferences regarding funeral arrangements and funeral payment plans. Staff are aware of their role and responsibilities in providing appropriate, sensitive support at such times. Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 12 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 standard(s) 12, 13, 14. The home is working hard, to increase the choice and appropriateness of activities provided. EVIDENCE: On my arrival residents had finished their evening meal and were sat in one of the communal lounges or in their own rooms. Each of the two lounges and the conservatory had televisions, which were showing different stations. Residents were socialising with each other or watching television, there were no other activities taking place during the inspection. There were four staff on duty, including three care staff and a shift leader. They were busy throughout the inspection as people wanted to get ready for bed or retire to their rooms, with many of them requiring some form of assistance. A cup of tea was brought round and served from a trolley. Everyone was given a cup of tea, with two biscuits on the saucer. There did not appear to be a choice of an alternative drink or the type of biscuits preferred. It is recommended that residents are offered alternatives at these times, to enable them to make an informed choice. The home has identified a member of staff who is taking a lead role in coordinating the activities provided. A specific file has been set up, which records individual needs and preferences, in relation to preferred activities, hobbies and interests. This has proved to be a useful resource, with staff referring to it when planning activities both in the home and in the community. Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 13 A good example of this was a recent activity involving pets. People had said how much they missed having pets. In response to this staff arranged for two people to get involved in walking a dog and other pets were introduced to the home, on a planned basis, to provide people with an opportunity to care for the pets or just stroke them. This had proved a popular exercise and something that people wanted to participate in again. There were photographs displayed around the home of recent social events, including a Halloween party, which been enjoyed by residents and staff alike. Feedback from family/representatives in the home’s quality assurance questionnaire was also complimentary regarding the value and benefit of activities, with one person saying, “I think the open day events are great”. Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 14 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 standard(s) 16, 18. The home’s policies and procedures and training ensure the safety of residents at all times from the risk of abuse. EVIDENCE: There have been no recorded complaints since the last inspection. Notifiable incidents were being appropriately reported to the relevant agencies. The home provides appropriate training, which is periodically refreshed, ensuring staff are knowledgeable and aware of the relevant reporting procedures. A checklist is maintained, to monitor that all necessary recruitment checks were being completed, this up to date and accurate. Although there had been no recorded complaints since the last inspection, the manager described how she had resolved some “issues of concern”, raised by family members. The merits of recording such “informal complaints” was discussed with the manager, with an agreement that it is good practice to record all issues of concern or complaints/compliments, so that people can see a balanced view of how the home listens and responds to concerns. Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 15 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 standard(s) 19, 20, 22, 25, 26. Gilling Reane is well maintained and provides a comfortable and accessible home. EVIDENCE: The home has been actively following a programme of repairs and renewal since the last inspection. All repairs and renewals carried out are now recorded. New chairs have been provided in the communal lounges and an edging strip has been fitted to the runners on the stair carpet, which can be easily seen and provides good grip under foot. The carpet in the conservatory has stretched and is rippling and could be a trip hazard if remedial action is not taken. There is a build up of moss and algae on the block-paved driveway to the front of the home, which is a slip hazard and must be removed. The laundry was well ordered with individual clothes baskets for each resident. However the laundry door was not locked and there were both liquid soap and cleaning fluids left unattended and accessible to residents. On the evening of the 14th November the staff room was not locked, which again gave residents Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 16 access to COSHH substances that were not securely stored. These issues are subject to a requirement under standard 38. On the whole the environment was being well maintained and was clean and hygienic throughout. Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30. The home provides a good continuity of care, with support from an experienced and well-trained staff team. EVIDENCE: The home was experiencing some difficulties with recruitment of staff, although this had not impacted on the quality of care provided, as adequate levels of staff had been maintained. The home had recently recruited an overseas member of staff to help alleviate the problem. Staff files were examined and found to be in line with the National Minimum Standards (NMS). All necessary checks and references were in place. The home maintains a training record for all staff, to monitor and plan the training for all staff. Based on these records and discussions with staff, they are receiving good levels of appropriate training when a need is identified. New staff receive a thorough induction using an induction workbook, which meets induction and foundation standards. In addition new staff will shadow a more experienced member of the team on different shifts, to gain an understanding about all aspects of home life. Staff I spoke to during the inspection had a sound knowledge of their role and responsibilities and reporting procedures. Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 36, 38. On the whole the home is being managed effectively and efficiently. However the management of COSHH substances must be improved. EVIDENCE: Since the last inspection the new manager Ms Smith, has established herself in the role and based on my own observations and discussions with staff, provides “good support and leadership” to the team. She has established new systems to support the effective and efficient management of the home. Staff said they felt “valued and there was always someone available for advice”. Supervision was taking place on a regular basis as required, with annual appraisals completed also. An annual quality assurance questionnaire had been completed and the results compiled. Over 80 of the responses to questions were rated good to excellent. An example of feedback from relatives “I can’t speak too highly of the home” and “I am pleased my relative is well cared for and happy”. Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 19 The manager responded to issues that received a lower rating or had been commented on in the survey or verbally, with actions being taken to resolve the individual concerns. As mentioned previously COSHH substances were not securely stored in both the laundry and the staff room. These issues are subject to a requirement to ensure COSHH substances are securely stored at all times. The home is producing a quarterly newsletter, which is not only available in the home, but is posted out to relatives and friends, to keep them updated with forthcoming events and other news items. This has been well received and is good practice. Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 x COMPLAINTS AND PROTECTION 2 3 x 3 x x 3 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 Standard No 16 17 18 Score 2 x 3 x 3 3 x x 3 x 2 Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 21 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. 2. 3. Standard 19 38 9 Regulation 13(4)a, c 13(4)a, c 13 (2) Requirement The moss and algae on the front driveway must be removed as it is a slip hazard. COSHH substances must be securely stored at all times. The home must ensure medication administered is recorded and signed for at the point of administration. Timescale for action 20/12/05 21/11/05 21/11/05 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. Refer to Standard 14 16 Good Practice Recommendations It is recommended that residents are offered alternatives when drinks are served, to enable them to make an informed choice. It is recommended that all complaints, including verbal complaints and concerns, are recorded and responded to formally. Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP 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 Gilling Reane F58 F10 s63296 gilling reane v242361 141105 ui stage 4.doc Version 1.40 Page 23 - 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. 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