Inspection on 17/01/07 for Gilling Reane

This inspection was carried out on 17th January 2007.

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 19/01/06

Gilling Reane 14/11/05

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 Inspection 09:00 17 January 2007 th X10015.doc Version 1.40 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 Gilling Reane DS0000063296.V311915.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 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 DS0000063296.V311915.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gilling Reane Address Gillinggate Kendal Cumbria LA9 4JB 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) 01539 731040 01539 721281 gillingreane@hotmail.co.uk Pearl care Ms Julie Ann Smith Care Home 33 Category(ies) of Dementia - over 65 years of age (11), Mental registration, with number disorder, excluding learning disability or of places dementia (1), Old age, not falling within any other category (33) Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 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) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Sufficient staff must be on duty at all times to meet the specialist needs of service users in the categories identified. 19th January 2006 2. 3. Date of last inspection Brief Description of the Service: Gilling Reane is a privately owned and run residential care home for thirtythree 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 passenger 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. Suitable information about the running of the home and the terms and conditions of staying there are provided in the service user guide, which is given to all new or current residents. The range of fees charged by the home is from £363 to £454. Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit took place as part of an unannounced key inspection, which involved meeting with residents either in their own rooms or in one of the lounges’ where I joined a group of them for lunch. I talked to the manager and staff on duty as they went about their work, as well as meeting three staff on their own. I also received comment cards from relatives/friends and residents and during the visit I spoke to visiting professionals and relatives. What the service does well: What has improved since the last inspection? The storage of cleaning materials has been looked at and new systems agreed to ensure the safety of residents. Residents weight is closely monitored and any changes and actions taken are recorded. The home no longer keeps any of the resident’s personal finances. The manager and supervisors make sure that all the staff get regular support and guidance. Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems in place to ensure the needs of new residents can be met by the home and the residents are supplied with sufficient information to make an informed choice about moving in. EVIDENCE: The home provides suitable information to residents and prospective residents in an informative service user guide. This had been regularly reviewed and updated ensuring the information was up to date and accurate. It included all relevant information as required by the National Minimum Standards, including the terms and conditions of residence. At the end of an initial stay of one month the placement is reviewed with all relevant parties and a formal contract of terms and conditions is agreed, signed and issued to residents or their representatives. I examined these on three resident’s personal files, which were all in order. Prior to admission the manager or one of the senior team will complete a pre admission assessment form. The ones I examined contained detailed information relating to all personal and healthcare needs and wishes. Based Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 Page 9 on these assessments and any other specialist assessments by other agencies comprehensive care plans are developed and agreed with residents. One of the residents I spoke to confirmed they were able to visit the home prior to moving in, although this does not always happen due to individual circumstances, such as people moving in from hospital, when a relative or representative has visited and made a decision for them. Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s care plan records are comprehensive and support and guide staff in providing a consistent level of care. EVIDENCE: The home has developed comprehensive care plans for all residents. These are based on the pre admission assessment and other specialist assessments in place including social work assessments. They include an informative social history/pen picture and medical history that really does ‘bring the plan to life’ and provides staff with valuable information that gives them a greater understanding of the individual and their idiosyncrasies. This is particularly important for people with dementia who may not be able to share such information with staff and it enables staff to take a “person centred approach” with them, which is good practice. The care plan guides staff with individual strategies developed for specific areas of need and included personal goals or targets and if the resident is making progress toward them. Manual handling and other relevant risk assessments were recorded such as pressure area care and risk from falls to ensure the safety of residents and staff. Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 Page 11 Residents healthcare needs are monitored with all visits to a healthcare agency or professional recorded. There was evidence of the care plans being reviewed on a monthly basis, which involved the completion of a dependency profile to identify changes in need. Weight is also recorded on a monthly basis, however it is recommended that nutritional assessments be used to monitor dietary needs. I met with a visiting District nurse who confirmed residents “always appear to be happy and well cared for”. Instructions are recorded and followed through by the home, who the nurse said are “good at raising concerns as they arise”. The care plans also include an ‘interests and activity plan’, which records resident’s personal interests and the activities they prefer and how these will be provided. I checked the medication storage, administration and recording systems including controlled drugs. The systems were up to date and accurate ensuring residents were receiving their medication as prescribed. All the medication was securely stored and the records were maintained in line with Royal Pharmaceutical good practice guidelines. A risk assessment was in place for residents who were able to self-administer ensuring they were competent. Staff have received training in relation to ‘caring for the dying’ and were aware of their role and responsibilities. The home works closely with other agencies at such times to ensure the comfort of the resident and their families. Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. On the whole the home provides a good range of activities for people to enjoy based on their individual preferences. EVIDENCE: Each resident has an interests and activity plan that they agree and sign as part of their care plan. This identifies their interests and hobbies and how they will be encouraged and supported to participate in them. Based on discussions with residents and the records held by the home it was evident the home provides a range of activities on both a one to one basis and in small groups, such as bingo, exercise to music and craft sessions. The home maintains a record of activities provided to enable them to monitor participation. The home has good links with the local community with the local church and school being regular visitors to the home. The home also has their own mini bus, which is used to provide day trips or access to other community facilities. It is recommended the home review how they offer choice and control to people in their daily lives when they are not engaged in formal activities, particularly people with dementia. I discussed with the manager current good practice in relation to dementia care and how to make environments more accessible to people. During this inspection I spent time with residents in different areas of the home. At one point in the conservatory there was Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 Page 13 classical music being played trying to create a relaxing atmosphere, however this was competing with two televisions in close proximity to each other on different channels. This made it impossible to enjoy any of the entertainment and trying to have a conversation was very difficult also. The home has a four-week rolling menu that has recently been reviewed with feedback from the residents. The menu was varied and gave people suitable choices of nutritional food throughout the day. The cooks have a detailed record of individual’s dietary needs such as diabetic diets, low fat and liquidised food. When liquidised food is required food is liquidised separately, which is good practice. Some people chose to eat their meals in their rooms whilst others used one of the lounge/dining rooms. I joined a group of residents for lunch in the dining room. The meal had been freshly prepared and was well presented. The residents I spoke to all said they “enjoyed the food”. Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems to ensure residents are listened to and their concerns or complaints are responded to. However abuse policies and procedures are in need of updating. EVIDENCE: There have been seven verbal complaints recorded and responded to since the last key inspection. The manager takes a lead role in ensuring complaints are recorded, investigated and responded to appropriately. All the complaints had been resolved and actions taken to prevent a reoccurrence. Recording and responding to verbal complaints in this way is good practice and confirms that staff take concerns and complaints seriously. The complaints policy is displayed in the home and is issued as part of the service user guide. The home provides training for all staff in identifying and responding to suspicions of abuse. However after examining the home’s policy and procedure it was evident it needs reviewing and updating in line with current legislation and the new local procedures. Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 25, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, safe and well maintained and provides a comfortable living environment for the residents. EVIDENCE: The home maintains a programme of repairs and renewals and keeps a record of all completed work. The main lounges were in the process of being decorated with the home ensuring there was minimal disruption to residents by completing the work in the evenings. The upstairs landing had been completed in addition to several bedrooms where carpets had also been replaced and in one bedroom new furniture had also been purchased. Residents were involved in choosing colour schemes for their own rooms and the communal areas. Suitable aids and adaptations were in place around the home including grab rails, handrails, hoists, walking frames, wheelchairs and pressure care equipment. There was evidence of appropriate referrals being made for advice and guidance from other professionals and specialist services regarding specialist needs and equipment. Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 Page 16 The home was clean and hygienic throughout with dedicated cleaning staff maintaining this standard. Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a stable staff team who have developed good working relationships with residents and their families to provide a consistent service. EVIDENCE: Gilling Reane has an experienced and well-trained staff team who work closely with the manager and senior team to ensure a good continuity of care for the residents. They liaise with various health services and professionals to make sure individuals get the support and treatment they require. The numbers of staff on duty were sufficient to meet the needs of the current group of residents, which is monitored by the manager on an ongoing basis. I examined staff personnel files and the home’s recruitment practice. All necessary information was in place in line with good practice guidance, including an appropriate application form, job description, photograph, a signed contract of employment, references and a Criminal Record Bureau disclosure. The manager and senior team provide formal supervision and an annual appraisal to identify training and development needs. I examined the training records and found these to be up to date and reflected a good level of training for new and existing staff including refresher training in key areas. The home recently used a staff questionnaire, which proved effective in getting feedback from staff and raising issues of concern. This enabled the manager to address the issues and according to staff improve the “atmosphere in the home”. Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Based on my observations and discussions with residents and staff the home is run in the best interests of residents. The safety and welfare of residents is promoted with good systems in place to monitor this. EVIDENCE: The home has recently restructured the senior team with the creation of a full time administrator post in addition to the registered manager and deputy manager. They work closely together to ensure the home is running effectively and efficiently and in the best interests of residents. The home completes an annual quality survey with residents and their representatives, the results of which are reported back to the residents and actions agreed in response. The manager also produces a newsletter 2 to 3 times each year to make sure residents and their families and representatives are kept up to date with changes in the home and future plans. This is also posted to relatives who do Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 Page 19 not live locally and are not able to visit the home on a regular basis, which is good practice. One family member I spoke to appreciated that they were “kept informed” and were able to feedback to the home about any concerns they may have. The home no longer looks after personal monies on behalf of residents with all additional costs being invoiced on a monthly basis. I examined records relating to health and safety and the running of the home as required by regulation. These included servicing records, regular health and safety checks and the fire log, which were all up to date and accurate. The previous day an Environmental Health inspection had taken place with no recommendations resulting. The records maintained by the home ensured the safety and well being of residents and staff at all times. Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 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 3 3 3 3 3 3 3 3 Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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 Refer to Standard OP7 OP14 Good Practice Recommendations It is recommended that nutritional assessments be used to monitor dietary needs. It is recommended the home review how they offer choice and control to people in their daily lives when they are not engaged in formal activities, particularly people with dementia. It is recommended the home review their policy and procedures on mistreatment and abuse in line with current legislation and guidance. 3 OP18 Gilling Reane DS0000063296.V311915.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000063296.V311915.R01.S.doc Version 5.2 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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