Inspection on 19/01/06 for Gilling Reane

This inspection was carried out on 19th January 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.

Other inspections for this house

Gilling Reane 09/06/08

Gilling Reane 17/01/07

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 19th January 2006 08:00 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.V275647.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 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.V275647.R01.S.doc Version 5.1 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 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.V275647.R01.S.doc Version 5.1 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. 14th November 2005 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 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 DS0000063296.V275647.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. I met with the majority of residents either in the shared lounges or in their own rooms. I spent time talking with residents and staff in all parts of the home and met with the manager and deputy manager. I had lunch with a group of residents and staff in the large dining room. I also spoke to a district nurse who is a regular visitor to the home. What the service does well: What has improved since the last inspection? What they could do better: The cleaner’s chemicals and the Hoover must be safely stored. When residents have a late breakfast or they do not eat normally this should be written down and choices offered. When a resident’s weight is changing steps taken should be written down. A clear record of resident’s personal money should be written down, when it comes into the home or is given to people. The manager should make sure all the staff gets support on a regular basis. The information notice board showing the date, menu for the day and activities, should be kept up to date at all times. Gilling Reane DS0000063296.V275647.R01.S.doc Version 5.1 Page 6 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 DS0000063296.V275647.R01.S.doc Version 5.1 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.V275647.R01.S.doc Version 5.1 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 the following standard(s): 1, 3, 4. The home has sound systems and procedures in place to ensure people’s needs are fully assessed and they can make an informed choice about moving into the home. EVIDENCE: The home provides suitable information to current and prospective residents. The previous inspection report summary is included in the service user guide. There has been no change to the admission procedure for the home with the manager or deputy completing a detailed assessment prior to admission. This is in addition to any Social work or specialist assessment that may be available. This ensures the home can meet people’s individual needs and the environment and resources available are adequate. Due to deterioration in some residents the home currently has a high volume of people with complex needs. This was discussed with the manager who was aware of the issues and is monitoring the situation closely, to maintain appropriate staffing levels and ensure resources are available. Gilling Reane DS0000063296.V275647.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 7, 8, 9, 10, 11. The home has good recording systems to identify and document people’s personal and healthcare needs. Residents felt their rights and choices were respected. EVIDENCE: The home has developed a detailed care plan for each resident. These are reviewed on a monthly basis using a dependency profile. The profile identifies people’s abilities in key areas of personal and healthcare, with a numbered grading. As these are reviewed on a monthly basis it identifies changes in need, enabling a timely response. Key areas such as pressure care, falls and weight are monitored, however the weight chart could be improved with the addition of a column to say what action has been taken if the weight fluctuates. Manual handling risk assessments including fracture and falls assessments were in place and kept under review. The home has developed both a medical and social history, which are invaluable in providing staff with an insight to a person’s past, significant events in their lives and what is important to them. Residents are all registered with a GP of their choice and are supported by staff to make and attend appointments when required. I met with a visiting District Gilling Reane DS0000063296.V275647.R01.S.doc Version 5.1 Page 10 nurse from one of the local GP practices. She confirmed that the home “make appropriate referrals for support and advice and have good communication systems and follow advice and guidance regarding ongoing care”. I met with two residents who chose to spend the majority of their time, including mealtimes, in their own rooms. They were both making an informed choice to live this way and had been provided with suitable aids and adaptations to promote and maintain their independence. Staff respected this choice and maintained discreet contact on the resident’s terms. One of the residents described one staff member “as my rock” but went onto say “all the staff are nice and helpful”. A detailed record of individual and family wishes upon death is recorded, including funeral arrangements, financing the funeral and any other specific preferences. Gilling Reane DS0000063296.V275647.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 12, 13, 14, 15. The home support and encourage residents to lead an independent lifestyle of their choice. EVIDENCE: The home provides a range of group activities on a daily basis, which are chosen by residents. On the day of the inspection an exercise session was provided, which residents enjoyed. People are supported and encouraged to keep contact with family, friends and associations outside the home. One resident is a long standing member of a local society, who has kept in touch with them through members visiting the home. Others talked to me about family visiting them in the home or going out to visit their family and friends. Some others enjoy a weekly visit to a local day centre where they have a social get together, a meal and activities. Aids and adaptations for people with specialist needs, such as sensory impairments and physical disabilities, are provided to promote or maintain their independence. The home has an orientation board including the date, day, the planned menu for the day and activities on offer. Unfortunately this was not up to date, which would cause confusion for residents. It is recommended the board is updated on a daily basis with the involvement of residents. Gilling Reane DS0000063296.V275647.R01.S.doc Version 5.1 Page 12 Several people in the home required physical support with feeding this was done in a dignified manner with staff sitting next to residents. During the inspection one resident who had moved onto a liquefied diet after a choking incident was given toast for their breakfast. When I queried this it was apparent the breakfast list had not been updated and it was a new member of staff who had unknowingly followed the old list. The breakfast list was reviewed during the inspection and updated. There was a wide selection of food on offer for breakfast and a choice of two hot meals or a cold alterative provided for lunch. Residents I spoke to confirmed they had a “good choice of food”. I joined a group of residents for lunch, which was a roast dinner with fresh vegetables this was a well presented, nutritious meal. Meals and mealtimes are very flexible with three residents, who prefer to get up late, not finishing their breakfast until 11am. However they were still served with lunch at 12.30. This was discussed with the manager as they may have refused food or eaten a smaller portion, which was not routinely recorded. It is recommended that more detailed recordings are made in relation to changes to dietary needs, particularly for people with dementia and they are passed onto all staff. Some people chose to eat their meals in their own rooms but the majority of residents used one of the two dining areas. Gilling Reane DS0000063296.V275647.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 16, 17, 18 Concerns and complaints are recorded and responded to appropriately. Records of personal finances should be improved. EVIDENCE: The home has a suitable complaints procedure that is issued to residents. I examined the complaints record, which recorded one complaint since the last inspection. This was investigated and recorded with actions identified to resolve the complaint. The home only keeps a small amount of personal finances for residents. These were securely stored, however records of transactions were not robust and must be improved to safeguard residents and staff. The deputy manager continues to provide training for staff in recognising and responding mistreatment and abuse. Gilling Reane DS0000063296.V275647.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26. Gilling Reane provides a safe and comfortable living environment, which is well maintained. EVIDENCE: Since the last inspection the home has purchased a power washer to remove algae and moss from paths and patios. The programme of repairs and renewals had continued, including re-decoration of the conservatory and lounge and the fitting of a new carpet. Two bedrooms have also been fitted with carpets. The home employs a handyman who ensures all areas of the home are in a good state of repair and safe. I spoke to several residents in their bedrooms, these were decorated and furnished to a good standard and provided a comfortable and homely space. Two people in particular spend a lot of time in their room, which is their choice. The home ensured they had suitable aids and adaptations to promote and maintain their independence. They also had furniture and belongings of their own, which also personalised their rooms. Gilling Reane DS0000063296.V275647.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. The home currently has a full compliment of staff, good recruitment practice is followed and staff received appropriate training. EVIDENCE: Based on discussions with staff and from examining staff records it was evident the home follows good practice guidelines in relation to recruitment and employment of staff. Job descriptions and contracts are issued to and signed by staff, with all necessary checks and references completed. Disciplinary procedures had been appropriately followed when the need arose. New staff completed an in-house induction, in addition to more formal training in core subjects. A training plan for the home was in place based on feedback from staff and the ongoing training needs identified through supervision and appraisal. Based on discussions with staff and from examining their training records, they were receiving suitable training in core areas and specialist subjects and had a good insight to their role and responsibilities. Staff displayed a good knowledge of resident’s needs and preferences. They were respectful when addressing residents and there was genuine warmth in their manner, although not being over familiar. Gilling Reane DS0000063296.V275647.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 34, 35, 36, 37, 38. The management and senior staff provide good leadership and support and ensure the home is run in an effective and efficient manner. EVIDENCE: With the support of her deputy and senior staff, Ms Smith continues to provide clear leadership and support to the staff and residents. The home has good relationships with other agencies and through ongoing consultation ensures the home is run in the best interests of residents. On the whole there is a stable staff team who provide a good continuity of care. The organisation provides financial information and support, with Ms Smith managing the homes budget locally. Some formal supervision sessions are now overdue, which the manager was aware of and is responding to. It is recommended a review take place to prioritise the overdue sessions. Gilling Reane DS0000063296.V275647.R01.S.doc Version 5.1 Page 17 During the inspection the cleaning/domestic staff were cleaning bedrooms. On two occasions the cleaning materials were left unattended and the Hoover was also left unattended with a trailing lead still plugged in. These are both potentially hazardous situations that must be addressed. Routine maintenance and servicing was taking place to maintain safe equipment and the environment. Gilling Reane DS0000063296.V275647.R01.S.doc Version 5.1 Page 18 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 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 2 18 x 3 3 3 3 3 3 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 X 3 2 2 3 2 Gilling Reane DS0000063296.V275647.R01.S.doc Version 5.1 Page 19 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. 1 Standard OP38 Regulation 13 (4) c Requirement The cleaning routines must be reviewed to ensure safe practice is followed at all times. Timescale for action 26/01/06 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 1 2 3 4 Refer to Standard OP8 OP14 OP15 OP17 OP36 Good Practice Recommendations It is recommended the weight monitoring chart, record actions taken when weight fluctuates. It is recommended the orientation board is updated on a daily basis with the involvement of residents. It is recommended that more detailed recordings are made in relation to changes to dietary needs, particularly for people with dementia and they are passed onto all staff It is recommended financial recording systems be strengthened. It is recommended a review take place to prioritise the overdue supervision sessions. Gilling Reane DS0000063296.V275647.R01.S.doc Version 5.1 Page 20 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 DS0000063296.V275647.R01.S.doc Version 5.1 Page 21 - 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!