Inspection on 09/06/08 for Gilling Reane

This inspection was carried out on 9th June 2008.

CSCI found this care home to be providing an Good service.

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 17/01/07

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 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Gilling Reane Gillinggate Kendal Cumbria LA9 4JB Lead Inspector Jenny Donnelly Unannounced Inspection 9th June 2008 09:15 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.V361833.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.V361833.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 (Kendal) Ltd 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.V361833.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. 17th January 2007 2. 3. Date of last inspection Brief Description of the Service: Gilling Reane is a residential care home for thirty-three older people, eleven of whom may have dementia. Pearl Care operates the home and the responsible individual is a Mrs Whitehead. The registered manager for the home is Ms Julie Smith. The home is situated in a quiet residential area of Kendal, within walking distance of the amenities of the town centre. The home has a mini-bus to meet 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. Accommodation is provided on two floors, the second floor being accessed by two staircases or 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 £432.00 to £494.00 per week according to the bedroom occupied. Gilling Reane DS0000063296.V361833.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was the main or ‘key’ inspection of the service. Jenny Donnelly inspector, made an unannounced visit to the service on 9th June 2008, and was accompanied by an ‘Expert by Experience’. An expert is a layperson from a voluntary organisation who accompanies the inspector and talks to people living in the home about their experiences. During the visit we toured the building, spoke with residents, staff and the management. We looked at care, medication, staffing and management records. We saw how people were spending their day, and observed lunch and the day’s activities. Prior to this inspection the manager had completed and returned an Annual Quality Assessment Audit (AQAA) that we had requested. The AQAA is a selfassessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. We also sent surveys out to some of the people who live in the home, their relatives and to staff. The findings of the surveys are included in this report. What the service does well: Gilling Reane is a small care home with a family atmosphere where people feel they are treated as individuals. The admission process is thorough and serves to ensure peoples health and personal care needs are fully assessed and known, before they are offered a place. Time and effort is spent in helping new people settle in. The delivery of personal care is good and is based on individual needs and preferences. People also benefit from the good liaisons with local health services. Complaints are dealt with promptly and fully, and the manager and staff are open to learn from these and make changes as needed. The staff team are friendly and work positively with people. There is a warm and welcoming atmosphere and staff display an affectionate attitude towards people living in the home. Staff training is good and the number of staff with, or working toward, a National Vocational Qualification in care is high. The overall management of the service is robust, and general record keeping is to a high standard. People’s views are listened to and taken into account. Gilling Reane DS0000063296.V361833.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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.V361833.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.V361833.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 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has robust systems in place to ensure the needs of new people are fully assessed, and that these can be catered for before people are offered a place in the care home. EVIDENCE: The home provides good written information for people about their services, in the form of a statement of purpose and service users guide. These documents are kept up to date and reflect any changes in the organisation or the service. Before new people are admitted to the home, the manager or one of the senior staff carries out a full needs assessment of the person. We looked at the admission assessments of three people and found they were very detailed and included all personal, health and social care needs. Information was gathered from a number of sources including the person themselves, their family and any professionals involved in their care. From the initial assessment the Gilling Reane DS0000063296.V361833.R01.S.doc Version 5.2 Page 9 manager makes a judgment as to whether Gilling Reane could meet that persons individual needs, and put a suitable plan of care in place. The home does not provide an intermediate care service, although there is one bedroom reserved for people receiving short-term respite care. Gilling Reane DS0000063296.V361833.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were receiving a good standard of personal and healthcare delivered in a way that was acceptable to them. EVIDENCE: There was a written plan of care in place for each person, which guided staff in what level of support people needed, and when. We examined three care plans in detail and found they were fully completed and had been kept under review and were up to date. The plans included information about people’s individual wishes on the way they liked to receive care and clearly set out any special requirements. The ‘social histories’ provided some valuable information, especially for those people suffering from dementia, about what was important to them and what people had achieved in their lives. This helped staff to understand people’s behaviours better and provided good information for planning appropriate social care. New nutritional assessments had been completed, which gave good detail not only on peoples dietary Gilling Reane DS0000063296.V361833.R01.S.doc Version 5.2 Page 11 needs, but also on their preferences of what they liked to eat, and when and where they liked to have their meals. Health care records showed that people had good access to their doctor and were able to regularly access other health services such as chiropody, optician, community nurses and the mental health team. There was evidence that staff had taken on board advice from these professionals and incorporated any necessary information into the persons care plan. The surveys we received indicated that people were generally happy with the level of care provided. One person wrote; • “My [relative] appears well and happy, the staff are friendly and helpful and have a lot of patience”. Another person commented that; • “Continence care is poor, my (relative) is often wet”. We did not observe anyone left ‘wet’ during our visit and noted that staff regularly helped people to use the toilet. The manager did tell us that they were experiencing problems with the new continence pads being provided by the health service, and she was following up on this. However, there was a smell of urine in the home, which is commented on further under the ‘environment’ section of this report. We saw that people were dressed in accordance with their wishes and observed staff kindly offering to assist a person whose clothes were in disarray. Staff were heard to speak kindly to people and took time to explain what was happening. We looked at how well medicines were being managed in the home. The medicines storage was safe and secure and the random stock checks we did showed the stock matched the records. Medicine records were well managed and staff demonstrated good practice in handling medicines safely. Gilling Reane DS0000063296.V361833.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 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Gilling Reane provides daily afternoon activities and people are offered a choice of food and given the appropriate help to eat it. The practice of locking internal doors restricts people’s freedom of movement and restricts their choice to freely access their own bedrooms. EVIDENCE: One of the care staff is employed as an activity organiser during the afternoons, and there was a monthly programme on display showing each days planned activity. We observed the afternoon activity of chair exercises to music. This took place initially in the main lounge and was attended by a good number of people, who joined in as much or as little as they wished to. There was a good atmosphere and people appeared to enjoy this opportunity for social interaction. The activity organiser then repeated the session in other areas of the home and visited the people who chose to stay in their bedrooms. The activity organiser told us she used a set of exercise cards to guide this activity. People’s hobbies and interests were recorded in their care plan and this information was used in planning the activity programme. Other activities included quizzes, bingo with numbers and music, reminiscing with flash cards Gilling Reane DS0000063296.V361833.R01.S.doc Version 5.2 Page 13 and films. There was a mini bus at the home that accommodates six people in wheelchairs, or eight without. Two staff including the driver go out with the mini plus, plus an extra carer for people with higher dependency needs. Bus trips take place more frequently during the summer months, and destinations include Blackpool lights, Grange duck pond, and Hayes garden centre. Some people were due to attend a dance performance later in the year. A music therapist and a visiting entertainer visit every two months. We received mixed comments in our surveys about the provision of activities and the quality of daily life; • “My [relative] is able to live completely in a relaxed and supportive environment”. • “They allow residents to do things at their own pace, according to their individual needs”. • “There is a lack of activities / stimulation and one to one time with residents”. People were offered the choice of staying in their bedrooms or sitting with others in the lounges, and there was free access into the enclosed patio and garden. People who were mobile were able to walk about freely and choose were to sit. However, the bedroom and bathroom doors were kept locked during the day and only a small number of people had been assessed as able to keep their own door key. This meant that some of the people who walked around the building, could not access their own bedrooms or a bathroom, without asking staff to unlock the door. The manager explained that doors were locked because one person would turn on the taps and some people would access other people’s bedrooms and take things. For people with dementia, coming against locked doors can cause increased confusion and frustration, and not being able to access, or see a toilet, can increase incontinence. It is recommended that rather than restricting everyone’s freedom of movement around the home by locking doors, certain individuals need to be more closely monitored and distracted from doing these things. There is further comment on this in the ‘environment’ section of this report. We observed lunch, which is the main meal of the day, and saw the majority of people ate in main dining room, with staff sitting at the table also having meal. This provided a pleasant opportunity for people to engage with staff and meant people were monitored and assisted without having staff ‘stand over’ them. People needing assistance with their food were helped quietly and discreetly, but we noticed some people struggling to eat independently who may benefit from using adapted cutlery, that is easier to hold. Staff were alert to those people choosing not to eat and knew what they had eaten so far that day. Peoples weight was monitored regularly and dietician advice sought as necessary. There was a choice of two main courses, and people placed their orders one day in advance. One person thought she did not get the meal she’d ordered. A few people chose to eat in their bedrooms and had their meals served on a tray, the main course and dessert were served together, and one person felt this meant the dessert was cold by the time they ate it. A small group of ladies ate at table in the main lounge and appeared to enjoy each Gilling Reane DS0000063296.V361833.R01.S.doc Version 5.2 Page 14 other’s company. Two individuals ate alone in quiet corners, and their choice to do this was recorded in their nutritional care plan. Tables were set with cloths and napkins, which were changed for fresh ones after the meal was finished, but the linen had not been ironed and was crumpled. Gilling Reane DS0000063296.V361833.R01.S.doc Version 5.2 Page 15 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and staff listen to, and act on, peoples concerns, and staff are knowledgeable in how to recognise abuse and keep people safe. EVIDENCE: The home had a clear complaints procedure that is handed out to new people and their families as part of the service users guide. A copy was also on display in the entrance hall. The manager reported having received five informal complaints in the last year. The complaint log showed the details of these and the action taken to put things right. There was evidence that the manager and staff worked promptly and positively to make improvements wherever shortfalls in the service were highlighted. People who completed the surveys told us they knew how to complain if they needed to, saying; • “If I ever needed to, I would speak to the manager, if she couldnt sort it out, I would contact social services” • “So far I haven’t had cause for concern”. Staff had received training on safeguarding people as part of their induction and National Vocational Qualification. There were also specific in-house training days on safeguarding and protection with a qualified external trainer. The last session on this subject was held in April 2008. Pearl Care had provided new policy and procedure guidance on safeguarding and staff had familiarised themselves with this. Gilling Reane DS0000063296.V361833.R01.S.doc Version 5.2 Page 16 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, 21, 22 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Gilling Reane has a very friendly and homely atmosphere; although some work has been done recently to improve the décor and furnishings, more work needs to be done to bring the environment up to standard. EVIDENCE: Gilling Reane is a large extended Victorian property set in its own grounds. It is situated in a quiet residential area of Kendal, near the town centre. There is a large enclosed garden at the back of the building, with patio areas, flowerbeds and lawns. The home has three floors, two of which are used for residents, the top floor being staff accommodation. There are two staircases and a passenger lift. Communal spaces comprise of a large main lounge, a dining room, a television lounge and a conservatory. There are also some small seating areas in corridor spaces. There are two bathrooms and one walk / wheel in shower room. The baths are ordinary household baths with Gilling Reane DS0000063296.V361833.R01.S.doc Version 5.2 Page 17 adjustable seats. There are toilets situated around the home. Bedrooms are mainly single with a few double bedrooms and some have en-suite facilities. We found the bedroom doors were kept locked to prevent people entering each other’s rooms. The use of better signage around the home with pictures and symbols relevant to particular individuals could help in directing people with dementia into their own bedrooms, and ways of doing this were recommended to the manager. Since the last inspection a refurbishment of the home has started. So far new carpets have been provided in the main hallway, dining room and two bedrooms, and the hallway was being painted. We toured the home and found there was a smell of urine throughout the building, although this was better in the areas where new carpets had been fitted. We believed the smell to be inherent in the old carpets and old fabric chairs. The smell was exacerbated by it being a hot day and by the lack of airflow through the upstairs corridors. The manager said there was a plan to replace some of the sealed window units with openers to allow fresh air in. Many of the armchairs and other furnishings were old and stained, and need to be replaced. A number of lights were not working, particularly in bathrooms. Further refurbishment work is needed to bring the home up to standard. Some aids and adaptations were available around the home including grab rails, hoists, walking frames, wheelchairs and pressure relieving equipment. But, there was only one recliner type armchair, and staff said people had to take turns to sit in this. There were a number of people living in the home who would be more supported and comfortable in this type of chair. It is recommended that as seating is upgraded; people’s mobility and comfort needs, as well as the ability to clean the seating should be taken into account. The service employs two domestics for three hours each morning to undertake general cleaning duties. Care staff, clean the lounges and dining room at night, and also do the laundry. There was an antiseptic hand gel for visitors in the entrance hall and staff carried individual hand gels around with them. There is no dedicated laundry person, which is unusual for a home catering for up to 33 people. We received a number of negative comments about the laundry, especially about the ‘poor ironing’. During our visit we established that no ironing takes place, and this was confirmed through discussion with the manager and staff, and observation of peoples clothing and the household linen. It is recommended that the home provides some dedicated laundry staff hours which includes ironing. Gilling Reane DS0000063296.V361833.R01.S.doc Version 5.2 Page 18 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Gilling Reane is staffed by a dedicated and well-trained staff team, but staffing levels at night are not sufficient to meet people’s needs. EVIDENCE: Gilling Reane has an experienced staff team who work well together to provide continuity of care for people. Staffing levels generally consist of one senior and four carers during the morning, reducing to one senior and three carers in the afternoons. There are two night staff. Staffing levels during the day seemed satisfactory to meet people’s care needs and provide some social time. Staffing levels were boosted at lunchtime by the presence of domestic and kitchen staff in the dining room. Night staffing levels were of concern, as there are just two carers for up to 33 people accommodated over two floors of a large building. Night staff were also responsible for cleaning the lounges and doing the laundry. From the care plans we looked at, it was evident that a number of people suffer from disturbed nights and are in need of frequent staff attention. A number of the falls/accidents recorded happened out of daytime hours. It is required that Pearl Care reassess the level of care people need at night and taking domestic duties into account, increase night staffing levels accordingly. Daytime provision of domestic, catering, administration and maintenance staff was satisfactory to provide a good service. Gilling Reane DS0000063296.V361833.R01.S.doc Version 5.2 Page 19 We received some very positive feedback about the staff team, with people telling us; • “They have a very difficult job to do and they do it very well with care and patience”. • “Staff are very attentive”. • “The staff are cheerful, helpful and caring and appear to put the needs of the residents first”. • “The atmosphere is homely. The staff have always contacted us when necessary and I know if any problems arose they would be happy to help us resolve them”. Two people thought that staffing levels were not sufficient and that staff needed to be trained in dementia care. The provision of staff training at Gilling Reane was very good. All new staff completed a ‘Skills for Care’ induction course, which was followed by individual sessions in a variety of subjects. Records showed that all health and safety training such as fire safety, safe moving and handling, food hygiene and infection control were up to date. All staff had attended recent training in diabetes, continence, dementia care, challenging behaviour and positive caring. An external training company provided the majority of training. There were plans to provide medicines training and further dementia care training this year. Forty percent of care staff had a National Vocational Qualification in care and a further thirty percent were working towards this, which is very good. Staff training records, and the homes annual training plan were very well organised. We looked at four staff files to check on recruitment procedures for new staff and found that all necessary checks were in place. Gilling Reane DS0000063296.V361833.R01.S.doc Version 5.2 Page 20 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, 33 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and people’s views are listened to and used to influence future planning. EVIDENCE: The registered manager has been in post for a number of years and is suitably qualified and experienced to manage the service. She is well supported by the Pearl Care area manager, who visits regularly and was present of the day of our visit, and also by a full time administrator. The home operates a quality assurance system that comprises of annual satisfaction surveys and internal audits. We saw the latest satisfaction surveys that had been returned by people who use the service and their relatives and these were mostly very positive. The results were in the process Gilling Reane DS0000063296.V361833.R01.S.doc Version 5.2 Page 21 of being put into graph form for display on the notice board. The manager said any negative comments received were addressed within the homes business plan. Internal audits comprised of regular quality checks on care plans, medicines and emergency equipment. New initiatives being implemented by Pearl Care include a monthly medicines audit by the area manager, a monthly health and safety and accident audit and weekly wheelchair checks. A room-by-room audit of the building was being done so that refurbishment work could be costed, and built into the homes business plan. The fire officer visited the home in March this year and the recommendation made at that time in relation to an emergency box, had been attended to. The environmental health officer visited in February and awarded the home 3 stars for food hygiene practices. New contracts were being set up for testing and maintaining some of the homes equipment and services. The fire logbook was up to date, showing that weekly alarm and extinguisher checks take place. Accident records were very detailed and had been completed for the smallest incident, which is good practice. Gilling Reane DS0000063296.V361833.R01.S.doc Version 5.2 Page 22 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 X 18 3 2 2 2 2 X X X 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Gilling Reane DS0000063296.V361833.R01.S.doc Version 5.2 Page 23 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 OP27 Regulation 18 (1) Requirement Staffing levels at night must be sufficient to meet peoples direct care needs in addition to any domestic tasks allocated. Timescale for action 01/08/08 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. 3. Refer to Standard OP14 OP22 OP19 Good Practice Recommendations It is recommended that the practice of locking bedroom and bathroom doors be reconsidered so people can have free access into their own bedrooms and toilets. It is recommended that better signage, including picture and symbols, be provided around the home to help people to find their way around. It is recommended that a full programme of refurbishment be planned and implemented to improve the physical environment of the home for people. This should include improving the flow of fresh air, so as to reduce bad smells. It is recommended that the provision of seating be upgraded to provide supportive and comfortable seating for people that can be easily cleaned. It is recommended that the laundry service be improved so that peoples clothing and household linen is ironed and presentable. DS0000063296.V361833.R01.S.doc Version 5.2 Page 24 4. 5. OP22 OP26 Gilling Reane Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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.V361833.R01.S.doc Version 5.2 Page 25 - 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. 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