Inspection on 15/08/07 for Gills Top

This inspection was carried out on 15th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Gills Top 27/08/09

Gills Top 13/08/09

Gills Top 06/09/06

Gills Top 20/02/06

Gills Top 07/11/05

Gills Top 02/02/05

Gills Top 07/09/04

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

CARE HOMES FOR OLDER PEOPLE Gills Top Scar Street Grassington Skipton North Yorkshire BD23 5AF Lead Inspector Mrs Irene Ward Unannounced Inspection 15th August 2007 09:00 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 Gills Top DS0000007960.V346173.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. Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gills Top Address Scar Street Grassington Skipton North Yorkshire BD23 5AF 01756 752699 01756 753804 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) sharon.blackwell@anchor.org Anchor Trust Mrs Judith Gibbs Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2006 Brief Description of the Service: Gills Top provides personal care and accommodation for up to 27 older people and is owned and managed by Anchor Trust. The home is a detached property within a short walk of Grassington village centre. The accommodation is purpose built and is spaced over two floors and all areas are accessed by a vertical passenger lift. The home is set in its own grounds. There is a car park to the front of the home. The weekly fees on 15th August 2007 range from £329.50 to £468.00 and do not include costs for hairdressing, chiropody, toiletries and newspapers and magazines. People who use the service/relatives and other interested parties are able to have access to inspection reports as they are displayed in the main hallway of the home. Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The accumulated evidence used in this report has included: • • • • A review of the information held on the homes file since its last inspection. Information submitted by the registered provider in the Annual Quality Assurance Assessment report. Surveys received from three people who use the service, two health professionals and two care managers. An unannounced visit by one inspector to the home lasting six hours. This visit included a tour of the premises; examination of records, observation of care practices. Talking to people who live at the home, their relatives, a visiting GP, care staff and management. Looking at five people’s care files in detail. What the service does well: The home is managed in the best interest of the people who live there this means they will be provided with a good service of their choice. Staff at Gills Top are aware of the major life changes for a person moving into the home and provide people with the extra support needed to help them adapt. People who live in the home responded that they all receive the care and support they needed and that staff listen and act on what they say. Positive comments made were: “I still enjoy living here, the staff are wonderful, and my needs are met. The care is just like being at home”. “They help with personal care if needed”. “I am very well looked after and comfortable. Anchor Trust, Grassington is a very friendly and happy home. I am very happy here. (I am very independent which is encouraged).” Gills Top DS0000007960.V346173.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. Gills Top DS0000007960.V346173.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 Gills Top DS0000007960.V346173.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): Standard 3. People who use the service experience good quality outcomes in this area. People are provided with good information about the home and their diverse personal needs are identified and planned for before moving in, this make sure Gills Top is the right place for them to live. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People who live at the home confirmed that they were provided with information about the service before moving in and they had the opportunity to look round the home before making a choice. One person said they came to look round the home with their family. Another person said: “It was my decision to come in for respite care. I then decided to become a permanent resident”. Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 9 The manager confirmed that a service user guide is sent to anyone when making an enquiry about the home. The registered manager or acting team leader usually visit prospective residents in their homes and complete an assessment. This is to make sure staff at the home will be able to provide a service that will meet the person’s needs. Following this people are encourage to spend a day at the home to provide them with the opportunity to meet everyone and to get a feel for the home before they decide whether they want to stay permanently. When people are accepted into Gills Top the manager or the acting team leader gathers information from the care manager, health professionals, the general practitioner and the relatives and use this information to write an assessment of the persons needs, when they first come into the home and for the persons care plan. Two records looked at where people were recently admitted. Both contained an assessment of the person’s individual needs, which was carried out before they had come into the home, and assessments from the local social services. These were detailed and provided enough information for the home to be sure it could meet the persons needs. Also, both had life histories completed which gave insight into their lifestyle before moving into the home. Gills Top does not provide intermediate care. Gills Top DS0000007960.V346173.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): Standards 7, 8, 9 and 10. People who use the service experience excellent quality outcomes in this area. People’s personal and healthcare is provided appropriately and sensitively according to individual needs. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Staff aimed to promote the independence of people who use the service and to provide support in a sensitive manner. People’s preferences as to how they wished to be supported were recorded within individual care plans. Daily record entries reflected the care that was being provided. Each person living at the home had a GP and access to chiropody, dental and optical services. Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 11 During the site visit staff were observed to be warm, friendly and respectful to people in the home, they knew them well and were aware of their personal preferences. The responses from the people who live at the home about the care offered to them were positive, comments made were: “I still enjoy living here, the staff are wonderful, and my needs are met. The care is just like being at home”. “They help with personal care if needed”. “I am very well looked after and comfortable. Anchor Trust, Grassington is a very friendly and happy home. I am very happy here. (I am very independent which is encouraged).” One GP was spoken to on the day and made positive comments about the home such as: “Very well run home and a fairly happy ship”. Survey were received from two health care professionals who made comments about the home and said: “Residents appear to be well cared for and well stimulated. Residents appear to be happy in their day to day living; all needs appear to be met. This is a beautiful home, residents well cared for, staff are very helpful and are always pleased to see us. “Provides a homely safe environment.” Two care managers also made positive comments via the surveys sent to them such as: “Families of residents are very complimentary about Gills Top and feel the care is excellent”. “Attends to the needs of the clients on an individual basis, with flexibility and respect for individual privacy.” All five care records had detailed risk assessments including reducing risks of falls. Care plans were well documented about people’s needs and how they were to be met by care staff. Daily records were in place and were also detailed well. People who were spoken to all confirmed that they have regular access to GP’s, district nurses, dentist, optician and chiropodist. This was also recorded in Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 12 their care plans. The manager said that the home is to introduce new lifestyle care plans, which are to be comprehensive in detail covering all aspects of people’s daily living. The home has a call bell system and people who live there confirmed that call bell requests were attended to quickly. The medication system and facilities were inspected. Medication is stored in a locked trolley and the home operates a monitored dosage system. Proper procedures were in place for the administration and storage of medication and a random check of medication supplies tallied with records. The medication administration records were up to date. However advice was given regarding medication for one person who had been in hospital for a short time and was unable to manage their medication on their return to the home. The person’s medication was currently being held by the home but was not part of the home’s monitored dosage system. The manager agreed that the medication would be given back to the individual for them to manage, as they are well enough now and are capable of looking after their own medication. All care staff who administer medication have received the appropriate training so that they are all competent in this area. Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 13 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): Standards 12, 13, 14 and 15. People who use the service experience excellent quality outcomes in this area. People who use this service are able to make choices about their lifestyle and are supported by staff to carry these out. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People living at the home all confirmed that they are able to get up and go to bed as and when they wish and that daily routines are flexible. Gills Top employs an activities organiser who works 20 hours per week. People living at the home said that they have the opportunities to attend various activities such as exercise classes, poetry and reading, music, arts and crafts, quiz corner, coffee mornings, friendship club. There was plenty of evidence of people choosing different things to do as people were observed in the morning reading magazines or a newspaper. One person was sat with their visitor playing cards. Other people were sat chatting in a lounge whilst having a cup of coffee/tea and biscuits, which had been Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 14 brought round by a drinks trolley. In the main dinning room there was fresh coffee available through out the day. There is also a water dispenser in the dinning room for anyone wanting a cold drink. Through out the day there were several visitors to the home. Visiting arrangements were flexible and people spoken to were able to confirm that they can see family and friends whenever they want. One visitor said they thought that Gills Top was a good home and there was only one fault and that was that the home was not larger so that it could accommodate more people from the local community. In the afternoon the activities organiser was reading from a book, which was an autobiography written by a person who lives at the home. About twelve people who live at the home attended this. All seem to enjoy listening and commenting about past history and events. People who live at Gills Top also have opportunities to go out on trips as people discussed the recent boat trip on the canal. People also said that they were going out on a trip the following day and were going on a ‘trip up the dales’. One person who lived at the home said they did not have enough hours in the day as they enjoyed attending the activities that were going on in the home as well as having hobbies of their own that they continued to enjoyed doing such as embroidery. The manager and people who live at Gills Top said that regular church services from the different denominations such as Methodist, Anglican and Congregational take place. There had been a church service that morning. The lunchtime routine was observed and people were offered choices. Daily menus were on the tables in the dinning room. People spoken to all commented that the food at Gills Top was always good. Comments made were: “It’s like a four star hotel with very posh menu’s and two choices available. Diets like vegetarian are provided for” “Food is wonderful”. “The food is excellent and we always have a choice”. “I require a special diet and every effort has been made to serve me with special meals”. Gills Top DS0000007960.V346173.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): Standards 16 and 18. People who use the service experience good outcome in this area. People who use the service have access to an effective complaints procedure and are protected from harm. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has a comprehensive complaints procedure in place, which is made available to people as it is displayed on the notice board. The home records all complaints they receive. Two complaints have been received by the home and appropriately investigated with satisfactory outcomes. The Commission For Social Care Inspection has received no complaints. People living at the home said that they were aware of how to raise any concerns. They said they would approach care staff or the homes management team if they had a serious complaint and they were confident that they would put things right. People also confirmed that residents meetings are held regular. There is a comprehensive policy and procedure with regard to adult protection and staff have a good awareness of this. All staff receives training in adult Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 16 protection issues during induction and further training organised by the organisation. The recruitment procedure continues to be robust, and ensures that only suitable people are employed, which helps to safeguard people from abuse. Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 17 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): Standards 19 and 26. People who use the service experience excellent outcome in this area. People live in a safe, clean and comfortable environment that is suitable for their needs. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: There is a large lounge/dinning room on the ground floor with a smaller lounge on the first floor. There is a passenger lift and a staircase that allows access to all floors. There is a large garden to the rear of the property that can be accessed from French doors in the lounge. Some people’s bedrooms on the ground floor have also doors out onto the garden. The garden had plenty of outdoor furniture for people to sit out in good weather, which people said they enjoyed doing. Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 18 Several people living at the home showed the inspector their rooms. All rooms seen were clean free of any odours and maintained to a good standard. People have been able to furnish their rooms with pieces of their own furniture. All bedrooms at Gills Top have en-suite toilet facilities. Assisted bathrooms and toilets were situated near to people’s bedrooms and communal areas on both floors. The main lounges and corridors have been redecorated and new pictures had been purchased giving the whole accommodation a fresh, clean look that is maintained to a high standard. There had been some building works completed in the main entrance making it larger than originally. This has made the entrance better for people especially people who use wheelchairs, as it is more spacious now. This had been further enhanced by the arrangement of fresh flowers on a hall table. The inspector was told that fresh flowers were bought each week for the main hallway as people who live at Gills Top and their relatives like to see them as it makes the home more welcoming. Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 19 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): Standards 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. Sufficient staffing levels, proper recruitment procedures and good staff training meant that people’s needs were met and their interests were safeguarded. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Staffing levels were sufficient for meeting the needs of people who live at Gills Top. Following a requirement made at the last inspection where it was found that all the staff including carers, were taking their lunch break together. This was not good practice as it was not in the best interest of people living at the home. Since the last inspection this practice has ceased and care staff now, all have staggered breaks so that carers are always available to see to people’s care needs. The rota was unclear at the last inspection as to which staff were on duty. This has now changed and the format used was clear as to which staff were on duty. The staff rota showed that there were four members of care staff on duty in a morning and three care staff each afternoon. This does not include all of the staff such as the manager’s, activities organiser, and ancillary and administrator hours. On the day of the site visit a new carer had commenced working at the home and was additional to the staff compliment as they were receiving their induction training (Skills for Care) from the registered manager. Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 20 People living at the home said they felt that their needs were being met by the staff and made positive comments such as; “Staff are very good, night carers always bring you a cup of tea each morning”. “I still enjoy living here the staff are wonderful. My needs are met”. Some people living at the home did say that the home continues to be short staffed as the home employed agency staff, although it was not a problem as it was regular staff that came to work at the home. The staff files of two members of the staff team were looked at. These showed that all the necessary pre-employment checks had been carried out prior to the new workers starting in post. All records showed completed application forms, two written references, CRB (Criminal Record Bureau) checks had been obtained. The home holds a training file for staff. This identifies what training staff has completed and what training is needed. Staff training records examined showed a good training programme. Staff have undertaken training in health and safety, fire safety, back care, first aid, food health and hygiene, protection of vulnerable adults and dementia training. The NVQ (National Vocational Qualification) Level 2/3 training is ongoing. The home has one trained assessor and two trainee assessors. Staff receive regular supervision and annual appraisals are carried out. Staff meetings are held regularly and minutes of meetings are recorded. Records of supervision were seen on both staff files. Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 21 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): Standards 31, 33, 35 and 38. People who use the service experience excellent quality outcomes in this area. People benefit from a well managed home in which their needs and wishes are put first. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has a good and effective management team in place. The ethos of the home is open and positive. People who use the service, relatives and health and social care professionals all commented highly about the home. An accident book is maintained in line with the requirements of Data Protection. Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 22 People’s finances were not checked at this site visit. Historical evidence from previous reports gives evidence that people’s financial interests are safeguarded. Quality Assurance systems are in place. People living at the home are sent surveys annually for their views about the home. This was done in October 2006. Regular residents meetings are held. The schemes manager carries out regular monthly visits to the home and reports are completed. Record keeping is of a consistently good standard. Information provided from the (AQAA) Annual Quality Assurance Assessment and the examination of selected health and safety documents show that regular checks to electricity and fire safety equipment are regularly undertaken. Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 23 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 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 4 X 4 X 3 X X 3 Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 24 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. Refer to Standard Good Practice Recommendations Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Gills Top DS0000007960.V346173.R01.S.doc Version 5.2 Page 26 - 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!