Inspection on 05/06/08 for Gingercroft

This inspection was carried out on 5th 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

Gingercroft 17/07/06

Gingercroft 30/11/05

Gingercroft 08/06/05

Gingercroft 05/01/05

Gingercroft 03/08/04

Gingercroft 19/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Gingercroft Wharf Road Gnosall Stafford Staffordshire ST20 0DB Lead Inspector Kathryn Marks Key Unannounced Inspection 5th June 2008 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 Gingercroft DS0000004946.V365819.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. Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gingercroft Address Wharf Road Gnosall Stafford Staffordshire ST20 0DB 01785 822142 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) gingercroft@ukonline.co.uk Gnosall Health Care Limited Susan Patricia Ecclestone Care Home 14 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (14) of places Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th July 2006 Brief Description of the Service: Gingercroft is a large detached house that has been extended to accommodate 14 elderly people. The home is situated in the village of Gnosall where there are shops, public houses, a church and a new Health Centre. Service users’ accommodation is located on the ground and first floor of the home offering both single and shared bedrooms, the first floor being accessed via a passenger shaft lift, stair chair lift or staircase. Communal areas consist of a very pleasant dining room that overlooks the patio and two lounges. Bathrooms and toilets are sited on both floors and offer assisted facilities. Externally there are gardens to the side and rear of the home with limited offroad parking. The four General Practitioners who are based at the Village Health Centre own Gingercroft. The homes Statement of Purpose and Service Users Guide were not reviewed at this visit therefore, readers of this report may wish to contact the home for up to date information regarding Fees. Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Overall quality rating for this service is 2 Star. This means that the people using the service experience good quality outcomes. This inspection was carried out on Thursday 5th July 2008 between 9am to 4pm. On arrival at the home for this unannounced Key Inspection there were a Senior Care and a Care Assistant on duty with the Deputy coming on duty at 10.30 am. There was also a Cook and Housekeeping staff. The Annual Quality Assurance Assessment had been returned to us by the service. Completion of the AQAA is a legal requirement and it enables the service to under-take a self-assessment, which focuses on how well outcomes are met for people using the service. It was completed to a good standard and gave detailed information about the services offered. The Care Manager also provided written information regarding staffing, staff training, menu and dietary provision that was observed by the inspector to be in place at the home. On arrival at Gingercroft one person using the service was just coming back to the home having been for an early morning walk. Remaining people who use the service were having breakfast chatting to staff and planning their day. We talked to people who use the service and three relatives during the visit all spoke positively about Gingercroft. People who use the service and their relatives made positive responses to surveys that had been carried out in house and sent by us. What the service does well: The homes Statement of Purpose and Service Users Guide provides detailed information for people who wish to use the service on the services Gingercroft provides. The home continues to provide a high standard of care with support being provided by the four general practitioners who own Gingercroft and the local health care practice. Throughout the time we spent at the home talking to staff and people who use the service people were chatting to each other and jovial banter was being exchanged Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 6 Individual accommodation is located on the ground and first floor, bedrooms visited were maintained to a good standard and personalised as individuals wished. Responses to Surveys we carried out included: 3 staff surveys that told us that they are usually given up to date information about the needs of people using the service. That all staff had CRB and POVA checks carried out and references taken up prior to employment to ensure people using the service are cared for appropriately and safely. All told us they received induction training relevant to their roles helping them to meet the needs of people using the service. What has improved since the last inspection? What they could do better: Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 7 The current plans to extend Gingercroft will provide the home with en/suite facilities giving people using the service more choice and will also reduce the amount of shared rooms the home has at present. The information obtained prior to, and during this inspection indicates that the management are keen to continue improving their service for the people living in the Home. 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. Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 8 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 Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 9 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, & 6 was reviewed at this visit. Quality in this outcome area is good. People who wish to move into Gingercroft receive all the information they require and they are assessed so that they can be assured the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA that we received before we went to the inspection told us that people wishing to move into the Home receive a thorough assessment before they move in. We talked to people using the service and two relatives who told us they had been given information about accommodation and the services the home is able to offer prior to moving in. Relatives told us they had visited the home before their relative moving in. One person using the service told us he knew the home because he had visited his brother who used to live here. Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 10 Prior to admission to Gingercroft a full assessment of the needs of people using the service is carried out to ensure that Gingercroft and its staff are able to meet the assessed needs. We saw detailed assessments in place for the last three people admitted to the home. This process-included district nursing service, social worker if involved and any other professional who had been involved with the person using the service. This means that they could be assured that the home could meet their needs before they moved in. The home does not provide intermediate care. Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is good. Standards 7,8,9,10 were reviewed at this visit. The home meets the personal, health and social needs of people using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff at the home supported by the four general practitioners who own Gingercroft meet the health and personal care needs of people using the service. Detailed care plans in a modular format provide information regarding health care that records doctors’ visits, diagnosis and treatment. Medication reviews and weights are also recorded. No one is currently self-medicating. Medication is administered from a monitored dosage system and signed for as given. Medication Administration sheets were seen that are signed and up to date. Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 12 Medication is stored in a locked metal cabinet. No staff under the age of 21 years administer medication, all other staff are trained to carry out this task. The people using the service are protected by the safe medication procedures. Care plans detail how the needs of people using the service are to be met. We saw that regular reviews take place to ensure all actions have been followed. Risk assessments are in the care plans, which means that the staff have the information they require to support people using the service safely. Observations were made of privacy and dignity being promoted. We saw people using the service being consulted about what they wanted to do, what they wanted to eat. People were spoken to in a respectful and considerate manner. The home gave us an analysis of the surveys they had given to the people using the service. This told us people using the service found the home to be friendly, comfortable and warm. We saw the surveys and talked to people who use the service who confirmed the information in them. All but one person felt that the staff met their needs as identified in their care plan. A reassessment of the needs of this person was carried out and their care plan updated. All felt that the staff dealt with personal issues with consideration for privacy and dignity. We discussed this with individuals whose records we had reviewed and they confirmed this. The AQAA tells us the home meets the Health and Personal Care needs of the people using the service with their records of individual care plans, risk assessments, policy for administration of medication, medication reviews, medication training all of which were seen at the time of inspection. Gingercroft DS0000004946.V365819.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, 15 were reviewed at this visit. Quality in this outcome area is good. The people using the service are given opportunities to enjoy fulfilling lifestyles and maintain relationships. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On arrival at the home we met a person using the service who was returning from an early morning walk. This person said they enjoyed living at the home and the feeling of security it gave them whilst having the opportunity to come and go as they pleased. One person has a vegetable plot and a greenhouse, which they look after and get a lot of pleasure from. This person said, “The Greenhouse gives me an interest growing tomatoes, cucumber, peppers and pumpkins” Other people using the service and visitors are interested in the produce that was being grown. One person using the service said she would like to go on a cruise, as she likes the sun so much. Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 14 People using the service who wish to attend the local church are assisted by staff or relatives to do so. One person using the service is going to the village church to see a staff member get married. At the time of this visit there were no people of different cultures or religions at the home. Two gentlemen are going to visit the National War Memorial Arboretum at Alrewas. One person has a tea making facility in their bedroom and the home makes sure that this is done safely. Comments from people using the service during this inspection included: “Staff ever so kind and helpful”, “Happy as anybody could be”, “Staff are really good”, “Lucky I ended up here”, “Very comfortable here”, “Lunch is delicious same every day never had anything that’s not been nice”, “Best restaurant I know”. We had lunch in the garden with people who use the service, lunch was nicely presented and the portions were generous. Contact is maintained with relatives and visitors; three were visiting the home during our visit and made very positive comments: “X is very happy at the home”, “You could not find a better home”, “Stops you worrying when you know X is being well cared for”, “Always wonderful cooking smells when you visit”. The menu is discussed with people using the service and the cook was seen to be discussing the day’s food with individuals. One person using the service told us, “I don’t have to have what’s on the board if I want something else”. The menu is displayed in the dining room with alternatives being available. All fresh meat and produce are used and the home has an aroma of home baking. Staff told us that recent questionnaires from people using the service had highlighted requests for different meals that had now been incorporated into the menu. We saw this documented in the minutes of service users’ meetings. The home demonstrates that they meet the social and recreational needs of the people using the service. Gingercroft DS0000004946.V365819.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, 18 were reviewed at this visit. Quality in this outcome area is good. People who use the service are able to make complaints and are safeguarded by the home’s procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is displayed in the hallway and our address was updated at the time of this inspection visit. This enables people to know how to contact us. All people using the service are given the complaints procedure on admission to Gingercroft. The people’s surveys told us that they are aware of the complaints procedure. The homes complaints procedure was discussed with people using the service who told us they knew how to complain and who to talk to. “I would talk to staff or my relative, but I have never had to.” We spoke to relatives who were visiting the home and they were also aware of the complaints procedure. We know that the people using the service are protected from abuse because staffs receive training via National Vocational Qualifications and all staff have received additional abuse awareness training. Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 16 Management told us they are confident that the staff understand issues of abuse; staff we spoke to were able to identify areas of abuse and told us that they had discussions about abuse and whistle blowing during supervision. The home has a complaints, grumbles, compliments book in which they would record any issue. Neither we, nor the home have received any complaints since the last inspection. The home demonstrates the above in the survey feedback from people using the service and their relatives, which indicates they are aware of the complaints procedure. Gingercroft DS0000004946.V365819.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, 26 were reviewed at this visit. Quality in this outcome area is good. Gingercroft offers a good standard of accommodation to people who use the service in a homely setting. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The location and layout of Gingercroft is suitable for its stated purpose providing accommodation for fourteen elderly people. A tour of the home identified that people using the service had personalised their bedrooms. One person would like an en/suite to their bedroom. When the planned new extension is built all bedrooms will have en/suite toilet. There is a friendly relaxed atmosphere with people using the service being comfortable in their surroundings. The home has just purchased new dining Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 18 room furniture and accessories that look very nice, crockery, tablecloths, and flowers. The handy person carries out routine maintenance as jobs arise. There is an ongoing redecorating refurbishment programme in place to ensure standards are maintained. Regular health and safety checks take place and are recorded. There has recently been a planned visit by the Fire Officer and the service is waiting for the report. The Deputy Manager told us no issues were identified. In December 2007 and February 2008 all staff received training in infection control procedures. On walking around Gingercroft, we saw that the home was clean and free from offensive odours. The AQAA tells us the home demonstrates the above by a rolling programme of maintenance, monthly health and safety audits, people using the service personalising their bedrooms. Gingercroft DS0000004946.V365819.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, 30 were reviewed at this visit. Quality in this outcome area is good. A well trained long standing team of staff support the people using the service and keeps them safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff on duty during our visit were as follows: Senior Care NVQ Level 2, care assistant NVQ Level 2, cook, housekeeper and the deputy manager NVQ Level 4. The deputy manager told us that 70 of staff are trained to NVQ Level 2 in care. The Care Manager and Deputy Manager have achieved NVQ Level 4 and the Registered Managers Award. We were told staff training is carried out and that staff had received the following: Abuse awareness Health and Safety Manual Handling Fire safety Equality and Diversity Infection Control MRSA C.Difficile Control Of Substances Hazardous to Health Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 20 Basic Life support Food Hygiene Data Protection This means that the staff have the skills to meet the needs of people using the service safely. We saw the staff training matrix which told us which training had been completed and where training needed to be booked. Robust recruitment procedures are in place to employ staff with Criminal Records Bureau and Protection of Vulnerable Adults checks being carried out to ensure people using the service are cared for safely. We saw Criminal Records Bureau and Protection Of Vulnerable Adults checks for the last three staff employed. The AQAA tells us that the home has maintained a consistent mix of sufficiently skilled and qualified staff to meet the needs of people using the service. No agency staff are employed. The service displays an equal opportunity policy, which tells us how they would meet diverse needs. Staffs are trained to work to this policy and discuss diverse issues at supervision. Specific food days are held i.e. French, Chinese, offering alternatives to those who do not like the particular style of food. All Staffs told us they received induction training relevant to their roles helping them to meet the needs of people using the service. Staffs told us they were aware of what to do if a person using the service wants to make a complaint and who to talk to. All staff said they felt well supported at the home. Gingercroft DS0000004946.V365819.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 were reviewed at this visit. Quality in this outcome area is good. The people using the service are safeguarded by competent management systems. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Gingercroft is a well managed home that provides comfortable homely surroundings for people who use the service. The Care Manager has the Registered Managers Award, 25 years experience in care and is competent and experienced to run the home and care for older people. Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 22 The home has a quality assurance system, which they use to monitor standards for the people using the service. Quality assurance and questionnaires are also used for people using the service and their relatives we saw an analysis of the completed questionnaires. The Annual Quality Assurance Assessment, (AQAA) was returned to us prior to this inspection-taking place and provided us with detailed information about the service. The manager told us in the AQAA that policies and procedures are in place and reviewed regularly. We saw some of them during this visit, which confirmed the manager’s statement. All people using the service deal with their own finances or are assisted by families or solicitors. Safe working practices are in place with all hazardous substances appropriately stored and regular servicing of equipment taking place. The staff training matrix identified that mandatory training is carried out and this was confirmed during conversations with staff and in the training records. The AQAA tells us that Care Manager and Deputy Manager hold the Registered Managers Award; that 70 of present carers have NVQ Level 2, and supervision records are kept on staff files. The proprietors carry out monthly visits to ensure standards are being maintained and people using the service are appropriately cared for. Gingercroft DS0000004946.V365819.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 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 4 X 3 X 3 X X 3 Gingercroft DS0000004946.V365819.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 Gingercroft DS0000004946.V365819.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West Midlands Office West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Gingercroft DS0000004946.V365819.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. 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