Inspection on 09/08/05 for Gladstone House

This inspection was carried out on 9th August 2005.

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

Gladstone House 25/07/07

Gladstone House 09/08/06

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

CARE HOME ADULTS 18-65 Gladstone House 28 West Street Scarborough North Yorkshire YO11 2QP Lead Inspector David Blackburn Unannounced 9 August 2005 8.30 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Gladstone House Address 28 West Street Scarborough North Yorkshire YO11 2QP 01723 373638 01723 373638 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Madoomatee Emambocus and Mr Hessan Emambocus Mrs Elaine Blake Care home only 11 Category(ies) of MD Mental disorder (11) registration, with number MD(E) Mental disorder - over 65 (11) of places Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 04/01/05 Brief Description of the Service: Gladstone House is a large detached property situated on the south side of the town. It is located on a public transport route and is convenient for local facilities and amenities. The premises occupy four floors. There are communal sitting and dining rooms for all service users on the ground floor. Bedrooms are provided on the two middle floors. The top floor is for staff use only. There is no passenger lift or stair lift. The property has a small garden to the front and a small rear yard. The staff offer care and services to persons who have had or who are experiencing mental health problems. The staff provide personal care, help, advice and guidance on daily living skills and activities, a catering service, a laundry service and domestic and cleaning services. All these services are offered in conjunction with input from residents. Leisure and recreational activities are offered in-house by the staff and at a number of external locations. Many residents can leave the premises unaided and take advantage of the many attractions available in the town. All residents are registered with local general medical practitioners who will make arrangements for the provision of more specialised health services where these are needed. Residents have direct access to community psychiatric nursing services. Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection upon which this report is based was the first to be undertaken in the inspection year April 2005 to March 2006. It was carried out over seven hours including preparation time. The focus was on a number of the key standards together with those that were the subject of requirements or recommendations at the last inspection. An inspection of some parts of the premises including a number of bedrooms was carried out. A number of records were examined including some policies and procedures and other documents, for example staff records. Discussions were held with the registered manager, the two staff on duty and seven residents, a number in confidence. A letter was received from a relative and a number of the responses to a questionnaire distributed by the manager to families, visiting professionals and other stakeholders were examined. Comments received from residents and in written form from visitors were supportive of the registered manager and her staff in the way care and services were offered in the home. This was the first inspection since the new registered providers took over and the manager was appointed and registered. The registered providers had not been involved with care home management in the past. The registered manager was formerly the deputy manager of the home. What the service does well: Good assessment procedures were in place that assured prospective residents that their needs would be fully and comprehensively assessed prior to admission. Detailed care plans including full risk assessments were in place. These were subject to regular review. This assured residents that their needs were well recorded and that care was delivered to meet those needs. One relative said “I am delighted with the superb attention she receives.” The registered manager and her staff took great care to ensure residents’ choices and preferences were properly recorded. This assured each resident that the required care and services could be given in the most appropriate manner. Residents were fully involved in all aspects of life in the home. They were able to devise the menus and enjoyed a varied diet with good choice. Residents were able to live in a clean, warm and safe environment. One resident said “I like my room. I have been encouraged to bring in my own personal items including some furniture.“ Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 6 Staff were well trained enabling them to meet individual resident’s needs. A number of residents said “All the staff are nice. We’re very well looked after.” The home was well managed. A relative said “I am delighted she is being cared for in such a well run and caring environment.” 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. Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2. Residents could be assured that through good assessment procedures their individual needs would be known and met. EVIDENCE: The files of the last two residents to be admitted were examined. Each contained a full assessment and care plan. These had been devised and compiled by a care manager of the funding authority. Further relevant information was available to enable the manager to make a reasoned judgement as to whether the prospective resident’s needs could or could not be met. Each assessment gave a clear indication of that particular person’s needs. This information formed the basis of the care plan used by staff in the home. The assessment of needs was regularly updated through the care plan reviews. For one former resident it was found that on re-assessment some of the original needs had been wrongly stated. The manager made the decision following re-assessment that the individual’s needs were beyond their capabilities and a transfer to a more suitable placement had been effected. Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9. Residents’ needs, choices and preferences were well recorded ensuring they were properly understood and met. They were able to enjoy a full lifestyle through good risk management. EVIDENCE: A number of case files were examined. Each was indexed and sectioned to enable ease of access to information and use. Each file contained the care plans. Copies were also kept in a locked cupboard in the dining room so that staff could easily refer to them. All care plans were reviewed on a monthly basis. These reviews had been signed by the keyworker (a staff member with special responsibility for one or more residents) and the resident. The care plans reflected how residents wished to organise their day. The manager and staff placed great emphasis on the rights of residents to make decisions for themselves. They were encouraged to take responsibility for their own lives. Any necessary limitations or restrictions were well recorded together with a risk assessment or risk and relapse management strategy. The manager was appointee for four residents. The records of transactions were seen and the money held reconciled against those records. There were no discrepancies. Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15, 16 and 17. Residents’ involvement with in-house activities and use of external facilities and amenities, regular contact with family and opportunities for social interaction were promoted and maintained enabling them to have a number of different life experiences. Residents’ dietary needs were well met through the provision of varied and nutritious meals. EVIDENCE: None of the residents was in gainful employment. It had been assessed that none would benefit from attendance at local further education classes. A number of residents were above retirement age. They were expected to take a part in the life of the home in terms of a number of domestic chores including tidying their rooms and some parts of the communal areas, washing up and helping with laundry. This expectation was recorded in the Statement of Purpose. Residents were encouraged by staff to continue to enjoy those activities that had been of interest to them prior to admission. A number of other activities had been introduced by staff. One resident said “They are always trying something new. But we also play bingo and for prizes!” Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 11 Residents made good use of the local community. They accessed shops, pubs, cafes, library and cinema. Regular outings to local places of interest were also organised. Public transport to the centre and other towns and villages passed the door. The notice board advertised a number of local events. One resident said “I like to go out most days. I walk into town but if I get tired I can catch the bus back.” Another said “I like to go to the shops on Ramshill. I can buy what I want there.” Positive comments were also made about activities in the home and the trips out. Four residents had no family contact either through the absence of any known relatives or through refusal of family to make contact. Family and friend contact for the rest of the residents varied between regular visits, spasmodic visits and contact through letter or card. Staff supported residents to maintain contact and would assist with visiting and letter writing. For those without contact staff paid special attention to their needs and often involved them in their own family life. Menus were devised and planned by residents. Food was bought locally to meet the requirements of those menus. Residents enjoyed four meals each day with a choice provided at breakfast and tea. Lunch usually the main meal of the day was a set menu but alternatives were available. Hot and cold drinks were available at each mealtime. One meal was observed. This was a pleasant social occasion with residents appearing to enjoy the food. A number of residents made complimentary remarks about the food and the overall catering service. “All food is nice here. They always give me what I want.” “I have no grumbles. They’re all good cooks.” “Meals are homemade. I can’t complain.” Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18. 19 and 20. Residents’ social and health care needs were met through good attention to the way care was offered, health services being readily obtained and proper systems in place for the administration of medication. EVIDENCE: All residents could self-care to a greater extent. Any assistance required was generally advice and encouragement about personal care. The manner in which any direct care was to be offered was recorded in the care plans. Healthcare needs were recorded within the care plans on a health referral sheet that detailed the reason(s) for referral, the outcomes and the need for further appointments. Completed sheets were seen on the care plans examined. Residents had access to local medical practitioners and members of the community mental health team. One resident said “The staff come with me when I see the doctor. I like them to be there.” Proper arrangements were in place for the receipt, storage, administration, recording and return of medication. A monitored dosage system was in use for the majority of medication. A receipt book recorded medicines delivered to the home and all medication was checked. Storage was in a locked cupboard. The medication administration sheets were examined and were being completed correctly. One resident self-medicated. All staff who administered medication had undertaken an external course of accredited training. Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23. Residents had the confidence their concerns and worries would be listened to and acted upon and that procedures were in place designed to promote and maintain their protection from harm. EVIDENCE: The complaints procedure was displayed in the home. It detailed how to complain, to whom and gave timescales for response. Appropriate references were made to the regulatory authority. Policies and procedures were in place for the protection of vulnerable adults. Copies were seen of the Department of Health publication “No Secrets” and the revised multi-agency agreement on the Protection of Vulnerable Adults. These were on display on the notice board. A number of other policies were seen on display including whistle blowing. Staff were aware of the procedures to be followed should abuse be suspected or alleged. Proper recruitment and selection procedures were in place. These required a completed application form, written references and a POVA/First check, where applicable and an enhanced disclosure from the Criminal Records Bureau. The files of the last two staff to be employed were examined. They contained the required documentation. Residents said if they were concerned they would “talk to Elaine (the manager). She’ll make it right.” Another resident commented “If Elaine can’t help, I’ll come to you. You’re an inspector aren’t you. It’s your job to sort it out.” Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30. Residents were provided with a homely, comfortable, safe and hygienic place in which to live. EVIDENCE: Gladstone House is a detached four storey building conveniently located for local amenities and facilities. The ground floor is used for communal areas, kitchen and laundry. The two middle floors have the bedroom accommodation; two shared rooms one with an en-suite facility and seven single rooms. There were adequate communal bathrooms and toilets. The top floor was for staff use only. There was a small garden to the front provided with tables and chairs and a small rear yard. Some bedrooms were seen. Two had new carpets. All were well personalised. All bedroom doors could be locked and residents had a key and one to the front door. The laundry was in an outbuilding but could be accessed without the need to go through communal areas or kitchen. Proper procedures were in place for the transfer of laundry and to eliminate the risk of cross contamination or infection. Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 15 Those parts of the premises seen were warm, clean, tidy and free from offensive smells. The latest reports from the fire officer and environmental health officer recorded no concerns. It was noted that a number of trailing leads and sockets were in use. These should be replaced with a safer and better means of enabling appliances to be connected to a power source. Residents were very happy with their rooms. “I have a nice room. I’ve brought in some of my own things.” “My room is my own. I’m lucky it’s so nice.” “I’m surrounded by things of my own. Staff say this is my room.” Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35. Residents were being cared for and their assessed needs met by a competent, motivated and well-trained staff. EVIDENCE: Some staff files were seen. They contained the relevant documentation following successful recruitment and selection together with a training plan and record. All staff had undertaken a period of in-house induction organised and facilitated by the registered manager. This was now being supplemented by an external course “Introduction to Care” organised and run by an independent company. Further training was given in-house to standards set by and using material supplied by “Skills for Care” (formerly the Training Organisation in Personal Social Services). Evidence of some of this work was seen. Staff confirmed their attendance on a number of training courses including moving and handling, fire safety, first aid and food hygiene. Their attendance on these courses and the dates for refreshers were noted in their training records. Staff were committed to training and eager to attend relevant courses. A number of staff had achieved a National Vocational Qualification in care while others continued work towards this award. Residents were extremely complimentary in their comments about the staff and the care they provided. “They’re all nice.” “They’re lovely. They all seem to care about us.” “You couldn’t get better girls anywhere.” Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42. Residents were able to live in a properly managed, safe and secure environment. EVIDENCE: The manager was registered by the Commission in April this year together with the new providers. She was previously the deputy manager and had a number of years experience in various care settings. She held a care management qualification and continued her work towards a National Vocational Qualification in care and management to level 4. Residents and staff spoke of the recent changes in ownership of the home. The registered providers must make certain that the appropriate support is available for the manager and staff to effect a smooth transition and to eliminate any adverse effects on residents. The registered manager was undertaking direct care on a number of shifts. The registered providers must ensure the manager has adequate time away from direct care for managerial and supervisory duties. Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 18 The registered providers must ensure that the home is visited at least monthly by them or their representative and a report on that visit submitted to the Commission. A quality assurance policy and procedure was seen. The manager was currently carrying out a survey through the use of a written questionnaire. This survey was directed at residents, families and visiting professionals. Some of the replies were seen. All were very supportive of the manager and staff in the way care was given, services provided and the home managed. The manager and staff were conscious of good practice in relation to health and safety maintenance. They were keen that the health, welfare and safety of service users, staff and visitors were maintained by the implementation of the correct procedures. Policies existed on general health and safety matters, COSHH (storage of hazardous substances), infection control and fire safety. A number of satisfactory safety reports and certificates were seen relating to the premises. However a safety certificate for the electrical installation and supply could not be found. Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Gladstone House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 1 x 3 x x 1 x J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 20 No. Are there any outstanding requirements from the last inspection? 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 37 Regulation 12(5)(a) Requirement The registered providers must ensure that the manager and staff are given proper and appropriate support to enable them to carry out their agreed roles. The registered providers must ensure that the manager is allowed sufficient time to undertake her managerial and supervisory duties. The registered providers must ensure that visits to the home are carried out at least monthly by them or their representative and a written report on these visits submitted to the Commission for Social Care Inspection. A safety certificate for all aspects of the electrical supply and installation within the home is required. Timescale for action By 31/08/05 2. 37 18(1)(a) By 31/08/05 3. 37 26 By 31/08/05 4. 42 13(4) BY 31/08/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 21 No. 1. Refer to Standard 24 Good Practice Recommendations Consideration should be given to the replacement of trailing wiring, extension leads and sockets with more suitable and safe alternatives. Gladstone House J53-J04 S63770 Gladstone House V239669 020805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit 4, Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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