Inspection on 04/11/05 for Gordon House

This inspection was carried out on 4th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Gordon House 20/11/08

Gordon House 27/11/06

Gordon House 11/08/04

Gordon House 26/04/04

Gordon House 28/01/04

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

CARE HOME ADULTS 18-65 Gordon House Belmont Grove Liverpool Merseyside L6 4EH Lead Inspector John McCabe Unannounced Inspection 09:30 4 November 2005 th Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 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 Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 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 Adults 18-65. 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. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gordon House Address Belmont Grove Liverpool Merseyside L6 4EH 0151 260 9022 0151 260 9022 gordonhouse@c-i-c.co.uk 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) Community Integrated Care Limited David George Bruce Care Home 20 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (20) of places Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Residents between ages 16 and 64 years 18 MD residents between ages 16 and 64 years (PC) and 3 named male residents 65 years MD/E (PC) 9th May 2005 Date of last inspection Brief Description of the Service: The care home is managed by Community Integrated Care (CIC) and consists of a single storey building which houses 20 residents with long term enduring mental health illness. All residents have their own bedroom. Shared communal spaces include a well-maintained garden. The residents are encouraged to follow a lifestyle in accordance with their own choices and preferences. Two experienced psychiatric nurses manage the home. Psychiatrists, GPs, community psychiatric nurses, social workers and family support all residents in the home. The residents are encouraged to take up paid jobs, attend daycentres, or follow educational programmes. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection commenced at 0930 hours. A full tour of the building was undertaken accompanied by a registered manager. The inspector spoke with staff and residents. Residents gave permission for the inspector to view their bedrooms. Documents and records relating to residents welfare and the safety of the environment were reviewed and discussed with the registered manager. Staffs’ personal files relating to the homes recruitment policy were reviewed and training programmes were discussed with the manager and staff on duty during the course of the inspection. The home was clean and tidy. What the service does well: What has improved since the last inspection? Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 6 More effort has been made for the Social Inclusion of the residents in the home. A senior member of staff and a resident completes a monthly monitoring document. This document is part of the on going Quality Assurance carried out in the home and reflects resident’s experiences. Staff development and training is on going for all staff. Currently care staff are involved in mental health awareness training provided by the Primary Care Trust. Residents who choose to do so are involved on the interview panel for prospective employees to the home. 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. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 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 the following standard(s): 1,2,3,4,5. The pre admission protocols for residents are undertaken by health care professionals and are robust, comprehensive, and always include a full and informed consultation with the resident and family. This ensures that the resident is accommodated in a therapeutic environment, which should enhance the mental and physical welfare of the resident. EVIDENCE: All residents suffering from a mental disorder undergo the Effective Care Coordination (ECC) assessment, which is undertaken by the resident’s social worker, psychiatrist, and community psychiatric nurse, before being admitted to the home. The pre admission assessment of the resident is to ensure that the care home can meet the care needs of the resident, and that the home can be a secure, therapeutic and safe place for the resident to live. Residents transferred from other psychiatric units can be placed on a Section 3 of the Mental health Act 1983, usually for six weeks to ensure that the resident is suited to Gordon House, and that the psycho social care needs of the resident can be met. On admission to the home, the senior nurses and carers work to ensure the safety of the residents. This includes undertaking extensive risk assessments Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 9 covering a range of issues such as smoking, pressure area care, nutrition, and challenging behaviours. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 6,7,8,9,10. The staff in the care home encourage residents to live a normal independent life as possible, which includes taking responsible risks. This promotes the independence and informed decision making by the resident. EVIDENCE: All residents in the home have an individual care plan, which is formulated by the senior nurses and the resident. The care plan includes risk assessments, choices and preferences of activities, nutrition, medications etc, and the naming of a support worker who will support the resident. Staff in the home provide residents with information, assistance and communication support to make decisions and to take responsible risks about their own lives, and daily living activities. Residents informed the inspector that the home was the best they had been in and enjoyed their independence, knowing that there was always a staff member to help them if they needed. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 11 Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 11,12,13,14,15,16,17. The care home staff have a good understanding of the residents and their support needs. This is evident from the positive relationships, which have been formed between staff and the residents. EVIDENCE: Residents in the care home are encouraged to take paid jobs, attend day centres, and participate in community activities. Many of the service users in the home are on Section 117 of The Mental Act (1983). These residents receive financial welfare allowances on a weekly basis; many of the residents told the inspector that it was not worth going out for paid work, as they would lose their welfare benefits. Resident’s enjoy leisure activities according to their choices and preferences. Residents told the inspector, that they had holidays in Lake Windermere; Blackpool, and Anglesey, and that staff have accompanied the residents if required. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 13 Residents help to plan menus, and organise “take away” meals on special occasions. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 18,19,20. The systems and policies for the administration and disposal of medications are clear and comprehensive. This ensures that residents are not put a risk EVIDENCE: All residents in the home can access their NHS entitlements; which includes, dentists, opticians, and chiropodist services. Care staff will accompany residents for hospital or clinic appointments. GPs visit residents when needs arise. No resident in the home self medicates, all medications for residents are administered by the nurses in the home. The protocols for the receipt, storage, disposal, and documentation of medications in the home are in accordance with the National Minimum Standards (NMS). Residents “Unwanted medications” are recorded by two first level nurses and then taken from the care home by a Clinical Waste Company. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 22,23. The arrangements and policies in the care home for protecting residents are robust, (including Whistle blowing) and staffs have the knowledge and understanding of Adult Protection issues, which protect residents from any potential abuse. EVIDENCE: The home has a complaints procedure and policy, which is documented in the resident’s guide/handbook. All information relating to complaints contains the address and telephone number of the CSCI. Since the last inspection, there has been no internal complaints, or complaints to the commission. The care home has up to date information on the Protection of Vulnerable Adults (POVA), which is included the induction course for newly appointed staff members. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 16 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 the following standard(s): 24,25,26,27,28,29,30. The standard of decor within this home is good, with evidence of continuing improvements, through maintenance and planning. The home does present as a homely, safe and comfortable environment for the residents. EVIDENCE: The care home environment is satisfactory; all areas of the home are clean, light, mostly well decorated and maintained including the rear garden area. Resident’s bedrooms have been personalised, and contain pictures and artefacts that reflect personal choices and preference; residents gave the inspector permission to view their bedrooms. The communal lounges are bright; one room is reserved for residents who smoke. All bathrooms and toilets in the home provide privacy, and meet individual needs. However the homes bathrooms and toilets need some upgrading, they especially need the replacement of cracked tiles, floor covering and repainting. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 17 Since the last inspection, it appears that the home was not as well maintained as previous. The inspector spoke to the handyman who said that since July 05 he is not based at Gordon Houses five days a week, but has to service many other sites in Merseyside which belong to the company. An outside contractor deals with emergencies such as water bursts. The homes infection control policy is in date and valid, and includes the prevention and spread of Methicillin Resistant Staphylococcus Aureus (MRSA) and Hepatitis B. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 18 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36. The standard of vetting and recruitment practices has improved with the appropriate checks being carried out on all new staff. This helps ensures that the residents are not put at risk. EVIDENCE: There is always a first level nurse on duty, who is assisted by care staff and ancillary staff. Currently there is a fulltime vacancy for a Registered Mental Nurse (RMN), a weekend chef, and a fulltime support worker. Advertising has begun for these posts. The homes recruitment policy is robust and in accordance with the National Minimum Standards (NMS). All staff in the home have an up to date CRB/POVA enhanced certificate, so ensuring the safety of the residents. The inspector evidenced the Personal Identification Numbers (PINS) of all the registered nurses in the home, which was documented on Nursing Midwifery Council (NMC) stationary. All PINS were in date and valid. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 19 Mandatory and specialist care training is facilitated in the home, evidenced of which was available on the day of the inspection. All staff in the home have documented supervision six times per year, this ensures that all staffs have the opportunity to discuss with the manager, and other senior nurses, any issues, which can effect or improve the care for the residents. Documented supervision of all staff gives the staff and managers opportunities to discuss their own /or identified training needs. Where possible residents look after their own financial affairs as the home doesn’t hold any bank accounts for individual residents. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 20 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42,43. The registered managers are supported well by senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. The documentation relating to the safety of the home is complete, up to date and valid, so ensuring a safe, comfortable, hygienic environment for residents to live in. EVIDENCE: The registered managers are very experienced psychiatric nurses, who have had many years care home management experience. Currently, one of the managers has successfully completed an NVQ Level 4 programme; the other registered manager will commence the course this year. The management approach of the home is open and positive and transparent for both residents and staff. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 21 The records in the home demonstrate that the views of residents and staff are taken into consideration when the home policies and procedures are formulated. The certificates of worthiness and insurances for homes appliances, including the Employees liability Certificate are in date and valid .The home has qualified First Aid staff on duty at all times of the day. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 22 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 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Gordon House Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 DS0000025106.V261034.R01.S.doc Version 5.0 Page 23 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. 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. 1 Refer to Standard YA27 Good Practice Recommendations It is recommended that a planned programme of refurbishment for the homes communal toilets and bathrooms be commenced. Gordon House DS0000025106.V261034.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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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