Inspection on 16/05/05 for Gorselands

This inspection was carried out on 16th May 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

Gorselands 27/09/06

Gorselands 07/01/06

Gorselands 17/11/04

Gorselands 25/08/04

Gorselands 02/02/04

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

CARE HOMES FOR OLDER PEOPLE Gorselands 45 The Avenue Clevedon North Somerset BS21 7BY Lead Inspector Juanita Glass Announced 16 May 2005 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 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. Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Gorselands Address 45 The Avenue, Clevedon, North Somerset, BS21 7DZ 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) 01275 872315 Mr Lawson Anthony Spiller Mr Lawson Anthony Spiller Care Home 27 Category(ies) of Dementia - 27 registration, with number Dementia over 65 - 27 of places Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17th and 19th November, 2004 Brief Description of the Service: Gorselands is registered to provide accommodation and personal care for up to 27 older people who are suffering from dementia. The property is set in a residential area of Clevedon near to the coast. The house provides accommodation on three floors and is set in attractively maintained and sheltered gardens which are secure. There is a passenger lift to all floors. Mr and Mrs Spiller have owned Gorselands for many years and are currently in the process of extending the property. Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a very positive inspection, which took place in the presence of Mr Spiller the owner and manager; residents spoken to although slightly confused could relay their feelings about staff and their accommodation. Staff spoken to felt supported in their work. During the inspection residents and staff were observed to have a close and friendly rapport, residents were well groomed and appeared to be very relaxed and happy in their surroundings. The secure gardens proved to be a popular asset during the warmer weather and residents were observed to wander outside when they wished to. During this inspection residents were spoken to either in a group or on a one-to-one basis, staff were spoken to and documentation was reviewed. What the service does well: What has improved since the last inspection? Mr Spiller the manager has completed his registered managers award. The extension work to the building is almost completed which will mean the secure gardens will be larger. Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 6 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. Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 and 5, as Gorselands does not provide intermediate care standard 6 does not apply. The needs of residents are assessed before admission to the home, and relatives are provided with clear information and a chance to visit the home to assist them in making an informed choice. EVIDENCE: The statement of purpose is very clear and contains all the required information including aims and objectives to promote privacy and dignity for residents. The resident guide includes a tariff off extra charges, which are not included in the fees. Copies of statements of terms and conditions or contracts were seen in the files reviewed during the inspection, these are usually signed by relatives or advocates, contracts included the room number and the name of the person responsible for paying the fee. The files of six residents were reviewed they all contained a full preadmission assessment carried out by the manager which were supported by a hospital or social service assessment and a social profile provided by the family; whenever possible prospective residents are encouraged to visit the home prior to admission with a relative, social worker or advocate. Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 The health and personal care needs of residents are well met, supported by a clear and consistent care planning system, which adequately provides staff with the information they require to satisfactorily meet residents needs. The rapport between staff and residents is informal and friendly whilst maintaining dignity and respect. EVIDENCE: Care records for six residents were reviewed, they were very clear and concise and provided adequate guidance for care staff concerning the residents physical, social and psychological needs. The records also included residents’ personal preferences such as their daily routine and their social interests and family history. Staff spoken to showed an awareness of residents personal interests and these are used throughout the day in one-to-one conversation. All the residents’ records contained a daily record of oral hygiene and staff were observed to be encouraging residents to clean their teeth after lunch, this is considered good practice. All residents are registered with the local dentist there was also evidence of attendance with the optician, chiropodist and the district nurse the home has a close relationship with the local mental health team. Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 10 All staff handling and administering medication have received appropriate training from the local pharmacist; staff observed during the inspection carried out the administration of medication in a safe manner, storage is appropriate to the needs of the home. Staff were observed throughout the day to treat residents with respect and dignity, residents spoken to said that staff were always kind and caring; one lady stated that they do difficult jobs but they continued to smile. The rapport between staff and residents was clearly relaxed and friendly. Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 The home provides a programme of meaningful activities that are organised by the care staff in the afternoons. Residents are encouraged to exercise personal choice where possible. The meals offered are nutritious, wellbalanced and a choice is provided. EVIDENCE: All staff are involved in organising activities, it was observed that residents regularly go for walks, and there are impromptu trips out in a minibus, visits by an outside entertainer are also arranged. Indoor games include bingo, memory lane, music and dance, one lady shows an interest in crosswords and the ball games are always popular, some residents appeared to particularly enjoy scripture readings. In discussion with the manager it was evident that activities are arranged to meet personal histories such as regular walks for a resident who once owned a dog and walked a lot, this is considered good practice. During the day residents were observed to exercise personal choice, many residents were able to wander out into the secure gardens when they wanted to, others could take part in any activity or sit quietly. There are no restrictions on visiting times from friends and relatives’ residents can entertain them in one of the lounges or the privacy of their own room if they wish. Residents spoken to confirmed that there was no pressure put upon them to do things they did not wish to do, care records stated preferred times of going to bed and getting up in the morning. Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The complaints procedure in the home is satisfactory and staff demonstrated good awareness of adult protection issues. EVIDENCE: The home has a clear and robust complaints policy and procedure, which gives timescales and directs relatives and residents to the Commission for Social Care Inspection. No complaints have been received since the last inspection and the complaints folder was available to read. The policies and procedures for the protection of vulnerable adults and whistle blowing were very clear and concise, staff spoken to were aware of the issues surrounding adult protection and knew where they could find the guidance in the office. The home also had a copy of the North Somerset interagency policy and procedure. Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 24 and 26 Gorselands offers comfortable and homely accommodation, which is clean, tidy and well furnished. Residents have access to a secure garden. EVIDENCE: Gorselands has a level access and lifts to all floors, there was evidence of ongoing maintenance and redecoration, the furnishings and décor are homely in style and lighting is adequate for residents to read by. The communal areas within the home consist of two lounges with dining areas, and a small quiet area, there is also a lounge area on the first floor, residents were observed to be using all the communal areas and the secure gardens. Residents spoken to said they had nice rooms and that the home was always clean and tidy, most rooms had been redecorated and refurbished some residents had chosen to bring in their own possessions and most of the residents rooms had been personalised and had a homely feel about them. The home was clean and free from any offensive odour during the inspection, suitable laundry facilities are provided and staff have all attended infection control training and showed an awareness of the importance of infection control within the home. Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Staffing levels within the home are adequate to meet the current needs of the residents. Staff training is maintained however manual handling training needs to be addressed. EVIDENCE: Current and past duty rotas showed that adequate staffing numbers are maintained in the home, residents and staff spoken to confirm that the there were always an adequate number of staff on duty. Most of the care staff employed have received training in dementia care and training dates are booked and advertised on the notice board for those who had not. Records showed that staff have attended training in first aid, food hygiene, health and safety and fire safety, staff spoken to showed an awareness of the needs of the residents with dementia. It was noted during the inspection that staff had not received regular updated training for manual handling, this is an important area that needs addressing and the manager confirmed that he would arrange training as soon as possible. Staff records contained most of the required information, CRB checks have been obtained for staff and the manager was aware of the need to carry out POVA first checks. Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, 37 and 38 The manager demonstrates an open and approachable ethos. New staff are offered a full induction and formal supervision is carried out on a regular basis. Health and safety issues are satisfactory, except for the documentation of a fire risk assessment. EVIDENCE: Mr Spiller, the manager, has attained his Registered Managers Award and has many years experience managing a care home, during the inspection it was observed that the manager had a very close rapport with residents and staff alike, residents spoken to jokingly called him the boss and said they liked him, staff stated that they felt they could go to Mr Spiller and the deputy manager Mrs Hopkins with any concerns they may have. The manager discussed the planned quality assurance, he is currently carrying out an audit of the policies and procedures and is in the process of composing a questionnaire for both residents and relatives, the manager maintains Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 16 contact with relatives on a regular basis, and they are involved in care plan reviews when they are given the chance to raise any comments or concerns. All new staff carry out an induction and records of the induction are kept with their personnel files. Formal supervision is carried out six times a year and covers six subject areas all areas are covered by the staff through the year these include revised policies and procedures, medication, vulnerable adults, care issues and health and safety, supervision can be carried out as joint working, observation or discussion. Health and safety within the home was satisfactory the firelog was reviewed and showed that all staff had received fire training updates throughout the year and that drills involving day staff and night staff were in line with current guidelines, a clear service record was available and insurance details were displayed in the entrance hall. In discussion with the manager it was noted that although a fire risk assessment had been carried out it was not documented and included with the fire log, a requirement was made that a full risk assessment must be carried out and documented. Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 3 2 Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 18 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. 2. Standard 38 38 Regulation 13 (5) 23 (4) Requirement The manager must provide and maintain Manual Handling updates for all staff The managher must carry out a fire risk assessment and documentation must be kept with the fire log. Timescale for action By 16/08/05 By 16/07/05 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 Good Practice Recommendations Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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. Extracts may not be used or reproduced without the express permission of CSCI Gorselands D53 - D02 S8097 Gorselands V220121 160505 Stage 4.doc Version 1.40 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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