Inspection on 07/01/06 for Gorselands

This inspection was carried out on 7th January 2006.

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 16/05/05

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 Gorselands 45 The Avenue Clevedon North Somerset BS21 7DZ Lead Inspector Juanita Glass Unannounced Inspection 07th January 2006 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 Gorselands DS0000008097.V263486.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 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 DS0000008097.V263486.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gorselands Address Gorselands 45 The Avenue Clevedon North Somerset BS21 7DZ 01275 872315 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) laspiller@aol.com Mr Lawson Anthony Spiller Mrs Lesley Karen Spiller Mr Lawson Anthony Spiller Care Home 30 Category(ies) of Dementia (30), Dementia - over 65 years of age registration, with number (30) of places Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 30 persons aged 6O years and over suffering with Dementia. 16th May 2005 Date of last inspection Brief Description of the Service: Goarselands is registered to provide accommodation and personal care for up to 30 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 Goarselands for many years and are have recently extended the property to include three new en-suite rooms. Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a very positive unannounced inspection, which took place in the presence of Mr Spiller the owner and Cindy Ellison the acting 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. The obtaining of POVA 1st confirmation was discussed with Mr Lawson as it was one of the requirements made at this inspection. Mr Lawson had been working to advice given to him by a CRB representative, which was incorrect, it was agreed that CRB would be contacted and the correct procedure confirmed. What the service does well: What has improved since the last inspection? Two requirements were made at the last inspection and both have been complied with. All staff have now received manual handling training which will be refreshed on an annual basis. Mr Spiller has completed a fire risk Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 Page 6 assessment of the home. Due to changing circumstances Mr Spiller has appointed Cindy Ellison as acting manager with a view to taking the post of registered manager in the future. 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 DS0000008097.V263486.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 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 the following standard(s): 1, 3,4 and 5. 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. Neither the statement of purpose nor the service user guide has required a review of its contents. The files of five 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. Mr Spiller confirmed that Ms Ellison would be involved in future admissions. Residents spoken to were unable to express an opinion on the admission process. Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 Page 9 Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following 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 resident’s needs, with the exception of clear risk assessment. The rapport between staff and residents is informal and friendly whilst maintaining dignity and respect. The recording of medication does not meet current guidelines. EVIDENCE: Care records for five 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. It was noted that residents at risk of falling were not adequately identified with a clear risk assessment this was discussed with Ms Ellison and an agreement met. Staff spoken to showed an awareness of Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 Page 11 residents personal interests and these are used throughout the day in one-toone 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. 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. However it was noted that a separate audit of Temazepam was not being maintained. An audit must be recorded in the Controlled drugs book. Staff were observed throughout the day to treat residents with respect and dignity, residents spoken to said that staff were always kind and caring; Several residents commented on specific members of staff pointing out those they referred to as ‘good girls.’ The rapport between staff and residents was clearly relaxed and friendly. Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 12, 13, 14 and 15 The home provides a programme of meaningful activities are organised by the care staff in the afternoons. Residents are encouraged to exercise personal choice where possible. The meals offered a nutritious well-balanced and choices 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. During the inspection one lady was observed to be reading about it with Reg Christie novel lost another was knitting another couple were taking the opportunity to wander out into the garden. It was evident from care records 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 Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 Page 13 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 DS0000008097.V263486.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 16 and 18 The complaints procedure in the home is satisfactory and staff demonstrated a 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 DS0000008097.V263486.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 19, 20, 21, 24 and 26 Goarselands 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 three 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 Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 Page 16 provided and staff have all attended infection control training and showed an awareness of the importance of infection control within the home. Three new en-suite rooms have been completed which are very bright and airy; and are appropriately furnished the new lounge area with patio doors onto a paved area of garden proved to be very popular on the day of the inspection. Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 and 30 The residents are not protected by the homes current recruitment policy and practices. Staff receive appropriate training to meet the needs of the current resident group. EVIDENCE: Most of the care staff employed have received training in dementia care and training dates are regularly advertised on the notice board for those who have not. Records showed that staff have attended training in first aid, food hygiene, health and safety and fire safety; since the last inspection staff of also received training in manual handling, and the new acting manager has plans for a full training programme for staff. Staff spoken to showed an awareness of the needs of the residents with dementia. Personnel records reviewed for staff showed that POVA first checks had not been obtained prior to staff commencing work at home this was discussed with the owner Mr Spiller who stated that he had been working to guidelines given to him by a representative from the CRB, which were incorrect. It was agreed that the correct procedure would be confirmed with the CRB however a POVA first must be obtained prior to a new member of staff commencing work with vulnerable adults. Staff records also lacked the information required under schedule to of the Care Standards Act 2000. Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 36 and 38 The manager is registered with the commission social care inspection. The management in the home is open and approachable. New staff are offered a full induction and formal supervision is carried out on a regular basis. Health and safety within the home a satisfactory. EVIDENCE: Mr Spiller, the manager, has attained his Registered Managers Award and has many years experience managing a care home. Mr Spiller has appointed Ms Ellison as the acting manager with a view to becoming the registered manager in the near future. During the inspection it was observed that the manager had a very close rapport with residents and staff alike, residents spoken said they liked him, staff stated that they felt they could approach Mr Spiller at any time. 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 Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 Page 19 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. Since the last inspection Mr Spiller has carried out a fire risk assessment of the home and this is included with the firelog records. Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 Page 20 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 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 3 X 3 STAFFING Standard No Score 27 X 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 3 X 3 Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 Page 21 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. 1 Standard OP8 Regulation 13(2) Requirement Timescale for action 17/02/06 2 3 4 OP9 OP29 OP29 13 (2) 19 (4) 19 Sch 2 The manager must identify residents at risk of falls and put in an appropriate risk assessment. An audit trail must be 17/01/06 maintained in the CD book for Temazepam A POVA 1st confirmation must be 17/01/06 obtained before new staff commence work. Staff records must contain the 17/02/06 information required under schedule 2 of the Care Standards Act 2000 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 Gorselands DS0000008097.V263486.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street 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 DS0000008097.V263486.R01.S.doc Version 5.0 Page 23 - 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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