Inspection on 27/02/07 for Gorselands Nursing Home

This inspection was carried out on 27th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Nursing Home 24/10/07

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

CARE HOMES FOR OLDER PEOPLE Gorselands Nursing Home Gorselands Nursing Home Coach Hill Lane Burley Street Ringwood Hampshire BH24 4HN Lead Inspector Tracey Horne Unannounced Inspection 27th February 2007 09:30 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 Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gorselands Nursing Home Address Gorselands Nursing Home Coach Hill Lane Burley Street Ringwood Hampshire BH24 4HN 01425 402316 01425 402110 Gorselands@bt.connect.com 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) Gorselands in the Forest Limited Mrs Patricia Christine Vinycomb Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37), Physical disability (7), Physical disability of places over 65 years of age (37), Terminally ill (7), Terminally ill over 65 years of age (37) Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection Brief Description of the Service: Gorselands is a registered care home providing nursing and personal care for up to 37 residents in the older person category. The home is situated in the village of Burley, in Ringwood. The service is privately owned and benefits from large well maintained gardens and views of the surrounding New Forest countryside. Accommodation is provided in a homely and tastefully furnished environment on two floors and passenger lifts are available that allows access to all parts of the home. The provider makes information available about the service, including a statement of purpose and service user guide and the commission’s report to prospective residents on request. Copies of these documents are available at the home and may be sent out by post on request. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place over one day. The people living at Gorselands prefer to be referred to as residents, therefore the rest of this report will reflect this. The opportunity was taken to look around the home, view records, procedures and talk with residents and staff. The inspector also had the opportunity to observe the interaction between residents and staff. Four residents were spoken with who stated that they were more than happy at the home. The inspector received thirty five comment cards from residents, five from relatives and twenty from staff prior to the site visit, all were very complimentary about the care and support provided / received at the home. The staff on duty during this visit felt they were very well supported to do their job. The manager confirmed the fees for the home range from £540.00 to £820.00 per week. What the service does well: The home had a very relaxed, homely atmosphere and residents spoken with all said that the staff were very caring, happy and friendly. Comments included ‘ I can’t fault them, I have wonderful care’ and ‘the staff are lovely.’ ‘The care I receive is next to none.’ Residents also said that staff were polite and treated them with respect at all times. The emphasis is on therapeutic, holistic, individual care. Staff said that they were very supported from the registered manager and the registered provider and that they all liked working in the home, and they feel very valued. One member of staff said people want to come and work here because they have heard how good it is to work at Gorselands. One member of staff who have worked in other care homes in the past said ‘Nothing compares to Gorselands, the residents definitely come first and are very well cared for by well trained, experienced staff. There are always enough staff on duty so that we don’t have to rush about, we spend quality time talking to residents, or doing exactly what they want, be it a walk in the lovely gardens or paint their nails.’ Two residents said ‘the staff team are very efficient and provide high standards of care for us.’ Residents are offered a variety of foods, fresh fruit and vegetables and lots of choice to enable a balanced, varied and healthy diet. All of the meals are Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 6 freshly prepared. All of the residents spoken with said ‘the food is always of an extremely high standard’ and said ‘we always seem to be eating, you are never hungry’. Four residents who were spoken with said ‘nothing is rushed here, there is a very relaxed atmosphere, take my time enjoying good food with conversation if I wish, the staff are very well organised and manage to ensure the high standards we expect and spend time with us if we wish. Cleanliness in the home is exceptional.’ Thank you cards were seen given to the home by relatives for the wonderful time they and their relatives had enjoyed at special birthday celebrations and Christmas. The home is extremely well maintained and suited to the service users needs. It is decorated and furnished to a very high standard, which creates a comfortable and homely ambience. The home offer various activities with external entertainers visiting regularly. Four residents said they usually attend activities, they enjoy the artwork sessions which were happening during the morning of the visit. The home has an open and good process in place for dealing with complaints, concerns and compliments. The staff teams at the home are skilled and receive regular training to be able to care for the residents. The home has a logical and detailed process for recruiting new staff. Residents said that they felt enough staff were on duty for each shift, with one resident saying ‘ I don’t have to wait if I want help, staff are always very attentive’. The staff said communication between each other is excellent, the trained staff ensure three detailed handovers occur for all staff on duty during a twenty-four hour period, staff said they are clear about what is expected of them and of their responsibilities during the shift. There are good systems in place for making sure that the service is run in a safe manner for the people who live and work at the home. One resident said they feel safe and comfortable at the home and their opinions are sought. The registered manager has a good rapport with residents and relatives and runs the home in their best interests. What has improved since the last inspection? Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 7 A whole new wing has been added to the home to provide a further ten ensuite bedrooms, a lounge/dining room, sluice rooms and an office, hence the new registration 30 June’06. Four bedrooms in the original part of the home have been made into en-suite rooms, and have been re decorated and had new carpets. Specialist equipment such as two ‘Parker’ baths, hoists and profile beds have been purchased. The garden has been landscaped, and a path laid to provide easy access and safe walking for people. A gardener attends the grounds each week. The staff team feel more settled, and say the whole atmosphere has improved since the refurbishment. 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. The summary of this inspection report can be made available in other formats on request. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A full care assessment is undertaken for everyone wishing to live in the home to ensure the home can meet their care needs. The home has the facilities to provide respite care to residents who have been assessed as requiring short term care. EVIDENCE: The manager explained the assessment process she follows, in line with company policy, and showed the inspector the information which is available to prospective residents, in the form of a colour brochure, which includes details that would enable people to make an informed choice about the home. One resident said ‘my daughter came to look around after it was recommended to her by my doctor, she looked around the home, the manager came to visit me and I moved in.’ Feedback from residents and relatives stated that they had received information from the home, which enabled them to decide that they wanted to visit the home to view the facilities and environment. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 10 The inspector looked at the three most recent pre admission assessment records. The manager had visited the prospective resident to complete the home’s pre admission assessment before a place was offered at the home. This was to ensure the home could meet their individual needs. The resident’s family were involved and asked to provide further information. Prospective residents and their families/ representatives are welcome to look around the home to see if the home would meet the individual’s needs. The pre admission information includes a moving and handling assessment, medical history, allergies, history and risk of falls, equipment needed, personal care needs, personal preferences, medication and any anxieties etc. One resident recalled the manager visiting them, and asking a lot of questions such as “what I liked and disliked, my interests, family history. Generally was interested in what I liked and could do, and what I needed help with”. The manager confirmed she is appropriately qualified to complete these assessments. Records showed that the resident, their family, next of kin were involved in a review of care six months after the resident moved into the home. Comments received from residents included, “They make you feel at home here,” and “It is like a family.” The home provides single accommodation, for one person to receive intermediate care for a short period of time before they return to their home. The inspector saw a room which a resident would use during their arranged stay in a few days time. There was a small bouquet of flowers on the windowsill of the room, the manager said the home always does this for new residents to welcome them. The room was tastefully decorated and had colour coordinated furnishings and a telephone point in case the resident wished to be connected to the telephone service. The manager showed the inspector letters that she sends out once a prospective resident has decided that they would like to live at the home. Once the manager is satisfied that the home can meet their needs, the home send a letter offering the prospective resident a place. The letter confirms which bedroom the resident will have. The resident’s contract states the fees that the home will charge them. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are involved in the development and review of their care plans and their health care needs are met. The home’s processes of storing and handling medication appropriately protect residents. Residents feel that they are treated with respect at all times. EVIDENCE: The inspector looked at four residents’ care plans. The plans were very comprehensive and contained the information gathered during the pre admission assessment. Staff said the care plans provide them with the information they need in order to provide the exact care and support the resident needs. Staff said they review the care plans with the resident on a monthly basis, records seen confirmed this and three residents said, when asked by the inspector, that they knew what was written in their care plans, as staff had discussed it with them and that they agreed with the information in their plans. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 12 All care plans have been signed and dated by the resident or their representative and by staff. One care plan gave clear guidelines for staff to provide palliative care and mouth care to the resident. Staff confirmed they had received training in this area. Risk assessments were included in the care plans including those for mobility, falls and nutritional risks. The manager confirmed that if staff have any concerns regarding nutrition of residents, dietetic advice would be sought. All risk assessments are specific to individual residents, for example the manager noticed that one resident was displaying symptoms of depression, the resident saw s psychiatrist who confirmed this. A risk assessment was completed and reviewed daily to ensure the resident was receiving the support they needed. Records showed that residents receive visits from GPs and other health professionals such as the physiotherapist, psychiatrists and holistic therapist. Records show residents were offered the choice of receiving an influenza vaccination. A resident said that she had received the vaccination, and this was recorded documented in her medical records. A trained nurse administers medication and there is a good medication policy and procedure in place, including the ‘Royal Pharmaceutical Society of Great Britain’ guidance for the administration and control of medicine in care homes. The home administers from single blister pack system provided by the local pharmacist. Medication is correctly stored in four lockable medicine trolleys, which were stored in the medical room. The home’s medical room and cupboards were clean and orderly with medication stored correctly in date and in sufficient quantities. The manager confirmed that at the time of the inspection no residents were self administering their medication. The manager said she orders and checks in all medicine received at the home. The records were seen and found to be satisfactory. The home uses the ‘Medicine Administration Record Sheets (MARS) system for recording the administration of medication. Each resident’s record also has a recent photograph. Medication that is in need of disposal is returned to the local pharmacy and a record is kept by the home that is signed on receipt by the pharmacist. Staff confirmed two trained nurses administer controlled drugs, the drugs were stored securely and records of administered drugs included two staff signatures, and tallied up with the number of drugs in storage. The inspector observed the staff interacting with the residents and found them attentive, caring, respectful and they have a good understanding of each individual’s needs. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 13 Staff induction records showed that privacy and dignity and the provision of personal care are covered during the induction process, and the response from residents indicated that the carers treat them with dignity and respect and that they are trustworthy. Four resident told the inspector that staff respected their choice and privacy at all times. Throughout the visit, staff were seen to knock on doors and wait before entering rooms and they spoke to residents in their preferred manner, as stated in their care plans, and were friendly but respectful. Staff said they are aware of the importance of dignity and respect, one staff said, “ I treat people as I wish to be treated”. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to exercise control over their lives, participate in social activities, receive visits from friends and relatives as they wish and enjoy a choice of meals served in a relaxed atmosphere. EVIDENCE: Residents felt they are able to exercise choice by participating in social activities if they wish, one resident said ‘I can join in with any of the activities if I wish, and I am free to spend time as I wish.’ Resident’s preferences are identified during the assessment process, and this information is included in the individual’s care plan, therefore staff are aware of what residents like doing. The home employ two part time activities coordinators who arrange various activities, during the inspection residents were painting, reading and chatting to staff. Residents were involved in a retirement party for one member of staff. All residents spoken with thought the activities matched their needs, and that staff respected their wishes to spend time on their own. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 15 Two residents recalled going on day trips in the home’s mini bus during the warmer months, just before Christmas, residents were taken (on a one to one basis) to go shopping to buy Christmas presents for their relatives. One resident said ‘it was lovely, staff pushed me in a wheelchair to save me from walking, they were, and are, very attentive and thoughtful.’ Residents feel they are supported to lead active lives as they prefer. Two residents spoken with said they prefer to spend time together and rarely participate in activities, and that staff respect their wishes. The manager said that there were no residents from any ethnic minority group at present but that if a resident had cultural or religious interests every effort is made to accommodate these preferences. The home has an open visiting policy, this was evidenced by records of visitors to the home and confirmed by four residents who said their relatives visit the home at different times of the day on a regular basis and are always welcomed. The inspectors observed residents eating lunch in two out of the three dining rooms, the main dining room overlooks the extensive gardens. One of the dining rooms was part of the new wing, and four residents said they prefer to eat their meals in this dining room, in private. The home employs one head cook and one assistant. The head cook said she really enjoys her work, as everything she cooks and prepares is fresh, nothing is pre cooked. On the day of the inspection refreshments were offered throughout the day for residents, the lunch consisted of two choices for each starter, main course dessert, followed by tea or coffee. Homemade cakes and tea were available mid afternoon. Supper consisted of another hot meal if residents wanted it, one resident said ‘I usually ask for soup and sandwiches’ another resident said ‘during lunch staff serve us our vegetables to accompany our meat, just like a waitress would do in a nice restaurant, the presentation of food is always delightful.’ All residents said, either verbally to the inspector, or in writing in the CSCI survey, that the meals were always very good, one resident said ‘you could never go hungry here!’ Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents and staff are confident that their complaints will be listened to, taken seriously and acted upon. Staff have a good understanding of Adult Protection issues that protect residents from potential abuse. EVIDENCE: Residents spoken with said that they were very aware of the complaints procedure, even though they have not had to use it. They said they would go straight to the manager if they had a concern or complaint and were confident that the manager would take their concerns seriously. Residents confirmed that the staff are very good and listen to them, no one has felt the need to complain, only compliment. Staff stated in their CSCI surveys that they were aware of the home’s complaint procedure which includes the address for the Commission and that all complaints will be dealt within 28 days. The complaint log was available which included sufficient detail to monitor complaints successfully, the manager confirmed no complaints have been received since the date of the last inspection. The inspector recommended the complaints log be numbered to show a true account of any complaints received, the manager confirmed in writing after the inspection that this has been completed. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 17 The home completed a questionnaire, which was submitted by the home to the CSCI prior to this inspection, and it stated that the home had not received any complaints. Two residents said that they welcomed CSCI inspections as well as the monthly unannounced visit by the service manager [Regulation 26 visits] as their role is to monitor and ensure the well being of the residents. All staff who responded to the CSCI survey stated that they were aware of the correct procedures to follow if a disclosure of abuse was reported to them, and they had received formal training in abuse awareness, certificates confirmed this. The home has procedures for staff to follow should abuse be suspected, including Hampshire County Council’s Protection of Vulnerable Adults and Whistle Blowing. The manager confirmed that policies and procedures are reviewed and available for staff to access regarding complaints and protection, staff confirmed this. The manager confirmed in the pre inspection questionnaire that there have been no incidents of abuse recorded in the home. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment continues to be improved to provide residents with a warm and comfortable home. There are good infection control procedures at the home to safeguard the welfare of residents. EVIDENCE: The home was warm and very welcoming, at the time of the visit the home looked extremely clean. A whole new wing has been added to the home to provide a further ten en-suite bedrooms, a lounge/dining room, sluice rooms and an office, new equipment such as ‘Parker baths’, hoists and mattresses meet the residents individual and group needs. The home has a maintenance programme to refurbish the remaining rooms to provide en suite accommodation; a porch will be added to the front door, air conditioning will be added to the conservatory and the residents will be involved in the construction of a ‘sensory garden. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 19 One resident said the home is always clean, the manager explained the home employ domestic staff who take great pride in their work to ensure the home is always clean and that staff ensure that Gorselands has a ‘homely’ feel by ensuring the communal areas look inviting, for example the dining room tables were laid very nicely for lunch, and the library area had comfortable chairs with ample lighting to enable people to read if they wish. Accommodation is provided over two floors. Access to the first floor is by two passenger lifts, and four flights of stairs. There was ample communal space for residents and their visitors to use, the majority of which overlooks the well maintained gardens and a small patio courtyard garden (the home have plans to include a moving sensory garden). Resident’s bedrooms looked very comfortable and contained many personal items such as pictures, furniture and ornaments. Two residents spoke of their satisfaction with their rooms with comments of ‘it’s very comfortable, the staff ensure it is cleaned every day, my bedding and towels are changed once a week’ and ‘What more could I ask for, I have everything I need’. ‘My room is decorated to my taste, and I have a fabulous view of the garden.’ Keys are provided for residents who wish to lock their doors, all residents said they feel safe and secure in the home and the grounds. The communal areas in the home let in plenty of natural light which residents said makes them feel as if they are outdoors. Residents were observed to walk freely around the home independently or with the assistance of staff or various walking aids. The home has an internal laundry that is well equipped. Infection control procedures were in place. Staff were observed to follow these guidance, equipment such as gloves and aprons were available, so too was antibacterial hand gel for staff and visitors to use. Staff stated in their CSCI surveys that they had received infection control training. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel that a sufficient number of staff are on duty to meet their individual and group needs. There is sufficient skill mix within the team and to meet the residents needs. The homes comprehensive recruitment practices ensure resident’s safety. Staff receive mandatory and specialist training and are supported to obtain NVQ level 2 or above. EVIDENCE: Residents spoken with said there are always enough staff on duty who know how they like to be cared for, staff stated in their CSCI surveys that they felt there are enough staff on duty on each shift. The manager confirmed their is always at least one trained nurse, (this does not include the manager or deputy manager) on shift. One member of staff wrote in the survey she returned to the CSCI, ‘we get the time to be able to ensure high standards are maintained, and more importantly have the time to spend with residents, I have worked in many homes, this is definitely much better, the owner is of the opinion that more staff are better, it works for me, I do not have to rush about, it’s a lovely relaxed home to work in.’ It was evident from practices and interactions observed that staff had developed a good relationship between themselves and residents. Comment Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 21 from residents included that staff were very kind and always helpful and that they were a “good team”. One resident praised the domestic staff for their hard work in keeping their bedrooms clean and tidy. Staff said they receive regular formal supervision by their line manager, this gives them the opportunity to discuss any training needs they may have. Staff wrote in their surveys to the CSCI that they receive very comprehensive handovers of information at the beginning of each shift, and that the trained nurse who is the ‘shift leader’ allocates work to staff according to their skill mix, which makes for an effective staff team, staff also receive an ‘evaluation of how their shift has been’ at the end of each shift, the staff stated this is beneficial to ‘de-stress’. The manager confirmed in the pre inspection questionnaire that 30 of the twenty three care staff employed at the home are either working towards, or have received an NVQ 2, the home employ ten first level nurses. The staff confirmed in their surveys to the CSCI that they undertake training regularly in the necessary health and safety subjects such as fire safety, first aid, moving and handling, health and safety, infection control and food hygiene. Other training courses attended by staff include abuse training, wound care, palliative care and pain control. The staff stated in their CSCI surveys that the recruitment process within the home is thorough. The inspector was able to see four different staff records and found that they were detailed with the necessary checks taken to ensure staff are fit to work at the home. Other records seen on file include signed contract of employments, job descriptions and criminal record bureau and protection of vulnerable adults register. The staff wrote in their CSCI surveys that they feel the induction programme run by the home was useful and detailed. The files seen held records of the individual staff induction training covering the key areas with the signatures of the staff member and trainer. The manager confirmed that the home’s induction programme meets the recently amended Skill For Care standards for induction. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager is experienced and competent to run the home. Management and administration of the home is based on openness and respect. An effective quality assurance system is in place. The home is not involved in monitoring or handling residents’ money. Residents’ health, safety and welfare are well promoted by the home with systems that ensure everyone is protected within the home. EVIDENCE: The manager is registered with the Commission. She has the required experience, is competent to run the home, however needs to start her Registered Managers Award (RMA). The registered manager confirmed in writing after this visit that she has organised to commence her RMA in the Autumn 2007. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 23 The manager says she is committed to quality assurance and continuing development of the service. There is a strong ethos of being open and transparent in all areas of running of the home, residents felt they were involved in the development of the home, and were confident in the manager’s ability. Staff stated in their surveys, and observations showed there are clear lines of accountability within the home. Also the management approach of the home creates an open, positive and inclusive atmosphere. The staff felt they were included in the day-to-day decision making within the home, stating that changes and or issues are discussed and actions agreed at regular staff meetings that are minuted. Residents said that they felt able to give their views, which they feel are valued, on the quality of care provided at the home to the manager and feel involved in issues affecting the home. Residents spoken with commented that management and staff are very approachable, always make themselves available and readily help with any problems. They also had nothing but positive comments to say about staff which included – “They really care”, “They don’t rush you” and “Staff like a laugh”. A quality assurance and monitoring system based on seeking the views of residents, relatives and professional is in place. As well as completing questionnaires, residents told the inspector that management are always asking how things are and if they would like anything different. The inspector read the findings taken from the most recent survey about the food the home provides, residents commented on their satisfaction with food, and the manager said any suggestions were listened to, the current menu reflects this. Resident said if they are not happy with something, all they need to do is tell someone, and it will be seen to. The manager said resident’s family or financial appointees safeguard residents money, rather than the home, two residents confirmed this. No unsafe practices were observed during the inspection. Certificates were available for required checks of systems and equipment. Risk assessments where necessary have been completed. Staff have received training in health and safety, first aid, fire safety, care of substances hazardous to health and moving and handling. The fire drill records showed that all staff had attended at least one fire drill in the last year. Regular risk assessments are undertaken and recorded to ensure that the safety within the home room by room. These were sampled and found to be satisfactory. All the residents and relatives spoken with stated that they felt safe at the home and some confirmed that the fire alarms are regularly tested. The manager explained the recording system for fires safety maintenance, training, evacuation and visual checks. The visual checks of all fire safety equipment Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 24 has been recorded and undertaken at appropriate intervals to ensure the safety of the residents. The home has a satisfactory reference file for the Control of Substances Hazardous to Health (COSHH) information leaflets for each chemical being utilised within the home The home has a policy, procedures and information on health and safety. A sample of policies and procedures were seen that are reviewed regularly. There is an ongoing system in place that ensures that all appliances are serviced, records and certificates seen indicated that the systems such as the electrics and specialist equipment including bath aides received regular servicing and maintenance. The employer’s insurance liability certificate was displayed and current. Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 4 X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 4 X X 4 Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? N/A 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. 2. Refer to Standard OP31 Good Practice Recommendations The manager needs to start her Registered Managers Award (RMA). Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Gorselands Nursing Home DS0000067854.V327396.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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