Inspection on 06/09/05 for Gorseway House

This inspection was carried out on 6th September 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

Gorseway House 06/01/06

Gorseway House 11/01/05

Gorseway House 12/08/04

Gorseway House 06/01/04

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

CARE HOMES FOR OLDER PEOPLE Gorseway House Nursing Home 354 Seafront Hayling Island Hampshire PO11 0BA Lead Inspector Sue Maynard Unannounced 6 September 2005, 9:00 th 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. Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Gorseway House Nursing Home Address 354 Seafront, Hayling Island, Hampshire PO11 0BA 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) (023) 92 466411 (023) 92 469222 fdennis@gorseway.co.uk Gorseway Care Limited Mrs Felicity Anne Dennis Care Home 28 Category(ies) of Terminally ill (6) registration, with number Terminally ill over 65 years of age (28) of places Old age, not falling within any other category (28) Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 All service users must be at least 60 years of age. 2 A maximum of 6 service users between the age of 60-64 years may be admitted to the home. Date of last inspection 11/01/2005 Brief Description of the Service: Gorseway House is a care home with nursing for service users over the age of 65 years. The Home is also registered to take service users who are terminally ill. There is a strict criterion for referrals to a GP bed that is funded by the local PC, to ensure that they are within the conditions of registration of the Home. The Home is situated in the Gorseway complex, which is adjacent to Hayling Island beach and amenities. The main meals are in the main prepared and cooked in Gorseway Lodge, also a nursing home, which is on the same site as Gorseway House. Both homes are set in landscaped grounds which are well maintained and able to be accessed by all the residents including wheel chair users. Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was the first of two statutory inspections for the year 2005/2006. The inspection was conducted by one inspector and lasted six hours. On arrival at the home the inspector was told that the manager for the home was attending a study day. The General Manager was present and the registered manager returned to the home and was present throughout the inspection. A tour of the building took place and the inspector spoke to both residents and staff members. Feedback from both residents and staff was very positive. Residents spoken to stated that they were very happy living in the home. They all stated how kind and caring the staff were towards them. One resident who had recently been admitted to the home for a short respite stay stated that she was very impressed with all the care she had been given by the care staff. She confirmed that the staff allowed her to choose how she planned her day and that she only had to ask and the staff would give assistance as it was required. All the residents praised the choice and quality of the food in the home, and that they had complete choice over where they ate their meals. Staff members were very positive about working in the home. They thought the manager of the home was very approachable and felt that any suggestions or issues raised were always listened to and acted upon. They confirmed that they have a very comprehensive training programme and are encouraged to attend additional training outside of the home if they wish. There were no requirements or recommendations made. What the service does well: There is a very welcoming atmosphere in the home. Residents are encouraged to maintain their maximum independence with staff assisting them to mobilise where possible and offering them choices over many aspects of their daily lives. A comprehensive training programme for the staff ensures that they are aware of current information and standards of care that is relevant to the care of the elderly. Training is open to all staff in the home including the catering staff. The staff in the home are proud of the standard of care they provide and this is reflected by the comments made by the residents in the home. Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 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 Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 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) 3 Standard 6 does not apply to this service. Service users moving into the home are appropriately assessed and assured that their needs will be met. EVIDENCE: Residents are only admitted following a full pre-admission assessment undertaken by the manager for the home. The assessment is very comprehensive and ascertains the level of care that will be required by the resident. This includes: Mobility Special dietary requirements Psychological needs Personal hygiene Social and religious needs Information for this assessment may be obtained from the person to be admitted to the home, members of their family, GP and other health care professionals. Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 Page 9 This assessment forms the basis for the care plans that will be written to provide guidance for the staff when providing care in the home. Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 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 standard(s) 7,8,9 and 10 The care planning and communication systems in the home ensure that the health and care needs of the residents are met in a way that respects their privacy and dignity. EVIDENCE: The records for four residents were examined. The information in the files contained the information that is needed to allow staff to be able to deliver care to the residents in an individual and consistent way. Details in the records included: Risk assessments for mobility, nutrition, and tissue viability Records of visits by other health professionals. Care plans detailing the specific care needs of the resident There was evidence that all the assessments had been regularly reviewed and re-assessed to reflect the changing needs of the residents to ensure that the needs of the residents are met at all times. Medication records were examined and were found to be in order. The manager for the home has compiled an information file with regard to all aspects of medication administration, storage and disposal within the home. Policies and procedures have been reviewed and re-written to reflect recent Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 Page 11 changes introduced nationally regarding the safe disposal of medications, as task now to be undertaken by the home and not by the supplying pharmacy. Other new policies and procedures include guidance for staff on the crushing and covert administration of drugs. These have been written following guidelines given by the Nursing and Midwifery Council and the medicine Management Pharmacist. Other guidelines available for staff include drug interactions with food and drinks. A requirement made at the last inspection about medications has been met Residents spoken to during the inspection said that staff were always respectful and acknowledged their right to dignity and privacy at all times. Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 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 standard(s) 12,13,14 and 15 The management of the social activities creates a positive, varied and interesting life for the residents, which meets their expectations for living in the home The arrangements for meals ensures that the residents have nourishing and well balanced diet and that residents are able to choose where they eat. EVIDENCE: The programme of entertainments and activities for the home has recently been revised in consultation with both the residents and the staff. The programme provides opportunities for the residents to visit local shopping centres as well as attend activities within the home. Within the grounds of the home are warden-controlled flats owned by Gorseway Care. The residents from these flats come into the home and attend coffee mornings and other activities. The home is planning a Christmas Fayre which the residents will able to help plan and contribute to. Links with the local community are maintained and clergy from the local churches visit the home to conduct services and meet with the residents. The families of the residents are made welcome within the home and are encouraged to attend any of the entertainments within the home. Residents spoken to by the inspector said that they were aware there was always something going on in the home but that they were always free to Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 Page 13 decline to attend. The staff always respected their right to choose to do what they wished. Comments about the food were very positive. The residents said they had a choice offered for all meals and that if they didn’t like any of the choices the catering staff would always provide them with another alternative. The catering staff are aware of the nutritional needs of the residents within the home and ensure that the food provided is well balanced and varied. Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 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 standard(s) 16 and 18 Procedures are in place to ensure that all complaints are acknowledged and handled objectively. The vulnerable adults procedure ensures that any allegation of abuse will be addressed appropriately EVIDENCE: The home has a detailed complaints procedure that is available in the home’s Statement of Purpose. No complaints against the home have been received by CSCI since the last inspection. Residents spoken to confirmed that their concerns are always taken seriously and acted upon. Robust policies and procedures for the reporting of allegations of abuse within the home are in place. Staff members spoken to confirmed that they are aware of the procedure and that they receive regular training for the awareness and reporting of abuse within the care home setting. Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 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 standard(s) 19 and 26 The ongoing review of services provided in the home ensures that all residents are enabled to live in a clean, safe and comfortable environment. EVIDENCE: On the day of the inspection the home was found to be clean and tidy. The manager for the home undertakes a monthly audit of all areas of the home to ensure that standards are maintained. Rooms are re-decorated as they become empty and carpets are replaced as necessary. All the rooms throughout the home well maintained and residents are able to bring small items of their own furniture into the home with them. Maintenance staff is made aware of day-to-day problems and these are addressed immediately. The home is set in landscaped gardens and these are well maintained and provide areas for residents to sit with their visitors or other residents. The gardens are accessible to wheelchair users. Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 Page 16 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 and 30 The numbers of staff on duty at any one time appear to be sufficient to meet the needs of the residents. Staff undertakes training that enables them to be competent to do their jobs. EVIDENCE: The inspector saw samples of staffing rotas. These demonstrated that all shifts throughout a twenty-four hour period were covered by above the recommended numbers and skill mix of staff, ensuring that staff were available to provide and maintain the high standard of care for all the residents in the home. To maintain the staffing levels above the required minimum numbers the home sometimes employs staff from a nursing agency. They are able to employ the same staff member who is familiar with the home. The manager has compiled a very comprehensive information file for agency staff. This file contains key relevant policies and procedures, emergency contact telephone numbers and a list of the routine duties for staff on all shifts. Staff spoken to confirmed that there is a comprehensive programme of training available to all the staff. The staff are supported to undertake relevant training that provides them with additional knowledge to provide the continuing high standard of care in the home. The training programme has included: Palliative Care Infection control “Trips and Falls” awareness for the elderly Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 Page 17 Nutrition for the Elderly Physiotherapy for the Elderly Medication Catheter care and continence promotion Specialist nurse practitioners and other external trainers provide the training. It was reported to the inspector that 85 of the care staff have their NVQ level 2. Three new members of staff will be commencing their NVQ 2 in October 2005. The manager for the home has recently completed her Registered Manager Award and will complete her NVQ 4 in management shortly. Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 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 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) 33 and 38 Standard 35- the home does not look after any resident’s money. The manager provides strong leadership in the home providing guidance and direction to the staff to ensure that standards within the home are maintained at all times. Close monitoring of practices within the home safeguard the health, safety and welfare of residents, staff and visitors to the home EVIDENCE: The manager has an “open door” policy for staff, residents and visitors to the home. Both staff and residents spoken to confirmed that this system works well and that any issues that are raised are addressed immediately. The outcomes are always fed back to the person who has raised the issue. The manager undertakes monitoring of services within the home and the results of her monthly audits are fed back to the management of Gorseway Care if any serious shortfalls in services are identified. Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 Page 19 Health and safety records show that regular testing of fire safety equipment is undertaken. Staff receive regular training in fire safety, manual handling and infection control. A full health and safety audit for the home was recently undertaken and standards were found to have been maintained and no requirements were made. An inspection in November 2004 by the environmental health officer commended the home for its “excellent standards”. Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A 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 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x N/A x x 3 Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Gorseway House Nursing Home H54 S11518 Gorseway House Nursing Home V240839 060905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Hampshire Area Office 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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