Inspection on 18/11/05 for Gorseway Lodge Nursing & Residential Care Home

This inspection was carried out on 18th November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Gorseway Lodge Nursing &... 25/06/07

Gorseway Lodge Nursing &... 05/07/05

Gorseway Lodge Nursing &... 02/11/04

Gorseway Lodge Nursing &... 04/05/04

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

CARE HOMES FOR OLDER PEOPLE Gorseway Lodge Nursing & Residential Care Home 354 Seafront Hayling Island Hampshire PO11 0BA Lead Inspector Sue Maynard Unannounced Inspection 18th November 2005 09:00a 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 Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.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. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gorseway Lodge Nursing & Residential Care Home 354 Seafront Hayling Island Hampshire PO11 0BA Address 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) 023 92 466411 023 92 469222 Gorseway Care Limited Mrs Katherine Mary Whyard Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60), Physical disability over 65 years of age of places (60), Terminally ill over 65 years of age (60) Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 10 beds may be used at any one time for service users who are only in need of personal care. 5th July 2005 Date of last inspection Brief Description of the Service: Gorseway Lodge is a purpose built care home for service users over the age of 65 years. The home is also registered to take service users who are; terminally ill or who are over the age of 65years and physically disabled. The Home also has 4 NHS GP beds that are used for a maximum of 2 weeks. There is a strict criterion for referrals for the use of these beds to ensure that they are within the conditions of registration of the Home. Gorseway Lodge is situated in the Gorseway complex, which is adjacent to Hayling Island beach and local amenities. The meals for the companys other home, Gorseway House, are prepared and cooked at Gorseway Lodge. The laundry facilities provide for both Homes. The home has recently been extended to accommodate a total of 60 service users. The existing accommodation has been redecorated and refurbished to the same high standard as the new building. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second statutory unannounced inspection for 2005/2006. The inspection took place on 18th November 2005 between 09.00 and 15.00. The registered manager for the home was present throughout the inspection. Records for the home and residents were examined. The inspector spoke to both residents and members of staff. A tour of the building was made. What the service does well: What has improved since the last inspection? What they could do better: Some risk assessments identified some areas that service users were evaluated to be at high risk. Not all these assessments had been taken forward and an appropriate care plan put in place to address the risk. The care plans and assessments must be regularly reviewed and updated. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 6 Residents must be involved in the formatting of these care plans. The staff responsible for making entries in the service users record of daily care must ensure that the statements are specific and measurable. 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 Lodge Nursing & Residential Care Home DS0000011517.V265985.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 Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.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): Standard 3 was assessed at the inspection undertaken on July 5th 2005. Standard 6 does not apply to this service. EVIDENCE: Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 8 Risk assessments are not always supported with documentary evidence of the actions taken to address the identified risks. Reviews and updates are not regularly undertaken to reflect changes in the daily care of the residents. The 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 inspector examined the records for two residents recently admitted to the home. Some relevant information about the residents had been omitted in both files. Neither of the files provided evidence that the resident had participated in the compiling of their care plans. Neither file contained the information about the organisation or other person who had arranged their admission to the home. One resident’s record did not state when the resident had been admitted to the home. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 10 The risk assessment for one resident documented that she was prone to falls. The inspector noted that a fall had been documented on two separate occasions, the resident sustaining a skin flap injury during one of these falls. Neither of these falls had been entered on the risk assessment and the risk assessment had not been reviewed or up dated. The injury had not been documented in a care plan and subsequent treatment was not recorded. The tissue viability assessment identified the resident as being at high risk of tissue damage. There was no evidence in the records to identify how this risk was to be managed. The care plans for this resident had not been reviewed or updated since September 2005. The daily records for both residents had comments such as “slept well” and “good day”. There was no evidence how staff had come to this conclusion. These issues were discussed with the manager at the time of the inspection. She has agreed to review and audit all the residents’ records and will discuss her findings with the staff at a forthcoming staff meeting. All the residents are able to retain their own doctor if they were living locally prior to their admission to the home. New residents from outside of Hayling Island are registered with a local doctor. An optician and dentist will visit the home on request. A chiropodist visits the home every four weeks. The home employs a qualified physiotherapist who provides physical activities for the residents. The inspector was able to observe the weekly session during the inspection. The residents were enjoying the activity and even those residents who were less physically able were joining in and receiving encouragement from the organiser. The manager told the inspector that these sessions had proved very popular and the number of residents attending each week is increasing. Residents spoken to by the inspector told her how much they enjoyed this activity every week. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): All these standards were assessed during the inspection in July 2005 EVIDENCE: Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were assessed in July 2005 EVIDENCE: Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The ongoing review of services provided in the home ensures that all residents live in a well-maintained, safe and comfortable environment. EVIDENCE: There have been no major changes to the premises since the last inspection. As part of the business plan for the home there is a programme of redecoration and maintenance for the building. All bedrooms are re-decorated as they become vacant. The carpet in the main corridor has been damaged and is to be replaced. The gardens are well maintained and residents are able to access the grounds whenever they wish. Many of the residents on the ground floor have direct access from their bedrooms. The fire safety officer visited the home in December 2004 and the environmental health officer visited in November 2004. No requirements or recommendations were made from either visit. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 27,28 and 30 The numbers of staff on duty at any one time appear to be sufficient to meet the needs of the residents. Staff undertake training that enables them to be competent to do their jobs. EVIDENCE: Staff rotas showed that the manager for the home ensures that the correct number of trained and care staff are on duty over a twenty-four hour period. In the event of staff sickness or annual leave arrangements are made that any shortfalls in numbers are adequately covered. Residents confirmed that they thought there were sufficient numbers of staff to provide for their needs and that the staff responded promptly when the nurse call system was activated. Staff spoken to confirmed that there is a comprehensive programme of training available to all the staff. Staff are supported to undertake relevant training that provides them with additional knowledge to provide the continuing high standard of care in the home. All staff undertake statutory training for fire safety, moving and handling, together with NVQ level 2 and 3. Additional training is also provided for topics such as infection control and continence care. The home has recently employed three trained nurses; one has specialist knowledge for tissue viability, one for nurse skills assessment and management of falls and one for psychological needs and welfare of the residents. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 15 Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 16 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, 33 and 38 The appropriate qualifications of the manager ensure that the home is well managed. The manager provides guidance and direction to the staff to ensure that standards within the home are maintained at all times. All safety checks are completed on a regular basis to promote the safety of residents and staff. EVIDENCE: The registered manager for the home has managed the home fro three years. She is a Registered General Nurse and ensures that her clinical knowledge and skills are regularly updated by attending relevant training. Recent training undertaken includes: Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 17 NVQ Level 4 in management. Registered managers award. Infection control Adult protection Teaching update for safe moving and handling. The manager monitors the views of the residents and their families to ensure that the care and services provided in the home are maintained to a high standard. An annual quality questionnaire is undertaken and the results of this are made available to the residents and their families. Residents spoken to confirmed that they are free to bring any issues that they are not happy with to the attention of the manager and that prompt action is taken to address the problem. The company is to ask staff to complete a questionnaire about their job description and working conditions and they are to be asked to make suggestions as to how improvements could be made to the services provided in the home for both themselves and the residents. The home has contracts for the servicing and maintenance of systems and equipment used in the home. All theses contracts were seen to be up to date. All policies and procedures for the home were updated in February 2005. Records demonstrated that staff working in the home have attended regular training for: Fire safety Safe moving and handling Infection control First Aid All the catering staff have undertaken food hygiene and safe food handling training. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 18 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 4 X X X X X X X STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15(1) Requirement Plans of care involving the service user or their representative must be drawn up to demonstrate how the health care needs of the service user are to be met. The care plans must be reviewed and updated monthly. This requirement was made at the last inspection with a time scale of 01/09/05 Timescale for action 31/01/06 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 OP7 Good Practice Recommendations Records of daily care implemented should be specific and measurable, avoiding subjective and formulaic words and phrases e.g. no problem, care as plan and slept well, Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Hampshire 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. Extracts may not be used or reproduced without the express permission of CSCI Gorseway Lodge Nursing & Residential Care Home DS0000011517.V265985.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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