Inspection on 25/06/07 for Gorseway Lodge Nursing & Residential Care Home

This inspection was carried out on 25th June 2007.

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 Lodge Nursing &... 18/11/05

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 Annie Taggart Unannounced Inspection 25th June 2007 10:00 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 Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.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. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 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 01252612539 kwhyard@gorseway.co.uk Gorseway Care Limited Post Vacant 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.V340545.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th November 2005 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. Current fees are £535 to £830 per week Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In preparation for the visit an Annual Quality Assurance Assessment (AQAA) was sent to the manager of the home for completion. Because of some difficulties in the document arriving in time it had not been completed prior to the visit but was discussed on the day with the manager. The last two inspection reports were read, along with any other relevant correspondence or documentation relating to the service and a planning document was completed. The unannounced visit was carried out at 9.30am and lasted for 5.5 hours. During that time we spent time talking with a large number of the people living in the home both in communal areas and in their private bedrooms. A large number of visitors were present and we were able to talk to them about their experiences of the home. Four care plans were tracked with any issues highlighted being discussed with the relevant service user or the staff on duty and we were also able to speak to seven staff members and observe staff practice. We saw lunch, the main meal of the day being prepared and served and asked people about how they enjoyed their meals and if the activities and outings on offer met their preferences. We looked at four staff recruitment files, training records and records for the running of the business including the complaints log, fire book; staff fire training, maintenance records and the home’s quality assurance process. The manager Mrs. McDonald was present during the day and received feedback following the visit. What the service does well: Gorseway Lodge provides a comfortable, attractive and homely environment for the people who live there and people say they are very happy with the care they receive. In order that individual needs can me met, pre-admission assessments are carried out and care plans agreed and documented. There are trained nurses on duty at all times and people have access to good healthcare support. A wide variety of fresh, home cooked meals are provided, visitors are made welcome at any time and an activities programme is in place. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 Page 6 Both the people living in the home and their families made very positive comments about the skills and commitment of the manager and staff team and said they were treated with kindness, dignity and respect. A comment from a current service user was, “ we are very well looked after here, nothing is too much trouble for the staff and there are trained nurses on duty all the time. The food is excellent, my family can visit me and I get taken to join in the activities”. 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 Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.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 Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.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): 1 2 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their families can be confident that they will be given information about the home and visits will be encouraged. Pre admission assessments will be completed to identify individual needs and contracts will be agreed. EVIDENCE: There is sufficient information available for service users to make and informed choice about whether they would like to live in the home. Records show that pre-admission assessments are carried out to ensure that the home can meet individual needs and people confirmed that they had been able to visit the home prior to moving in. Contracts detailing the terms and conditions of residency are in place and have been signed by service users or their representatives. Gorseway Lodge does not provide intermediate care. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although there are care plans in place, people receive good healthcare support and medication is well managed, daily recording by the staff team could be improved to assist with continuity of care EVIDENCE: In order to ensure that the staff team have the information they need to support the people living in the home, the system of care planning has been improved and there is evidence that service users are involved in the process. Four care plans and supporting documentation were tracked and all had recently been reviewed. The plans contained individual daily support preferences, a detailed health plan and risk assessments and also indicated the support needed to assist with people’s emotional and psychological wellbeing. Plans could be further improved by including a background history for service users especially those with memory loss. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 Page 11 The home works with a variety of healthcare professionals including a physiotherapist, a local optician, chiropodists, and local doctors and people are supported to attend hospital appointments. One person said, “they are very good at looking after my health here and I can see my doctor when I need to”. A visitor who comes to the home each day said, “the care my family member gets is second to none and the staff here are very skilled and patient”. Daily records are in place but could be improved by more detail being recorded to assist with continuity of care. In many instances phrases such as “all care given” or “care plan followed” were all that were recorded. This was discussed with the manager Mrs McDonald, who said that she would ensure that this was improved and would be communicated to the care team at the next staff meeting. Medication is safely stored and is only administered by trained nurses. Medication Administration Sheets are current and medication is well managed. A service user said, “ when I came here I had lots of medicines to sort out but the nurses helped me and they always make sure I get my tablets on time”. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a variety of activities and outings and visitors are made welcome at any time. Fresh, home cooked meals are offered daily but the presentation of pureed meals could be improved. EVIDENCE: The people living in the home confirmed that they enjoyed a variety of activities including gentle keep fit; quiz afternoons, craftwork, reminiscence sessions and visiting musicians. Some people said that they had recently really enjoyed a visit out to Southsea for tea and regular coffee mornings have recently been started with great success. The manager Mrs. McDonald said that one carer has now been given special responsibility for co-ordinating activities and is booked to attend a relevant course. There are also attractive landscaped gardens and a fishpond where people said they really enjoyed spending time in good weather. Visitors are made welcome at any time and during the visit there were a large number in the home. Some people said that they visited every day to be with their family member and could have their meals at the home if they wished to do so. One person said, “ I can spend every day here with my wife and have my lunch and drinks Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 Page 13 with her. All my family are so pleased with the care being provided and they really look after visitors too”. Religious beliefs are addressed and one person had their local Methodist minister visiting, another person said that her local priest came to provide Communion every week. The home provides a wide variety of fresh home cooked meals and service users confirmed that they were always given a choice. Each person has a copy of the menu in his or her room and several alternatives are available. People were very complimentary about the food provided with comments such as “ excellent chefs and wonderful food”, “ this is so much better than where I used to live because we get fresh food and vegetables every day” and “ the food is excellent and if I don’t want anything on the menu, they will always make me something else”. Special diets can also be catered for. Pureed meals are currently being processed all together instead of foods being individually presented. This was discussed with the chef and catering manager who said that it would immediately be addressed and the practice changed Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their families can be confident that their concerns or complaints will be recorded and acted upon and the home’s procedure and staff training are designed to protect residents from risk of abuse. EVIDENCE: There is a complaints procedure in place, a copy of which is included in the Statement of Purpose and also posted within the home. Service users and their families said that they would feel confident in making a complaint and felt sure that their concerns would be listened to and any issues would be addressed. Records show that two complaints have been made in the last year and the manager of the home had addressed both in a timely manner. The care staff team have attended training in the protection of vulnerable adults from abuse and the care staff on duty were aware of their responsibilities should they suspect any form of abuse had occurred. One person said, “ If I suspected any unkindness to people I would report it to the manager straight away”. The home employs a large number of cleaning and ancillary staff and some of those spoken to were not sure of the correct procedures to follow. This was discussed with the manager who said that ancillary staff would also attend the training in the near future. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 24 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Gorseway Lodge provides a safe, comfortable and homely environment for the people who live there and people say they are happy with the facilities provided. EVIDENCE: Gorseway Lodge provides a high standard of accommodation and a comfortable, attractive and homely environment for the people who live there. The building is situated over two floors each with lounge areas and dining rooms. Corridors are wide and easily accessible and two service users said this was really important to their independence as they both use electric wheelchairs. Many bedrooms overlook attractive landscaped gardens with a fishpond, stream and seating areas and the garden has wheelchair accessible paths. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 Page 16 There is an ongoing programme of maintenance and refurbishment in place and all bedrooms are redecorated when they become vacant. Recently some new carpets have been fitted to communal areas, the home is clean and hygienic throughout and equipment is in place to address infection control issues . The people living in the home confirmed that they were very happy with their private bedrooms and said that they had been able to bring some of their own furniture and belongings with them. Specialist equipment is provided as needed and is regularly serviced. One service user said, “The difference between this place and the home I used to live in, is that here it feels like home as soon as you come in, it’s always clean and everyone is so friendly”. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home are protected by robust recruitment practice and are supported by a competent caring and well-trained staff team. EVIDENCE: There were fourteen care staff working on the day shift, four were trained nurses. In addition there were chefs and kitchen staff, cleaners, two laundry people, maintenance staff and a catering manager. The manager’s and office support staff hours are in addition to the rota. Many of the staff team have worked in the home for a number of years and have developed good relationships with the people they support. The people living in the home confirmed that there were sufficient staff available to meet their needs and were very complimentary about their skills and commitment. Comments included, “the staff here are so kind and friendly and there is always someone to help you” and “the staff are very good, very kind and caring and it is as nice here as it could be anywhere that was not your own home”. In order to ensure that the people living in the home are protected, a robust recruitment process is in place and new staff are only employed following an Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 Page 18 interview process, a Criminal Bureau Check and two references being in place. Four staff records were seen and all had the required documentation on file, this also includes the current professional registration details of registered nurses. New staff members receive a structured induction and spend time “shadowing” more experienced staff. There is a programme of staff training and development in place and records show that as well as mandatory courses staff attend further relevant training such as wound management, infection control, working with people with arthritis and communication. Records show that ten care staff are currently working towards the NVQ award and are being supported by an internal assessor. The staff on duty confirmed that they received supervision but these need to be updated. The manager Mrs. McDonald said that as she was fairly new she was compiling a plan to address this but staff also confirmed that they felt very supported in that day to day, on the job supervision was undertaken by the manager, trained nurses and senior staff members. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 Page 19 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 37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and run in the best interests of the people who live there. Records for the running of the business are in good order and health and safety issues addressed. EVIDENCE: The manager of the home Mrs. McDonald is a registered nurse and has only recently taken up post. The people living in the home, visitors and the staff on duty were complimentary about Mrs. McDonald’s management style and said that she was friendly and accessible. There was a general agreement that Mrs. McDonald was very “person centred” in her approach and had used the views of residents and other people involved with the home to make improvements to the service provided. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 Page 20 The home has recently begun a new system of quality assurance that provides the organisation with an annual audit programme. Surveys are sent to service user, families and the staff team and comments are collated and published to inform the future development of the service. There is also a large file of letters and cards from relatives giving positive feedback about their experiences of the service provided. It is the policy of the home not to hold monies on behalf of service users and financial issues are dealt with by families or legal representatives. There is a locked facility in each bedroom for money and valuables. Records regarding health and safety and for the running of the business were seen including the fire book and staff fire training record, electrical appliance testing, lift maintenance and other service contracts. All were current and in good order. Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 Page 21 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 3 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 x 3 X 3 3 Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 Page 22 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. 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. Refer to Standard Good Practice Recommendations Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 Page 23 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 Gorseway Lodge Nursing & Residential Care Home DS0000011517.V340545.R01.S.doc Version 5.2 Page 24 - 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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