Inspection on 05/07/05 for Gorseway Lodge Nursing & Residential Care Home

This inspection was carried out on 5th July 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 Lodge Nursing &... 25/06/07

Gorseway Lodge Nursing &... 18/11/05

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 5 July 2005, 9:15 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 Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 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 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 k.whyard@gorseway.co.uk Gorseway Care Limited Mrs Katherine Mary Whyard Care Home 60 Category(ies) of Terminally ill over 65 years of age (60) registration, with number Old age, not falling within any other category of places (60) Physical disability over 65 years of age (60) Gorseway Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 02/11/04 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 company’s 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 H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on 5th July 2005 between 09.10 and 15.00. The inspection was unannounced and was the first inspection for this year. The Registered Manager for the home was on annual leave. The Registered manager for Gorseway House conducted the inspection. During the inspection the inspector spoke with nine service users and four staff members. Care records for three service users and three staff members were sampled. The inspector toured the environment and observed the daily routine of service users and staff. One requirement and one recommendation have been made with regard to minor shortfalls in service user’s records. What the service does well: Recently the home has had to accommodate a number of service users from another care home at very short notice. In the absence of the manager for Gorseway Lodge the manager for Gorseway House undertook all the preadmission assessments for these service users over a period of one day. The service users were admitted to the home later that night. The home was prepared and the service users have settled into the home. The new service users who spoke with the inspector commented on the kindness and support that all the staff in the home have given them since their arrival and that they now feel safe and well cared for. The home has a varied programme of events and activities, which is available for all service users who wish to participate. The home is tastefully decorated and provides a very pleasant living environment for all service users. The catering services provide a very high standard of meals for all service users. The meals are well presented and offer a varied choice of menus. The grounds surrounding the home are landscaped and well maintained. Service users confirmed that they access the grounds in clement weather and enjoy the freedom to wander as they wish. The manager for the home ensures that all grades of staff undertake regular training that is relevant to the care provided in the home. Staff confirmed that Gorseway Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 Page 6 they are well supported to participate in training programmes outside of the home and that knowledge gained from courses is then cascaded to other staff members. 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 Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 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 Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 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 is not relevant to this home. The comprehensive assessment of all the service user’s needs undertaken prior to admission to the home to ensures that all their needs can be met. EVIDENCE: A comprehensive pre-admission assessment is undertaken for all prospective new service users to be admitted to the home. This assessment forms part of the basis for the care plans that are drawn up on admission to the home. Information entered on this form is obtained from either the service user themselves, their family, their care manager and other health care professionals. This ensures that all relevant information is given to the home to enabling them to make an informed decision as to whether the home can provide the level of care needed can be provided and the service user’s needs are to be fully met. The assessment includes both physical and psychological needs. Gorseway Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 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 standard(s) 7, 9 and 10 The staff demonstrates their respect towards service users in approaching them with sensitivity and kindness confirming that all their needs are met. Plans of care are generally clear and concise and support the individual needs of the service users but risk assessments are not always supported with documentary evidence of the actions taken to address the identified risks. EVIDENCE: The inspector examined the records for three service users. Two of the service users had been admitted to the home at short notice and had only been in the home for a very short time. Full assessments had been undertaken for the service users and care plans were in place. For one service user, health care issues had been identified as part of the assessment but the relevant care plans to address these needs were not in place. In all the records seen there were individual areas of care, these included tissue viability and nutrition that had been risk assessed and noted as high risk. There were no action plans recorded, although in one instant with regard Gorseway Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 Page 10 to tissue viability risk the inspector noted that an appropriate mattress was in place but this was not recorded in the records. Not all the care plans were signed by the service user or their representative. There were no psychological care plans in place for service user who were displaying some short term memory and confusion problems therefore there was no indication that their needs in this area of care were being met. It is recommended that the records of daily care are specific and measurable, avoiding phrases such as “no problems” or “care as plan” with specifying which plan. The inspector spoke with both of these service users. They appeared settled and content. All these issues were discussed with the manager present at the inspection. She explained that some of the needs for two of the service users who had only recently been admitted to the home were being allowed time to settle and for staff to get to know them before some of the appropriate care plans were put into place. Requirements made at the last inspection with regard to staff to have a training update for medications. This has been fully met. All trained staff have undergone training since the inspection and further training is planned to take place in the near future. Medication records were seen by the inspector to be accurate and up to date. During the visit staff were seen and heard addressing service users in polite and gentle manner. They spoke with service users as they carried out their daily routine in the provision of care. Service users spoken to all confirmed that the staff in the home were supportive, kind and respectful to them at all times. Gorseway Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 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 standard(s) 12,13,14 and 15` The varied aspects of daily life for the service users at Gorseway Lodge ensure that they enjoy a quality of life that matches their expectations and needs. The service users are supported and encouraged to make choices about how they live their lives including choosing from a daily menu that provides them with a well balanced and varied diet. Their families, were possible, continue to be an important part of their lives. EVIDENCE: A number of service users in the home were spoken to and all commented on the excellent standard and presentation of the food at every meal and how good it was to have such a varied choice for each meal. Sample menus were seen and the inspector was informed that mealtimes were flexible to accommodate individual preferences. The service users told the inspector that there was “always something going on in the home if they wanted to be involved”. Service users confirmed that they were never under pressure to join in activities that were arranged and they were free to have visitors at any time. Many of the service users are able to be taken by their family to the beach which is nearby. Gorseway Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 Page 12 Several service users who have recently been admitted to the home from another nursing home expressed their pleasure in being given so many choices with regard to food and their daily routine. Two of these service users explained to the inspector that having moved from their previous home they were further away from their family but that they did not mind as they thought their new home was “wonderful”. Gorseway Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 Page 13 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 The home has a satisfactory complaints system with evidence that service users feel that their views are listened to and acted upon The home’s attitude towards the protection of vulnerable adults ensures that there will be a prompt and proper response to any suspicion or allegation of abuse. EVIDENCE: The home has complaints procedure which is included as part of the information given to all new service users. All service users spoken to were aware of who they should complain to in the event that they were unhappy with some aspect of their care. There have been no complaints against the home since the last inspection. The home has robust policies and procedures for responding to allegations of all forms of abuse. These are reviewed annually and are updated as required. Staff in the home receive frequent training from both external trainers and from the Registered Manager. The managers’ consider awareness training in this area of care to be paramount. Service users spoken to were able to confirm that the staff treated them with the utmost respect at all times and that if they were at all unhappy with any aspect of their treatment in the home. They said they did not feel intimidated and were free to report any issues to the manager or senior nurse on duty. They also confirmed that their concerns were always readily listened to and acted upon. Gorseway Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 Page 14 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) 26 High standards of hygiene in all areas of the home are maintained at all times. EVIDENCE: On the day of the inspection all areas of the home were found to be clean and tidy. A conscientious team of domestic staff ensure that the high standards of cleanliness and tidiness are maintained at all times. Gorseway Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 Page 15 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) 29 The home’s recruitment procedures adequately protect the vulnerable people living in the home. EVIDENCE: Three staff files were seen. All the records were found to be in order. Application forms which included employment history had been completed, two written references had been obtained and proof of the employee’s identity was available. All prospective employees are interviewed and checks from the Criminal Records Bureau are obtained. The staff files also contained copies of certificates for all training that the staff member had undertaken. Staff records for members of staff who are Registered nurses provided proof that a check had been undertaken with The Nursing and Midwifery Council to check the validity of their PIN. Gorseway Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 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 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) 35 and 38 The monitoring and maintenance of all systems and equipment in the home protects the health and welfare of both service users and staff in the home. EVIDENCE: The home does not look after money for service users. All service users are provided with lockable space in their rooms for safe storage of money and other personal items. Inspection of records showed that regular tests and maintenance of all equipment in the home are undertaken. Records were available to show that staff attends regular fire safety training and drills. Staff spoken to confirmed this. The fire alarm was tested during the inspection. Fire exits were all found to be clear of any obstructions. Staff receive regular training updates for safe moving and handling and infection control. Gorseway Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 Page 17 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 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 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 x x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 3 30 x 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 x x 3 x x 3 Gorseway Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 Page 18 NO 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 OP 7.2 Regulation 15(1) Requirement A plan of care must be drawn up that sets out how all the service users needs in respect of health and welfare are to be met Timescale for action 1-9-05 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 OP 7 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 H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 Page 19 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. Extracts may not be used or reproduced without the express permission of CSCI Gorseway Lodge Nursing & Residential Care Home H54 S11517 Gorseway Lodge V236484 050705 Stage 4.doc Version 1.40 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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