Inspection on 12/07/05 for Gorsey Clough Nursing Home Limited

This inspection was carried out on 12th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Gorsey Clough Nursing Home... 26/08/09

Gorsey Clough Nursing Home... 22/05/09

Gorsey Clough Nursing Home... 30/08/07

Gorsey Clough Nursing Home... 18/05/06

Gorsey Clough Nursing Home... 24/02/06

Gorsey Clough Nursing Home... 18/03/05

Gorsey Clough Nursing Home... 30/06/04

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

CARE HOMES FOR OLDER PEOPLE GORSEY CLOUGH Harwood Road Tottington Bury BL8 3PT Lead Inspector Grace Tarney Unannounced 12th July 2005 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. GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Gorsey Clough Nursing Home Address Harwood Road Tottington Bury BL8 3PT 01204 882976 01204 886824 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) Mr Eric Goldsmith Mrs Collette Conway CRH N Care Home with Nursing 61 Category(ies) of OP Old age (over 65 years of age) - 36 registration, with number DE(E) Dementia (over 65 years of age) - 24 of places PD Physical Disabilities - 3 GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service users to include up to 36 OP, up to 24 DE(E) and up to 3 PD The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 18th March 2005 Brief Description of the Service: Gorsey Clough is a large detached extended property situated in a very pleasant rural area of Tottington Bury. The house is set in its own very large beautifully kept gardens. There is a very large terrace to the rear of the house that has plenty of garden furniture for residents use. There is plenty of parking within the grounds of the home. Gorsey Clough is not easily accessible by public transport but it is approximately 2 miles from the centre of Tottington Village. The doors at the front and back of the home allow a level access for wheelchair users and people who have problems climbing steps.The home provides accommodation in single and double bedrooms on the ground and first floor. The bedrooms on the first floor are reached either by stairs or a passenger lift.The home is divided into 2 areas,Windermere and Kendal.The Windermere Unit is a designated supervised combined lounge/dining area. The Kendal unit has a combined lounge and dining area plus 3 other lounges. The toilets and bathrooms have aids to assist any resident with a disability or mobility problem. The home is registered to provide general nursing, dementia or social care for up to 61 residents. 24-hour nursing care is provided by suitably qualified nurses supported by care assistants. GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was not made aware that this inspection was to take place. This was an unannounced inspection. The Inspector spent 6 hours at the home. During this time she looked at care and medicine records to ensure that health and care needs were being met. She also looked at records about the handling of complaints and records about staff training. The Inspector walked around some areas of the home to check that the things that needed improving from the last inspection had been done. In order to obtain information about the home the Inspector also spent time speaking to 4 residents, 2 relatives, 3 of the qualified nurses, the manager and the administrator. At one point during the inspection the Inspector was also able to talk to the owner of the home. Not all the National Minimum Standards were looked at on this visit. During the next inspection the Inspector will look at the rest of the Standards that are considered to be important for residents safety and well-being. These are the Standards that have to be inspected at least once a year. What the service does well: What has improved since the last inspection? The manager and the owner had made good progress in ensuring that most of the things that needed improving from the last inspection had been done. Although all of the building was not looked at in detail on this inspection, the Inspector saw that the home had bought a lot of new bedroom furniture and GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 Stage 4.doc Version 1.40 Page 6 new carpets for some bedrooms and corridors. They had also decorated and improved the appearance of some toilets and shower rooms. The residents spoken to by the Inspector said they were pleased with these improvements. 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. GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 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 GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 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 The system for assessing a residents’ needs was not detailed enough and because of this does not give an assurance to either staff, residents or relatives that the home can meet their needs. EVIDENCE: Before any resident was admitted to the home an assessment of their needs was undertaken, either by a senior member of staff from the home or from the professional i.e. care manager, requesting their admission. The assessments were kept within the residents individual care plans. This is good practice. The pre-admission assessment document used however, allowed only the scantiest of information to be recorded. Against the activities of living there was only a tick box. The preadmission assessment document needs to be amended so that a clearer, more detailed assessment of a residents’ needs can be undertaken and recorded. The amended document should also include information about the residents’ oral health, foot care and social interests. GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 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) 7,8,9,10 &11. The care plans reflected the support needs of the residents. Care practices ensured that the residents were treated with respect and their dignity was upheld. They also ensured that most health care needs were met apart from the inadequate system for weighing the residents. Accurate weight monitoring must be undertaken to ensure that dietary needs are met. The medication system ensured that the residents received their medicines safely and correctly. EVIDENCE: Individual care plans were in place for each resident. The care plans of 3 residents were examined. The care plans gave clear guidance on how the care needs at the residents were to be met. They were reviewed monthly and any changes were noted and acted upon. Risk assessments were in place and covered such areas as moving and handling, nutrition, pressure sores, the use of bed rails and falls. A discussion with residents identified that they had access to other services including hearing and sight tests and a visiting chiropodist. Evidence of these visits was kept in the residents’ individual file and a list was also kept in the nurses’ office. The residents’ weight records were also kept in the individual files. The nurses told the Inspector that the residents were routinely weighed GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 Stage 4.doc Version 1.40 Page 10 every month. The weight records indicated that this was not happening. Staff were advised to ensure that the care plan identifies how often residents are to be weighed. It was emphasised to staff that residents should be weighed in accordance with their nutritional risk assessments. The regular monitoring of residents weight is essential to ensure that their nutritional needs are met, to prevent any further deterioration in their physical condition and to identify any underlying undetected medical conditions. The medication system was safe. Some issues were identified however in relation to the storage of medication. It was noted that internal medicines and external medicines, i.e. creams and lotions, were stored together. To reduce the risk of any medication error, internal and external medications must be segregated. There was also an excess stock of prescribed paracetamol tablets. The stock of paracetamol tablets was not being rotated resulting in the most recently prescribed tablets being given first. Temazepam was not being stored in the controlled drug cupboard. It was being stored securely but in the outer section of the metal cupboard. The manager rectified this immediately. Staff were advised to ensure that when they are handwriting a prescription onto the medication prescription sheets that they sign the sheets and ask another member of the nursing staff to countersign it. This will ensure that the prescription is the correct one and ensure the safety of the resident. Whilst the Inspector was in the home she was made aware that two GPs were visiting the home, at the managers request, to review most of the residents medications. This is good practice. Its reassures residents, relatives and staff that a residents condition and medication usage are being monitored. The residents said that the staff treat them with kindness and respect. During the inspection staff members spoke with residents in a kindly and respectful way. Staff spoken to gave examples of how privacy and dignity were promoted. They also gave good practice examples of how they would care for a resident who was terminally ill. GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 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) EVIDENCE: Standards 12, 13, 14 and 15 will be looked at during the next inspection. GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 Stage 4.doc Version 1.40 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 standard(s) 16 &18. The complaint system in place enabled residents to feel that their views are listened to and acted upon. Staff have a good knowledge and understanding of adult protection procedures thereby reducing the possible risk of harm or abuse. EVIDENCE: A discussion with the residents identified that there was a general awareness of how to make of complaint. A detailed and accessible complaints procedure was prominently displayed in the entrance hall and also attached to the Service User Guide. A discussion with the senior nursing staff identified that they were aware of the procedure to follow in the event of any allegation of abuse. The manager had recently undergone training in relation to the protection of vulnerable adults and she told the Inspector that she was trying to arrange further training for her staff, with the Local Authority. GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 Stage 4.doc Version 1.40 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 standard(s) EVIDENCE: Standards 19 and 26 will be looked at during the next inspection. GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 Stage 4.doc Version 1.40 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 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 & 30. The residents were cared for by a sufficient numbers of staff that were suitably qualified and trained and therefore had the knowledge and skills to meet the residents needs. EVIDENCE: Examination of the duty rotas and a discussion with staff, residents and relatives showed that there was enough staff on duty to meet the needs of the 58 residents. 24-hour nursing care continues to be provided by qualified nurses who are supported by suitably trained care assistants. The home continues to provide training in NVQ Care and further training continues to be provided in moving and handling, fire safety, dementia care and challenging behaviour. GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 Stage 4.doc Version 1.40 Page 15 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) EVIDENCE: Standards 33, 35 and 38 will be looked at during the next inspection. GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 Stage 4.doc Version 1.40 Page 16 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 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 3 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 x x x x GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 Stage 4.doc Version 1.40 Page 17 Yes 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 8 Regulation 12(1)(a) Requirement Residents must be weighed in accordance with their nutritional risk assessment. If there is no identified risk then they must be weighed at least monthly and the weight recorded in their care plan. The frequency of weighing must also be detailed in their care plan. To reduce the risk of any medication error internal and external medications must be segregated. Stocks of medication must be rotated to ensure that the most recently prescribed tablets are not given first. Temazepam must be stored in the controlled drug cupboard. All the bedrooms must have a lockable space. (Previous time frame was 30/6/05). Timescale for action 31/7/05. 2. 9 13(2) 31/7/05. 3. 9 13(2) 31/7/05. 4. 5. 9 24 13(2) 23(m) 12/7/05. 31/10/05. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations F56 F06 S17324 Gorsey Clough V221915 070705 Stage 4.doc Version 1.40 Page 18 GORSEY CLOUGH 1. Standard 3 2. 9 The preadmission assessment document should be amended so that a clearer more detailed assessment of the residents needs can be undertaken and recorded. This document should also include information about the residents oral health, fought care and social interests. When a prescription is being transcribed it should be signed and countersigned. GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 GORSEY CLOUGH F56 F06 S17324 Gorsey Clough V221915 070705 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. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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