Inspection on 26/08/09 for Gorsey Clough Nursing Home Limited

This inspection was carried out on 26th August 2009.

CQC found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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... 12/07/05

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 25/11/2009.

Key inspection report Care homes for older people Name: Address: Gorsey Clough Nursing Home Limited Harwood Road Tottington Bury Lancashire BL8 3PT     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Michael Murphy     Date: 2 6 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Gorsey Clough Nursing Home Limited Harwood Road Tottington Bury Lancashire BL8 3PT 01204882976 01204886824 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Gorsey Clough Nursing Home Limited care home 61 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: The home is registered for a maximum of 61 service users, to include: up to 31 service users in the category of (OP) Older People, up to 24 service users in the catrgory of DE(E) Dementia (over 65 years of age), up to 3 service users in the category of PD Physical Disabilities (under 65 years of age), up to 5 service users (one of whom is named) in the category of (MD) Mental Disorder (under 65 years of age). The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 0 5 0 3 Over 65 24 0 31 0 Care Homes for Older People Page 4 of 23 Brief description of the care home 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 2 other lounges. Some of 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. We were informed that the fees at the time of this inspection ranged from 368.68 pounds per week to 465.00 pounds per week. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection included an unannounced visit to the home on the 26th of August 2009 between 9am and 5pm. During the visit we talked to residents, relatives, staff and the registered home manager. We also looked at documents and records the home have to keep such as residents care records, medicine records, written policies and other records. Before the inspection, we also asked the registered home manager to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home sees the service they provide the same way that we see the service. We felt this form had been completed in sufficient detail and provided useful information. Care Homes for Older People Page 6 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All prosective residents were properly assessed prior to admission to ensure their care and support needs could be properly met following admission. Evidence: All prospective residents are thoroughly assesed prior to being admitted to the home. The homes registered manager or one of the senior nurses (both are qualified psychiatric nurses) conducts the pre-admission assessment. This assessment is very important to ensure the home is able to judge if the prospective resident can be cared for and supported properly should they be admitted. Residents and relatives spoken to said that they felt they were appropriatly consulted and involved in relation to their admission to the home. A detailed record of the pre-admission assessment is kept in each residents care records file. The pre-admission assessments carried out by the home manager/senior nurse were supported by assessments conducted by social workers and/or health professionals such as doctors and specialist nurses. Care Homes for Older People Page 9 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were being properly supported to ensure their health and personal care needs were being met appropriately. Evidence: Residents health, personal and social care needs were being set out in an individual plan of care. We looked at the care records of three residents on this occasion. These were well organised and properly maintained. Care plans described what action needed to be taken by the nursing and care staff to ensure that residents care and support needs were being properly met. Care plans had been developed in a way that were very particular to the resident as an individual person. The care records also contained risk assessments that identified possible threats to a residents health and safety and described things that needed to be done to keep them safe at the same time as maintaining their freedom and independence. For example risk assessments had been done with regard to residents mobility, nutrition and moving and handling needs. Care records had been kept up to date. Arrangements had been made to register all residents with a local GP. Information in the care records and discussion with residents, their relatives and staff indicated Care Homes for Older People Page 10 of 23 Evidence: residents were able to access health care services appropriately. A record of all such access was kept. Residents medicines were being looked after safely and securely. The qualified nurses managed residents medicines. A medicine record was kept in respect of each resident. These had been completed properly. The registered manager regularly conducted checks (audits) to make sure the way residents medicines were being looked after continued to be safe. Residents spoken to said that the nursing and care staff treated them respectfully and maintained their privacy and dignity, especially when they were being provided with personal care. They said that staff knocked on bedroom doors before entering and spoke to them in a proper manner. Comments made included: the staff are very kind, they speak to me nicely, I am happy here and am cared for well, my relative is well looked after by pleasant staff who are caring and helpful, another relative said we are confidant the care our relative gets is of a very good standard and have no worries, the staff keep us informed of any changes in our relatives condition. Care Homes for Older People Page 11 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were supported to enjoy a stimulating lifestyle and access a wide range of social and leisure activities. Residents were encouraged to make as many personal choices in their daily lives as possible, and the general view of food provision was positive. Evidence: The routines of daily living and the social activities available were flexible and varied and meet residents expectations, preferences and capacities. Residents were supported to access a wide range of social and leisure activities (such as arts and crafts, singing and dancing, games, pub lunches and other local outings) and entertainments. Information about forthcoming events, activities and entertainments are prominently displayed. Residents said they enjoyed the programme of activities available. Relatives and friends of residents are actively encouraged to participate in all the social and leisure activities available. Particularly popular with residents and their relatives are the entertainment shows that are put on three times a year by the manager and her staff (the shows are so popular they are taken to other care homes in the area. Residents were able to follow their own religious practices and as in other areas of life in the home were are able to exercise their own personal choices in respect of this. Residents and relatives spoken to said there were no unreasonable Care Homes for Older People Page 12 of 23 Evidence: restrictions on visiting at the home. Residents may receive their visitors in the privacy of their own room or quieter lounge areas of the home if preferred. Residents also said they were able to exercise choice and independence in their daily lives. Comments made included: I am able to choose when I get up in the morning and when I go to bed, I decide what activities I take part in, You are able to stay in your room for some privacy or go to the lounge - it is up to you, I decide what clothes I am going to wear and what meals I want, The staff always ask me what I think or want to do and try to respect my decisions. Menus were displayed throughout the home and were varied, balanced and provided choice. Residents said they can always request an alternative from the menu if they wish and are comfortable to do so. Comments regarding the food included: the food is of a good quality, the food is lovely, I love the food, they will always give you something else if you want something different, I visit regularly at meal times - the standard of the food in my opinion is very good, the food my relative and the others are proided with appears to be of a good qulaity and quantity. Lunch was observed on the day of inspection. This was a hot and substantial meal. Staff served and assisted residents appropriately and sensitively. The recently refurbished dining areas were comfortable, suitably furnished and appropriate for residents to take their meals in. Care Homes for Older People Page 13 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an accessible and clear procedure in place to deal with complaints. Staff have been provided with recent safeguarding training and there are procedures in place that describe how to protect residents and keep them safe. Evidence: Information on how to make a complaint was prominently displayed in the home. This information detailed who to contact and how the complaint would be dealt with. A complaints record is kept by the home. Complaints appeared to have been dealt with properly. Discussion with residents and relatives indicated that manager or senior staff are always available and that any issues raised are dealt with promptly and rarely need to become formal complaints. The home operates safeguarding and whistle-blowing policies (including those developed locally and operated by Bury social services) that seek to keep residents safe. Staff spoken to were aware of the importance of safeguarding and protecting residents and described their role in doing so. They confirmed they have been provided with recent safeguarding training. Inspection of training records revealed that safeguarding training has been provided to all staff at the home. In relation to the Mental Capacity Act the registered manager informed us that no people living at the home were suject to a deprivation of liberty authorisation and that no one living at the home was having their liberty deprived without authorisation. Care Homes for Older People Page 14 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided a suitable, safe and well-maintained environment for residents. Evidence: An extensive programme of redecoration and refurbishement of the home has been conducted since the last key inspection in August 2007. This has improved the quality of the environment and more importantly the comfort of residents at the home. Dining and lounge areas have been redecorated and refurbished. These areas were clean and warm, suitably and comfortably furnished, newly decorated, had new floor coverings and contained new large screen televisons and other leisure equipment such as music centres and DVD players. Twenty four residents bedrooms were looked at on this occasion. These were clean and appropriately furnished and equipped. Most residents bedrooms have been completely redecorated and refurbished since the last key inspection. Plans are in place for the remaining bedrooms to be refurbished in the near future. Many residents bedrooms were highly personalised. Residents spoken to said they were happy with the accommodtion provided. Comments made included: I like my room and have been able to bring in some of my own things, so it feels like home, my relatives room is very clean, warm and bright and was recently done up, I am able to spend time in my room during the day, but I also use the lounges and dining room too and they are good, when I come and visit the home is always very clean, and if things need repairing it is done quickly. Suitable arrangements were in place to manage residents laundry needs. And Care Homes for Older People Page 15 of 23 Evidence: appropriate measures were being taken to minimize the potential spread of infection within the home such as adequate hand washing facilities and the provision of protective clothing for staff as well as appropriate cleaning practices within the home. Care Homes for Older People Page 16 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing provision, staff recruitment procedure and the staff training provided at the home seek to ensure residents are cared for and supported safely and appropriately Evidence: The registered manager and staff spoken to on the day of inspection were of the view that staffing levels were meeting the care and support needs of the residents. Residents spoken to said that they were being properly cared for in a timely way. Relatives also said that there always seemed to be enough staff on duty and that they were confidant their relatives were being cared for very well. We also note there were adequate staffing arrangements in place to meet the administrative, catering, laundry and housekeeping requirements of the home. The home had in the main a proper procedure in place for recruiting new staff. This is vital to ensure, as far as possible, that residents are being cared for and supported by suitable staff. The recruitment procedure included criminal records checks and another special check regarding the suitability of the applicant to work with vulnerable people. However to protect residents as much as possible the application form completed by applicants should contain a rehabilitaion of offenders declaration. The programme of staff training ensures that staff are provided with the skills required to care for and support residents properly. Inspection of staff training records and discussuion with staff and the registered manager demonstrated that staff training Care Homes for Older People Page 17 of 23 Evidence: (including regular updates) is well organised and appropriate. Training is provided by trainers employed by the home and the local authority training partnership. The registered manager has also identified the need to provide staff with training related to challenging behaviour and assertiveness. 63 of the care staff have obtained a national vocational qualification in care (NVQ). The remaining care staff were undergoing this training or were expected to do so in the near future. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was being managed in a very effective and well organised way. Residents, their relatives and staff are confident the home is run in the best interests of residents. Evidence: The registered manager is a qualified psychiatric nurse (and has obtained a relevant management qualification) and has managed care services for older people for many years. Discussion with residents, their relatives and staff revealed that the manager creates a positive, inclusive and open atmosphere at the home and is a strong leader. Since the last inspection the manager has been particularly active in further developing the programme of staff training and developing an approach to the care of residents that minimises the need for sedative medications (an article about this was published in the nursing press in early 2009). There is also a comitment to ensure the quality of the service provided to residents is of a high standard and that the home is run in their best interests. The registered manager and owners of the home regularly obtain the views of residents, relatives and Care Homes for Older People Page 19 of 23 Evidence: staff in respect of this. Discussion with these groups of people showed that the manager and owners listen to any issues/suggestions raised and take any neccessary action. The manager also conducts checks (audits) on how good the home is run. For example regular checks are made in respect of residents medicines, how care records are maintained and the state of the environment. The arrangements to support residents with their money (personal allowances only) were secure and appropriately documented. The arrangements for the health and safety of residents (and others) in the home were adequate and appropriate. Staff are provided with regular training in respect of moving and handling, fire safety, food hygiene and the prevention of infection. Hazardous substances were being securely stored and gas and electrical systems had been checked/certificated regularly, we were informed hot water temperatures are controlled by special valves. Proper procedures were in place for the reporting of accidents, illnesses and injuries. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 19 That prospective staff make a written declaration in respect of any criminal convictions or police cautions they have. To protect residents as much as possible and ensure that they are being cared for and supported by suitable people. 30/09/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 30 That formal arrangements are made to provide staff with training in respect of challenging behaviour. Such training will enhance the skills of staff in supporting residents who display such behaviour as part of their illness. Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!