Inspection on 30/08/07 for Gorsey Clough Nursing Home Limited

This inspection was carried out on 30th August 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

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

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

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Gorsey Clough Nursing Home Limited Harwood Road Tottington Bury Lancashire BL8 3PT Lead Inspector Mike Murphy Unannounced Inspection 30th August 2007 09:30 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 Gorsey Clough Nursing Home Limited DS0000017324.V337589.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. Gorsey Clough Nursing Home Limited DS0000017324.V337589.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gorsey Clough Nursing Home Limited Address Harwood Road Tottington Bury Lancashire BL8 3PT 01204 882976 01204 886824 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) Gorsey Clough Nursing Home Limited Mrs Collette Conway Care Home 61 Category(ies) of Dementia - over 65 years of age (24), Mental registration, with number disorder, excluding learning disability or of places dementia (5), Old age, not falling within any other category (31), Physical disability (3) Gorsey Clough Nursing Home Limited DS0000017324.V337589.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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 category 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. 17th January 2007 2. Date of last inspection 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 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. The current fees for residential care is £355.11 to £400.00 per week (with nursing fees being structured in accordance with the PCT assessment if appropriate) - information supplied by the provider. Gorsey Clough Nursing Home Limited DS0000017324.V337589.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection which the home did not know was going to happen took place on the 30th of August 2007. The inspection took place over five hours. The inspection included discussion with residents, their relatives, a tour of the premises, inspection of care and other records maintained at the home and discussion with management and staff. What the service does well: What has improved since the last inspection? What they could do better: Whilst it is acknowledged that there have been major improvements to the environment of the home some areas have not been completed. The inspector was informed this would be addressed in the near future. The home will be required to provide details to the CSCI what this work will consist of and what time frame it will be completed in. Gorsey Clough Nursing Home Limited DS0000017324.V337589.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Gorsey Clough Nursing Home Limited DS0000017324.V337589.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gorsey Clough Nursing Home Limited DS0000017324.V337589.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All prospective residents are appropriately assessed and both they and their relatives are encouraged to be fully involved in the process leading to admission. EVIDENCE: Prior to residents being admitted to the home the senior member of the nursing staff who specialises in the pre-admission assessment process carries out an assessment of the prospective resident’s needs in consultation with the resident (if possible), their relatives and relevant health (for example doctors) and social care professionals (for example social workers). The purpose of such an assessment is to assist the prospective resident (and their relatives) in their considerations of how appropriate a placement at the home would be and enable the nurse conducting the assessment to decide if the home will be able to meet the prospective resident’s needs appropriately. Gorsey Clough Nursing Home Limited DS0000017324.V337589.R01.S.doc Version 5.2 Page 9 The care records for the last five residents admitted to the home all contained a record of such assessment. Gorsey Clough Nursing Home Limited DS0000017324.V337589.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. The health and personal care provided for residents is suitable, well organised, and meets the expectations of residents and their relatives. EVIDENCE: The care records of five residents were inspected. These contained care plans that were initially based on the pre-admission assessment that is referred to earlier in this report. Care plans addressed the health and personal care needs of residents in a clear, organised way and were evaluated at least monthly. Risk assessments, that seek to protect resident’s health and welfare are incorporated into the care records in respect of residents skin integrity (assessing the risk of pressure sores), mobility/moving and handling, nutrition, (including regular weight monitoring) and other areas of potential risk for individual residents were also assessed at least monthly (for example the need for bed rails to be used). Daily statements regarding resident’s progress are also recorded and these are timed and signed by staff. Gorsey Clough Nursing Home Limited DS0000017324.V337589.R01.S.doc Version 5.2 Page 11 All residents are registered with a local GP and it was evident that all were enabled to access dieticians, opticians, chiropodists, dentists, district nurses and other specialist services as individual residents needed. Pre-inspection comment cards completed by relatives and discussion with relatives on the day of inspection indicated that they are kept informed of all changes in their relation’s health. The practices for the receipt, recording, storage, handling, administration and disposal of resident’s medicines were appropriate and safe. Medicine records had been completed properly. However it is recommended that all handwritten transcriptions to medicine administration records are checked and signed by 2 nurses. Discussion with residents and staff (and responses in Pre-inspection comment cards completed by residents and relatives) revealed that residents were treated with respect and that their right to privacy was upheld. Comments made included; ‘The nurses and carers seem to treat all the residents, including my mum in a decent and caring way, and that has always been so when I have visited – which is many, many times over the last couple of years’, ‘Collette and her staff see to it that people are treated properly and as individuals even though most are very confused’, ‘the carers are wonderful with dad he is always nicely dressed, clean and they make sure his dignity is preserved as he cannot do this for himself’. On the day of inspection staff were observed to interact positively with residents and show them respect, protect their dignity and assist them properly throughout the day. Residents and visitors appeared to have a good relationship with the manager and her staff. Relatives of residents all spoke very positively about the care and attention provided to their relation at the home. Gorsey Clough Nursing Home Limited DS0000017324.V337589.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. Residents are being supported by staff to participate in social activities and are able to retain the ability to make personal choices. There was a general satisfaction with meals provision at the home. EVIDENCE: Discussion with residents and relatives (and observations made on the day of inspection) indicate that the routines of daily life in the home are as flexible as possible in a communal setting. Residents were enabled to choose what time they get up and go to bed, what activities to engage in and staff inform and consult them (as far as possible) about the care and support they need. Clearly this is very important in enabling residents to retain as much control over their life as possible. However this must be seen in the context of the fact that all the residents who live at the home experience confusion to a lesser or greater degree. This is a consequence of their illness and means that to provide for residents preferences staff depend on information provided by relatives concerning these areas. The arrangements for providing social and leisure activities are satisfactory. Activities at the home are co-ordinated by staff. A varied programme of Gorsey Clough Nursing Home Limited DS0000017324.V337589.R01.S.doc Version 5.2 Page 13 activities/pastimes is provided such as art, games, singing and dancing, exercise, going for walks, shopping, pub lunch etc. The home maintains an activities diary on a daily basis. Outside entertainers visit on a regular basis and the staff perform shows two or three times each year. Relatives are invited to shows and a buffet is provided. The home also has links with the local churches and the local social club who keep them informed of any suitable events; there is a contract with the local taxi service who provide suitable transport for residents. There is a visiting Hairdresser who has been providing residents with this service for many years. Staff also organise clothes, makeup and jewellery parties on a regular basis and this enables residents to exercise choice. The home is also a memebr of NAPA (National Association of Providers of Activities). Residents wishing to maintain their religious links are enabled to do so. The home has an open visiting policy. There are no restrictions on the time people visit. The only time restrictions would be imposed is when requested by residents. Relatives spoken to during the inspection said they were always made welcome at the home and were able to see their relatives in the privacy of their own room or in a quieter communal area. Residents and relatives spoken to expressed satisfaction with care provided and organisation of life at the home. Observation of care practice and information in care plans indicated residents are encouraged to make choices. For example what time they like to get up/go to bed. While some residents chose to sit in the lounge a number were observed to spend their time in their own rooms. Meals are cooked on site in the home’s kitchen. Menus are varied, balanced and provide choice. Meals are served in a designated dining room. This is an appropriately furnished room that provides a comfortable area for residents to have their meals. Residents’ meal times are as reasonable and as flexible as they can be in a communal setting. Lunch was observed on the day of inspection. This was a hot and substantial meal and staff assisted and served residents their meals appropriately. Discussion with residents revealed a general satisfaction with the meals provided. Gorsey Clough Nursing Home Limited DS0000017324.V337589.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. Residents and relatives knew how to make a complaint if they felt it necessary. Written guidance and training arrangements ensure that staff members have knowledge of abuse and protection arrangements and safeguards were in place to protect the welfare of residents EVIDENCE: The complaints procedure was prominently displayed in the home and included details of how to contact the CSCI if it was felt necessary by the complainant. Relatives spoken to on the day of inspection said concerns or worries brought to the manager’s attention are responded to quickly and don’t become formal complaints. Policies and practices aimed at protecting residents from abuse are in place. Also Bury’s inter agency protection procedure is held on site. Staff spoken to confirmed that they had received adult protection training (this was also reflected in training records maintained by the home) and were aware of the whistle-blowing policy operated by the home. Training records indicated that approximately all the staff had received recent adult protection training. Gorsey Clough Nursing Home Limited DS0000017324.V337589.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 good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and appropriate environment to accommodate, care for and support residents. The environment has improved significantly since the last inspection, however some improvements do still need to be made. EVIDENCE: A tour of the home during this inspection revealed it to be clean with odours being well managed. Communal lounge and dining areas were clean, adequately decorated and furnished. WC and shower/bath areas were clean and appropriately adapted/equipped. Resident bedrooms were clean, warm and adequately decorated and furnished. Many were highly personalised. A programme of redecoration and refurbishment of resident’s bedrooms and communal areas within the home is Gorsey Clough Nursing Home Limited DS0000017324.V337589.R01.S.doc Version 5.2 Page 16 nearly completed. The inspector was informed of plans to improve those areas of the home not yet completed in the near future. Appropriate measures to prevent the spread of infection were in place – including adequate hand washing/cleaning facilities, laundry and sluicing arrangements, provision of disposable gloves and aprons for staff, adequate provision of house keeping staff and appropriate arrangements for the disposal of waste. Gorsey Clough Nursing Home Limited DS0000017324.V337589.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 recruitment, provision and training of staff employed at the home are being managed appropriately. This is important to ensure resident’ are being cared for adequately and appropriately by staff who able to deliver this support safely and competently. EVIDENCE: Inspection of staffing rotas indicated that staffing provision at the home complied with the current minimum requirements that apply to care homes for older people. Discussion with manager and staff at the home indicated that they were of the view that staffing levels were appropriate to meet the dependency levels and needs of resident’s. A weekly rota is on display which indicates which staff are on duty. There is limited use of agency staff and only from a preferred agency. All Nurses have current registration with the Nursing and Midwifery Council and regularly attend updates on their field of practice. There is adequate provision of housekeeping, catering and ancillary staff at the home. Inspection of 3 staff personnel files revealed that these contained an application form (including health declaration), 2 written references, a Criminal Records Bureau check (including a ‘POVA first’ check), proof of identity and evidence of induction and other training. Gorsey Clough Nursing Home Limited DS0000017324.V337589.R01.S.doc Version 5.2 Page 18 There is a commitment to NVQ. Sixty percent of Care staff have achieved level 2 NVQ in Care or above and a further twenty-five percent are presently working towards level 2 NVQ. This training is available for all staff. All the domestic staff have achieved level 2 NVQ in Cleaning and Support Services. The Maintenance person is working towards his NVQ 2 in Painting and decorating. Training in, moving and handling, fire safety, first aid and protection of vulnerable adults is available all staff at the home. The registered manager and administrator have been working in conjunction with Bury adult training partnership to ensure that the induction and ongoing training provided by the home meets the common foundation standards and other requirements of ‘Skills for Care’ (part of the Sector Skills Council). This is to be commended. Gorsey Clough Nursing Home Limited DS0000017324.V337589.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 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 was being appropriately managed in a way that enables residents, their relatives and staff to feel that they are being supported properly EVIDENCE: The registered manager is a qualified psychiatric nurse and has worked at Gorsey Clough for 12 years, the last 5 years as Registered Manager. She keeps herself updated in all relevant areas and completed the NVQ level 4 in Management in 2006. Residents, relatives and staff say that the manager is accessible, approachable and supportive. The Administrator has worked at Gorsey Clough for 20 years and has undertaken extensive training including NVQ in Management level 5; she has undertaken the responsibility for the organisation of staff training. All staff have regular supervision and annual Gorsey Clough Nursing Home Limited DS0000017324.V337589.R01.S.doc Version 5.2 Page 20 appraisals and training plans. The Home has a clear Organisation Chart and this is on display in reception. Ther is a structured method of monitoring Quality Assurance and there are monthly quality assurance meetings. The home actively seek the opinions of their residents, relatives, staff and visiting professionals. Records are kept for 7 years. If a resident is unable to deal with their own finances and has no relatives the home manage their finances. Detailed records are kept and monies are kept secure. Accidents and incidents are appropriately recorded and reported to the CSCI. The health, safety and welfare of residents and others is promoted and protected. For example staff are provided with regular training and appropriate equipment to ensure resident’s moving and handling needs are met. An example of this would be for a resident who needs to be safely moved with the aid of a hoist. Fire safety training is regularly provided. Information provided by the home indicates that electrical, gas and other equipment safety inspections and servicing has been carried out. Gorsey Clough Nursing Home Limited DS0000017324.V337589.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 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 X X 2 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Gorsey Clough Nursing Home Limited DS0000017324.V337589.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. 2 Standard OP19 Regulation 23 Requirement That the CSCI is informed in writing what progress has been made with the proposed improvements to the home’s environment Timescale for action 01/11/07 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 OP9 Good Practice Recommendations That all handwritten transcriptions to medicine administration records are checked and signed by 2 nurses. Gorsey Clough Nursing Home Limited DS0000017324.V337589.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Gorsey Clough Nursing Home Limited DS0000017324.V337589.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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