Inspection on 20/11/06 for Gosberton House Nursing Home

This inspection was carried out on 20th November 2006.

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

Gosberton House Nursing Home 17/11/08

Gosberton House Nursing Home 26/02/06

Gosberton House Nursing Home 04/07/05

Gosberton House Nursing Home 11/03/05

Gosberton House Nursing Home 07/05/04

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

CARE HOMES FOR OLDER PEOPLE Gosberton House Nursing Home Westhorpe Road Gosberton Spalding Lincs PE11 4EW Lead Inspector Wendy Taylor Key Unannounced Inspection 20th November 2006 09:50 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 Gosberton House Nursing Home DS0000002637.V320450.R02.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. Gosberton House Nursing Home DS0000002637.V320450.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gosberton House Nursing Home Address Westhorpe Road Gosberton Spalding Lincs PE11 4EW 01775 840581 01775 841298 caregosbertonhouse@yahoo.co.uk 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) Mr Gordon Lee Mrs Violet Bessie Lee John Edward Thornley Care Home 57 Category(ies) of Old age, not falling within any other category registration, with number (57) of places Gosberton House Nursing Home DS0000002637.V320450.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th February 2006 Brief Description of the Service: Gosberton House is a care home providing nursing and personal care for 57 older people; on the day of the inspection 51 residents were being accommodated. The owners are Mr and Mrs Lee and there is a business partner, Mrs Janet Eastgate, who is responsible for the day-to-day administration of the home. The registered manager of the home is Mr John Thornley. The home is located in landscaped grounds in a quiet area of Gosberton village, which is some 6 miles from the market town of Spalding. The local church is next to the home and there are footpaths to the local amenities such as post office, shops and pub. The home was opened in 1989 with a ground floor extension built in 2000 to provide further bedroom and communal areas. The original building is a converted grade II listed building with the third floor providing space for administration services. The home has 38 single rooms with 18 having en-suite bathrooms and 8 double rooms for those service users who chose to share. A passenger lift is in place to serve all floors of the home. The current fees are between £336:00 and £475:00 Gosberton House Nursing Home DS0000002637.V320450.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place during November 2006 and the visit to the home was carried out over approximately 6 hours on one day. In the absence of the registered manager, the administrative manager was available throughout the visit. The care received by four residents was followed in detail. Feedback was obtained from some of these people and others who live at the home, about their experiences of living there. Individual resident’s records and general house records were looked at; staff and a manager were spoken to and observation of the care being provided was made. Feedback was also received prior to the visit from surveys filled in by residents and relatives, and a questionnaire completed by the registered manager. Feedback from residents was generally positive and comments such as ‘I love living here’, ‘I’ve got a lovely room, and ‘there’s always plenty to do’ were made. Other comments from residents and relatives are reflected in the body of the report. What the service does well: What has improved since the last inspection? Since the last inspection the complaints procedure has been included in the service user guide so that residents and their representatives have good access to the information. The local pharmacist now visits the home regularly to audit and advise on medication storage, administration and recording arrangements; and ancillary Gosberton House Nursing Home DS0000002637.V320450.R02.S.doc Version 5.2 Page 6 staff sign to say what household tasks they have completed in order to monitor that cleaning is carried out appropriately. 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. The summary of this inspection report can be made available in other formats on request. Gosberton House Nursing Home DS0000002637.V320450.R02.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 Gosberton House Nursing Home DS0000002637.V320450.R02.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): 1, 3, 5, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a robust assessment process, which assures residents that their needs will be met; and they receive enough information to help them make a choice about where to live. EVIDENCE: A service user guide and statement of purpose are available as one document. The document contains information about the staff, managers and the environment, as well as the complaints procedure. Residents and relatives said that they were welcomed into the home at the first visit and they were advised to look around the home before making their choice. They also confirmed that they have received a service user guide. Gosberton House Nursing Home DS0000002637.V320450.R02.S.doc Version 5.2 Page 9 Individual assessments are carried out prior to admission. The assessments contain information about needs such as spiritual, social, emotional, motivational, communication, behaviour, cognition, personal care and pain. There are no intermediate care services provided at the home. Gosberton House Nursing Home DS0000002637.V320450.R02.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, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual needs are reflected in clear, comprehensive and up to date care plans; and the privacy and dignity of residents is maintained. EVIDENCE: Individual care plans are available that cross-reference to assessed needs. Plans are in place for needs such as orientation, memory, cognition, personal hygiene, mobility, sleep, decision making/choices and pain. Core care plans are used and are personalised for each resident. There are also care plan breakdown sheets in each resident’s room so that staff are always up to date with care needs. Residents where they are able, or their relatives sign the care plans. One resident said that they have a care plan but they prefer their family to deal with it. There is evidence that care plans are reviewed on a monthly basis, and there is a schedule of dates available that shows when reviews are due for each resident. During the inspection call bells were answered promptly and a resident said ‘they come as soon as I ring the bell’. Call bells were in reach of people, and Gosberton House Nursing Home DS0000002637.V320450.R02.S.doc Version 5.2 Page 11 staff were observed to place them appropriately when they helped residents move to different areas of the home. Pressure area relief routines were being followed in line with care plans, and the routines were confirmed during the staff handover period. A staff member said that no one is currently being treated for pressure sores. Residents made comments such as ‘I get a weekly bath, the day might change but I always get one’. A manager said that residents have a bath once a week but they can have one at other times if they request such. A survey currently being carried out among residents and relatives has not highlighted any issues with bathing routines or opportunities so far. Residents and relatives made comments such as ‘staff are very attentive’, ‘staff are always helpful’; and ‘they make sure I have my privacy when I want it’. They also said that staff are very polite. Pre inspection information shows that there is a policy available regarding privacy, dignity, choice and independence. A clear medication policy is available and staff demonstrated the use of appropriate administration procedures. There is evidence in records that the local pharmacist carries out regular visits to the home to audit the management of medication. There is a new system in place for the dispensing and administering of medication, and the administration records and storage arrangements were satisfactory. Records show that residents have access to support services provided such as chiropody and an optician. Physiotherapy, Occupational Therapy and Dietician services are available by referral to the appropriate service. Gosberton House Nursing Home DS0000002637.V320450.R02.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, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from access to a wide range of social and leisure activities. There is a balanced menu that offers residents a choice of well-prepared foods. EVIDENCE: There is evidence in records and through feedback from residents that activities such as bingo, various outings, keep fit, relaxation and knitting are available. Residents said that there is always plenty to do and staff are very nice to their visitors. One resident described the support they receive to help them maintain a weekly activity that they took part in before moving into the home, and a specific outing that they wished to have. During the visit a keep fit session, and a toiletry and gift sale were occurring. Monthly activity leaflets were available in resident’s bedrooms and communal areas. Activities listed included a sing-a-long session, religious services, a men’s club, flower arranging and a British Legion visit. Staff said that the activity plans are based on people’s expressed wishes, and the views of the residents in relation to activities are sought through quality surveys. Records show what activities each resident has joined in with. One resident said that there is a lot to do but they choose not to join in. Gosberton House Nursing Home DS0000002637.V320450.R02.S.doc Version 5.2 Page 13 Pre inspection questionnaires indicated that most residents are happy with the food provided for them. During the visit residents made comments such as ‘the food’s always good’, ‘we get home made cakes’, ‘there’s always plenty to drink’, and they said that the vegetables are well cooked. Relatives said that the food is well cooked and choices are always available. One relative said that they are invited to stay for meals and they always enjoy them. Staff were seen offering residents a choice of where to eat their meals, and some residents chose to eat in their rooms. Meals were nicely presented, and staff and residents were seen discussing the choices of food available. Records of individual needs, likes and dislikes are available to the catering staff. Menus show a varied and balanced diet is offered, and meals such as salads, crumpets, toasted teacakes, beans on toast, omelettes and macaroni cheese are offered at teatime. A good range of quality foods were seen in the kitchen stores. A food safety and nutrition policy is available. Notice boards are available on each floor of the home, which remind residents what activities are available for the day and what is available on the menu. Gosberton House Nursing Home DS0000002637.V320450.R02.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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear policies, risk assessments and a knowledgeable and well-trained staff team protect residents. EVIDENCE: There are policies available for safeguarding adults, whistle blowing and risk management. A copy of the complaints procedure is displayed in each bedroom, and is contained in the service user guide. Staff said that they receive training in regard to safeguarding adults and records confirmed this. During discussions, they demonstrated that they have a good knowledge of safeguarding adult issues, and what to do if they suspect or witness such. Records show that there have been no formal complaints or safeguarding adult referrals since the last inspection. Residents said that they know how to make a complaint, and that when they talk to staff they always help to put things right. One resident said that they could talk to the registered manager if they’re not happy with anything. A relative said that they have never had to make a complaint but they know what to do if they need to. Risk assessments are available in individual care files for needs such as falls, moving and handling, self-medication and the use of bed rails. Gosberton House Nursing Home DS0000002637.V320450.R02.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, 22, 23, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained, clean and tidy; and it meets the individual health and safety needs of residents. EVIDENCE: During the visit residents said that the home is comfortable, always clean and there was never any odour. Several residents and a relative said that they like the main entrance hallway because it is ‘nice and cosy’. Pre inspection information shows that the entrance hallway has recently been redecorated. A tour of the building showed that décor and furniture are generally well maintained and a manager said that some carpets have recently been renewed. No unpleasant odours were identified and the home was comfortable and tidy throughout. Cleaning rotas were seen and there was evidence that household tasks are carried out during the weekends and are signed for by the person who completes them. Gosberton House Nursing Home DS0000002637.V320450.R02.S.doc Version 5.2 Page 16 Residents said that they liked their rooms, and one person said ‘I have a nice room with everything I need, and a good view’. Some residents in double rooms said that although they are not unhappy with their rooms, they have asked for a single room when one becomes available. Other residents said that they have been accommodated when they have asked to move rooms. Bedrooms are spacious, with specialist equipment available in line with individual care plans, for example nursing beds, pressure relief mattresses and hoists. There are privacy curtains available in double rooms. A relative said that laundry is of a good quality, and new matching curtains, bedspreads and light shades have recently been provided. Aprons and gloves are available around the home, and staff were using them appropriately during the visit. Hand sanitizer gel is provided at the entrances to the home with an explanatory message to visitors about infection control measures (see Standards 31-38). There is an assisted bath and a sluice area available on each floor of the home, and signs are appropriately placed to indicate where oxygen cylinders are used and stored. A new boiler system has recently been installed. Gosberton House Nursing Home DS0000002637.V320450.R02.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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by appropriately trained staff; and they are safeguarded by robust recruitment procedures. EVIDENCE: During the visit a relaxed atmosphere was evident, call bells were answered promptly, and staff demonstrated efficient management of an emergency situation. Relatives said that staff are very helpful and friendly, and a pre inspection questionnaire described them as ‘outstanding, patient and helpful’. Another questionnaire described them as doing ‘an excellent job’. Staff said that there are enough people on duty to meet needs, and if shortages occur through sickness, there is a good bank of staff to call upon or managers will cover shifts. Rotas show satisfactory numbers of staff are available on each shift. There is currently no use of agency staff and any gaps in numbers are covered by the internal bank system. Rotas also show that ancillary staff are available at weekends. Records show that staff receive training in areas such as moving and handling, fire safety, health and safety, optical awareness, diabetes, palliative care, mouth care, stoma care and dementia. There is also evidence that induction training is provided in line with a nationally recognised induction process; and training for a nationally recognised qualification is available. There is an Gosberton House Nursing Home DS0000002637.V320450.R02.S.doc Version 5.2 Page 18 assessment and training process for promotion to senior care positions in place. Staff confirmed this and said that access to training was very good and they received a very good induction process. There is a large training room available on the top floor of the building and the service is accredited as a Royal College of Nursing resource centre and as a National Vocational Qualification (NVQ) training centre. There is a training co-ordinator and 4 NVQ assessors currently working at the home. Recruitment records include application forms, criminal record bureau checks, references, identification and terms and conditions of employment. Policies are available for recruitment and disciplinary processes, and the service has been recently reassessed for the Investors In People Award, which they retain until 2009. Gosberton House Nursing Home DS0000002637.V320450.R02.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, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to ensure that care is provided in a safe and appropriate manner, and that residents and their relatives can influence the way the service is run. EVIDENCE: There is evidence that a resident’s, relatives and stakeholder survey is currently being undertaken, and information from a recent staff survey is currently being collated. Residents said that they have filled in surveys to give their views of the service. Policies available include quality assurance, complaints, confidentiality, equal opportunities, substances that are likely to cause a hazard, resident’s finances, Gosberton House Nursing Home DS0000002637.V320450.R02.S.doc Version 5.2 Page 20 record keeping and continence. The service holds a nationally recognised quality award, which is due to be audited again in April 2007. Records show that fire equipment checks were carried out in September 2006 and the fire risk assessment was recently updated. A manager said that an automatic door release system is in the process of being fitted to all rooms as recommended by the local fire officer. There is also evidence in records that the lift and the call bell system have recently been serviced. Information sheets and risk assessments are available for most substances that are likely to cause a hazard, with the exception of hand sanitizer gel. There are no accident or incident records relating to the use or availability of the gel. Fridge and freezer temperature checks are carried out in line with environmental health guidance, but temperatures cited on standard recording formats do not cross-reference with temperatures recorded. A manager said that she would liaise with the Environmental Health Officer to ensure that formats contain correct information. Money belonging to residents is stored in a locked safe and financial transaction records are clear and cross-reference with receipts. There are clear daily records kept for each resident and used to carry out a detailed handover process. Accident records also cross reference with daily notes. Staff said that managers, including the registered manager, are very supportive and will listen to what they have to say. They said that they receive supervision regularly and find it useful in terms of communication, and discussing training needs. Records show that supervision takes place and that there are regular staff meetings. Gosberton House Nursing Home DS0000002637.V320450.R02.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 3 X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Gosberton House Nursing Home DS0000002637.V320450.R02.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP38 Good Practice Recommendations It is recommended that a risk assessment and data sheets are available for hand sanitizer gels. Gosberton House Nursing Home DS0000002637.V320450.R02.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Gosberton House Nursing Home DS0000002637.V320450.R02.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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