CARE HOMES FOR OLDER PEOPLE
Gosberton House Nursing Home Westhorpe Road Gosberton Spalding Lincs PE11 4EW Lead Inspector
Julie Western Unannounced Inspection 25th February 2006 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 Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 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.V284073.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Gosberton House Nursing Home Address Westhorpe Road Gosberton Spalding Lincs PE11 4EW 01775 840581 01775 841298 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.V284073.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 4th July 2005 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. Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 3 hours. A partial tour of the building was undertaken and care records were inspected. The main method of inspection used was called ‘case-tracking’ – this involved selecting three residents and tracking the care they received through the checking of their records, discussions with residents, relatives and care staff and observation of practices. Policies and procedures were examined and some of the records concerning the safety of the home were also seen. Four of the 51 residents, four care and ancillary staff and two visitors were spoken with. Since the inspection took place on a Saturday, the registered Manager was not available but the business partner was present for the majority of the inspection. What the service does well: What has improved since the last inspection?
Improvements to the building and environment have included the redecoration of the hall, including new feature curtains to the 30-foot high period window on the staircase landing. The lounges, dining room and entrance hall in the Heeson wing have been redecorated and on the day of the inspection, the office floor was being redecorated. Work has commenced on a Japanese garden with a pond and bridge near the front entrance, which will provide a quiet and reflective place for residents and visitors. There is now an OTEX hygiene system in place in the laundry to prevent MRSA-type bacteria from spreading. The complaints procedure has been re-written. The Manager and
Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 Page 6 business manager have revised kitchen procedures and menus, following working shifts themselves in the kitchen over the Christmas period. 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. Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 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.V284073.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 The home clearly sets out what it intends to do for its residents and this information is freely available to residents. The service user guide should contain a copy of the complaints procedure. A comprehensive initial assessment ensures that the needs of residents can be met. Prospective residents are encouraged to take time before making the decision to move into the home on a permanent basis. EVIDENCE: The statement of purpose and the service user guide were in the same document and were comprehensive and clear; they were retained in the main office for prospective residents or their relatives to read. The terms and conditions were clearly set out. Visitors confirmed that their relatives had been able to stay in the home for a trial period before deciding to live there permanently. Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7-10 The home’s records give a clear indication of the needs of residents and enable staff to meet their needs with sensitivity and regard for their privacy and dignity. EVIDENCE: The three care plans seen contained sufficient detail for staff to be clear on resident’s needs and abilities. Reviews were taking place and documents were being updated. Care plans were signed, either by residents or relatives. Visitors confirmed that they were involved in their relatives’ care plans and attended reviews regularly. Risk assessments were in place for certain activities such as the fitting of bed rails to beds. The trained nurse on duty administered all medication. A comprehensive medication policy and procedure was in place; however, the home has not had a visit from a pharmacist in the last eighteen months. The staff team were observed carrying out their duties with kindness and sensitivity towards the residents, especially when attending to their personal needs and a visitor said ‘they’re angels, they’re very good’.
Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 Social activities create a variety of events and activities, which residents are informed about. Residents exercise choice about which activities, if any, they wish to participate in and what food they want to eat from a choice of balanced and nutritious meals. EVIDENCE: The home employs a full time activities coordinator [known as a diversional therapist] five days a week 9-3; she is responsible for assessing the abilities of residents and discussing with them their hobbies, interests and wishes regarding pastimes. Residents and visitors spoken with described recent activities including walks, coffee mornings, a day at the zoo and a trip to the theatre. Regular activities included exercises, darts, board games, bingo, quizzes and cookery. Residents meetings were held quarterly. The business manager said that the home produced a quarterly newsletter and the monthly activities programme showed a range of activities. The head chef is responsible for the ordering of all food. Residents were seen enjoying the mid-day meal, which was well presented. Menus showed ample quantities of fresh fruit and vegetables, all locally sourced and there was a menu board displaying the day’s menu. A visitor said ‘I have lunch here every
Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 Page 11 day with my relative and I couldn’t fault it’. Residents are weighed regularly. The kitchen serves 8 diabetic meals, 4 soft diets and 13 pureed meals. Care staff confirmed that residents have an initial nutritional assessment and then the head chef meets with the resident to discuss dietary preferences. A record is maintained of the food provided and cleaning rotas were in evidence. Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The home’s complaints procedure is clear and gives residents and their relatives the confidence that comments and concerns will be listened to; there is a robust adult protection procedure. EVIDENCE: The home had received no complaints since the last inspection. Residents and visitors spoken with all said they did not wish to complain but knew how to make a complaint; complaints procedures were to be found in a small frame in every resident’s room. There was a clear adult protection procedure, which was linked to the Local Authority procedures. Staff members spoken with had all received training on adult abuse as part of their induction training and were knowledgeable about complaints. Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 26 The residents live in a comfortable and safe environment, with both private and communal space being generally suitable for their needs. EVIDENCE: Overall, the standard of decoration internally was good and afforded residents a great degree of comfort. Recent improvements to the environment had included the redecoration of the hall, including new feature curtains to the 30foot high period window on the staircase landing. The lounges, dining room and entrance hall in the Heeson wing have been redecorated and on the day of the inspection, the office floor was being redecorated. Residents’ rooms were comfortable and well furnished. There was evidence of specialist equipment including raised toilet seats, hoists and grab rails. Externally, the grounds were well maintained; work has commenced on a Japanese garden with a pond and bridge near the front entrance, which will provide a quiet and reflective place for residents and visitors. The home was clean and tidy and smelled fresh throughout.
Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected. EVIDENCE: Although these standards were not fully inspected, the staff rota showed that there were enough staff numbers according to the staffing matrix and shifts were staggered to accommodate the needs of residents; staff members said that usually there were enough staff members on duty to complete their tasks, although on the day of the inspection a second nurse was absent through sickness. However, a visitor commented that there were less staff members at the weekends and during later discussions, it was agreed that this was because there was a reduced ancillary presence and normally no management presence at these times. It was recommended that this was reviewed. Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31-33, 35, 37 The home is well run by the manager, with good guidance and leadership for staff. Record keeping is of a good standard and the health and safety and welfare of residents is promoted. EVIDENCE: The registered manager is a qualified nurse with many years experience of working with older people; he has been the manager of the home for over a year and has worked in the home for 3 years. Residents and visitors to the home said they felt confident that he would listen to them. The administrator has worked at the home for many years and has a wealth of experience of managing the home’s day-to-day issues. The home has a range of policies and procedures and a selection of these were sampled, including infection control, health and safety, moving and handling, fire safety and infection controls. The personal allowance monies kept by the home for two residents were checked and found to balance.
Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 Page 16 Gosberton House has been accredited to ISO9001 and has the Investors In People award; these are regularly audited and inspected by the agencies managing these awards. Questionnaires completed by residents and the resulting responses were then analysed and acted upon. Monthly reports regarding the conduct of the home are produced by Mrs Eastgate and sent to the commission; a copy is given to the manager and the other owners of the home. Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X 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 3 3 X X 3 X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 X Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 Page 18 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. 1. Standard OP1 Regulation 4 Requirement The registered person must include a copy of the complaints procedure in the service user guide The registered person must make arrangements for a pharmacist to visit the home regularly to provide advice and guidance Timescale for action 22/04/06 2. OP9 13 22/04/06 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 OP27 Good Practice Recommendations It is a recommendation that staffing arrangements at weekends, when there is a decreased presence of ancillary and management staff, should be continually monitored. Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Gosberton House Nursing Home DS0000002637.V284073.R01.S.doc Version 5.1 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!
