Inspection on 04/07/05 for Gosberton House Nursing Home

This inspection was carried out on 4th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 20/11/06

Gosberton House Nursing Home 26/02/06

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 Kathryn Emmons Unannounced 04 July 2005 9:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Gosberton House Address Westhorpe Road Gosberton Spalding Lincs PE11 4EW 01775 840581 01775 841298 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Gordon Lee Mrs Violet Bessie Lee John Edward Thornley Care home with nursing 57 Category(ies) of OP Old age (57) registration, with number of places Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 11 March 2005 Brief Description of the Service: Gosberton House is a care home providing nursing and personal care for 57 older people. The home is owned by Mr and Mrs Lee and a business partner called Mrs Janet Eastgate who is responsible for the day to day administration of the home. Since August 2004 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 ensuite 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 C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The homes manager and the nurse in charge assisted the inspector during the unannounced inspection. One inspector undertook the inspection spending Four hours in the home .The inspector toured the building and spoke with the homes manager and 2 staff. The main method of inspection used was called “case tracking” which involved selecting clients and tracking the care they receive through checking of their records, discussion with them, the care staff and observation of care practices. The home has been visited four times since the last inspection in March to investigate a complaint. The findings are provided within the main text of this report. What the service does well: What has improved since the last inspection? Since the last inspection monthly reports are being produced by Mrs Eastgate, one of the business partners and these are forwarded to the commission. The other partners Mr and Mrs Lee also receive a copy of this report. The home has undertaken further work on their quality assurance programme and has continued to attain the Investors in People award. Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 Residents are able to make an informed choice about living at the home and are given information regarding the service they can expect. Through confirmation letters and pre assessments residents are confident that their needs will be met. EVIDENCE: The manager confirmed that all residents or their relatives are given a copy of the service user guide prior to being admitted to the home. Those residents case tracked have copies of their terms and conditions or contract within their care files. One resident was able to confirm that they had seen a contract when the moved into the home. There was evidence that pre admission assessments were undertaken and a letter is sent to the resident confirming that their needs can be met. Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,9 Resident care needs are being identified, and reviewed but resident involvement needs to be demonstrated. Medication systems ensure medication is administered in a safe manner. EVIDENCE: 3 residents were case tracked. Care plans contained sufficient detail for staff to be clear on resident’s needs and abilities. Reviews were taking place and documents were being updated. It was evidenced that residents or their relatives had not always signed the care plans to demonstrate their involvement. Part of the complaint investigated was the allegation that residents were being woken and washed and dressed at 5am. During 2 unannounced early morning visits to the home this allegation was not upheld. It was evidenced, when the 2 visits took place that those residents who chose to rise early did not always have this documented in their care plan, this issue has now been addressed. Risk assessments were in place for activities such as self-medication and the fitting of bed rails to beds. Records for activities involvement need to be Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 10 updated, as some do not provide a clear picture of resident involvement with the activities programme the home provided. The trained nurse on duty administers all medications. Medication administration records inspected had been completed satisfactorily. There is a system for the reordering of medication and the home have a good service provision with a local pharmacist. Residents spoken with said that they received their medication when they should and that they were not rushed to take it. One resident said that they did not like being watched while they took their medication but understood why this needed to happen, and felt that the nursing staff undertook it in a dignified way. Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,15 Residents are provided with an activities programme that meets their recreational and social needs. Catering arrangements reflect resident’s preferences and nutritional needs. EVIDENCE: Three residents were spoken with about the activities programme and how this was put into practice. Residents made comments that the activities were varied and how they were offered a lot of opportunities to attend activities outside of the home as well as in group sessions in the home. The home employs a full time activities coordinator who is responsible for assessing residents abilities and discussing with them their hobbies and interests. One resident confirmed that the home was going to assist them in meeting up with people from a previous home they had lived at. The kitchen was inspected at the commencement of the inspection. The head chef is responsible for the ordering of all food. There were ample quantities of fresh fruit and vegetables and all produce is locally sourced. Residents who require a puréed diet have this presented in individual portions. It was evidenced that a choice was available at meal times. Residents spoken Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 12 with confirmed that the food was of a good quality and that they are involved in producing the menus and these change every six months. Care staff undertake 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. A cleaning schedule is in place and this was up to date. A recent inspection from Environmental Health did not show any deficiencies. Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The management of the homes complaints procedure does not give complainants confidence that their concerns will be investigated. Residents are given information regarding how to raise issues of concern and complaints. EVIDENCE: Since the last inspection a complaint has been made to the commission. This concerned itself with recruitment procedures and the attitudes of 3 of the care team, the manager on one occasion and the attitude of one of the partners. The findings are reported upon within the text of this report. During the investigation, regarding one of the partners’ management of concerns raised, it was evidenced that the home did not always make a record of concerns raised. This issue has been addressed and a record is now maintained of all comments and concerns made. The home has a complaints procedure in place and this is on display in the main foyer of the home and within the statement of purpose and service users guide. Residents spoken with said that they had not had a need to raise any concerns but were clear that they could report any concerns to any member of staff. Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23,26 Resident’s communal areas are clean and tidy however the cleanliness of individual bedrooms is variable. Systems for infection control keep residents safe. EVIDENCE: Those bedrooms inspected with resident permission were noted to be tidy and contained sufficient space for residents to move around their rooms freely. One resident stated that they were not satisfied with the cleanliness of their room and that the floor was not always vacuumed and furniture dusted. This was evidenced in this particular room and was discussed with the manager. All the other rooms were noted to be clean and tidy and free from any odours. 4 part time cleaners are employed working a total of 104 hours per week and have responsibility for all communal areas and residents’ bedrooms. This quantity of cleaning hours may need to be reviewed. The home has a policy in place for the management of infection control and all staff are expected to read this as part of their induction and ongoing training plan. Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Resident’s needs are being met by staffing levels but not all residents have confidence that their requests for assistance are responded to. Recruitment procedures do not always protect residents. EVIDENCE: Part of the complaint investigated surrounded allegations that 3 care staff had not behaved in a professional manner when dealing with 3 separate incidents. The Commission interviewed all of the care team members involved and the outcome was that these allegations were not upheld. The home employs a full team of care staff and nurses and the duty rota demonstrated that the minimum staffing level is maintained. Night duty staff levels are worked at a minimum with additional care support provided if needed. 2 residents stated that when they called for assistance using the call bell this took some time for care staff to answer. A carer was spoken to regarding this and they confirmed that if a bell was called the staff would attend as soon as possible. The inspector pressed 2 call bells and they were responded to within 1 minute and one and a half minutes. One of the residents believed that the bell had been responded to promptly because the inspector was in the home. This issue has been discussed with the manager who will be monitoring call bell times. Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 16 One care staffs records were inspected and it was evidenced that a Criminal record bureau checks were in place. References were in place but did not contain a lot of information. The manager said that when this happened another reference would normally be sought and could not explain why this had not happened on this occasion. The file contained all the other relevant documents and information. Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33, The home is well run, with good guidance and leadership for staff from the manager. EVIDENCE: The registered manager Mr John Thornley is qualified nurse with many years experience of working with older people. Mr Thornley has been the manager of the home for over a year and has worked in the home for 3 years. Residents spoke highly of Mr Thornley and the inspector noted Mr Thornley to have a good, professional rapport with residents and staff. Part of the complaint investigated was an allegation that Mr Thornley had made an unprofessional comment about a service user. Interviews of staff involved did not uphold this allegation. Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 18 Since the last inspection monthly reports are being produced by Mrs Eastgate, regarding the conduct of the home. These are sent to the commission and a copy is given to the manager and the other owners of the home. Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 19 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 4 14 x 15 3 COMPLAINTS AND PROTECTION x x x x 3 x x 2 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x 3 3 3 x x x x x Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP 7 Regulation 15 Requirement The registered person must ensure that residents are involved in the compilation of their care plan and this is evidenced. The registered person must ensure that a record is maintained of any concerns raised and the action taken The registered person must ensure that all references provide satisfactory information The registered person must ensure that all residents bedrooms are maintained to a satisfactory level of cleanliness. Timescale for action 31 October 2005 2. OP 16 22 31 October 2005 30 September 2005 30 September 2005 3. OP 29 19 4. OP 26 23(2)(d) 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 strongly recommended that call bell response times are monitored. Gosberton House Nursing Home C53-C04 S2637 GosbertonHouse V235812 040705 Stage 4.doc Version 1.20 Page 21 Commission for Social Care Inspection 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. 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