Inspection on 13/02/06 for Great Western Court

This inspection was carried out on 13th February 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

Great Western Court 31/01/07

Great Western Court 21/04/05

Great Western Court 24/11/04

Great Western Court 28/04/04

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

CARE HOMES FOR OLDER PEOPLE Great Western Court 33a Millbrook Street Gloucester GL1 4BG Lead Inspector Pat Edwards-Jackson Unannounced Inspection 13th 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 Great Western Court DS0000031570.V282554.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. Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Great Western Court Address 33a Millbrook Street Gloucester GL1 4BG 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) 01452 423495 01452330810 Gloucestershire County Council Mrs Angela Rosalyn Neilens Care Home 30 Category(ies) of Dementia (6), Old age, not falling within any registration, with number other category (23) of places Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One respite bed to accommodate service users between the ages of 60 - 65 years. One bed to accommodate service users from the age of 55 years Date of last inspection 21st April 2005 Brief Description of the Service: Great Western Court is a purpose built home for care of older people. The Home comprises of five individual living units linked with a larger central unit, which houses the reception, offices, kitchen, laundry and day centre. The individual units accommodate eight residents in each. Each unit has a lounge, dining room, kitchen and bathroom. All rooms are single occupancy, and there are six bedrooms in each unit. With four en suite shower rooms in each unit. Assisted bathrooms and toilets are spacious and well equipped. The Home has an intermediate care co-ordinator from the Primary Care Trust, and has a multi-disciplinary team, which now includes care staff, a physiotherapist, occupational therapist, a dietician, a pharmacist, a stroke nurse specialist and general practitioner for residents receiving intermediate care. Nursing services are accessed from community resources if needed. The day centre provides a service for people in the community as well as for residents in the Home, and also holds the Asian Elders Club on a weekly basis. The available day care space has recently been expanded via the provision of a large conservatory area. Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day and was conducted by one inspector. The majority of standards were inspected on this occasion. For standards not assessed the reader is advised to read this report in conjunction with the previous inspection report 21/4/05. A tour of the premises took place. A sample of bedrooms and all communal areas were seen during the course of the day. Records relating to care, medication, staff recruitment, and training were examined. At the time of this unannounced inspection the Team Leader, Chris Rogers was in charge of the home; she was supported by a team of staff. She was supported by, a small staff team. It was the inspector’s first visit to the home. The inspector met the majority of residents before the end of the inspection. Feedback was provided to the team leader at the end of the inspection. What the service does well: What has improved since the last inspection? Building work has been completed and each of the units in the home now provide six individual bedrooms, all having private facilities for washing and toileting. Each of the units has been renamed, Apperley, Epney, Cranham, Deerhurst and Blaisney. Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 Page 6 A large conservatory has also been built; this has been decorated and carpeted but is yet to be brought fully into use. The homes’ handyman is currently decorating throughout the communal areas of the home. 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. Great Western Court DS0000031570.V282554.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 Great Western Court DS0000031570.V282554.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; 2; 3; 4; 5; 6 The home caters for a wide range of older people who are admitted for a varying length of stay according to their needs. Assessments of need take place according to the specific requirements of the individual placement. The Statement of Purpose and Service Users Guide aid prospective service users and their families in making a choice regarding placement. EVIDENCE: The Statement of Purpose and Service User guide (as described at the previous inspection 21/4/05). Discussions took place with the senior member of staff on duty; resident service users; a sample of care and support plans were also seen. A system is in place to ensure potential service users needs are assessed prior to admission. For those whose stay is short term, with a view to rehabilitation assessment is ongoing and involves the multi-disciplinary team (based on the same site). A Statement of terms and conditions was available in each of the care and support plans seen, these were either signed by the service user (if they were able) or their representative. Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 Page 9 Several short-term service users were able to comment on their admission to the home from hospital and their plans to return back to their own homes in due course. One person had only just been transferred from the hospital and thought he’d ‘had a stroke’. He was however quite clear about the reason for his admission to the home and that it was a short term arrangement until he was fit enough to return home. Several groups of relatives visited during the course of the inspection. Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7; 8; 9; 10; 11 Health and social care needs are clearly set out in the care and support plans. Systems are in place to ensure needs are appropriately met. The homes medication policy and procedures would benefit from further development regarding a more comprehensive homely remedies policy. Service users are treated with respect and their right to privacy is protected – this extends to those whose condition is deteriorating. EVIDENCE: Discussions took place with the team leader; a sample of resident service users; visiting relatives. Observations of service user/staff interactions took place. A sample of care and support plans; the medication records; policies and procedures were seen. The homely remedies policy currently provides for the administration of paracetamol. It would benefit from review involving the advising pharmacist. Also see Std. 37 here relating to records kept in the home). Individual service users spoken with 1:1 were able to confirm that they felt well cared for and their health care needs were being met. At least one person was visited by a nurse (changing dressings) during the inspection. This service user was able to describe how her ulcer treatment was now working. Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 Page 11 Another person had been due for discharge home but had developed a minor setback in her condition. Plans for her discharge were being temporarily delayed for a few days to ensure she was well enough to return home. The team leader was sensitive to the anxieties older people sometimes experience when faced with the prospect of returning home. Gentle encouragement and support was being offered to this person by both the staff and her family. Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12; 13; 14; 15 The home caters for a wide range of people and aims to meet the needs of individuals. Contact with friends and family, and links with the local community are supported by the home. Encouraging and supporting individuals to maintain or rebuild their independence is an important feature of the service provided. EVIDENCE: Discussions took place with the team leader, staff, a sample of resident service users and their visiting relatives. Observations of service user/staff interactions took place. A sample of care and support plans were seen. Unobtrusive observations took place during the lunch period. Several resident service users received visits from friends and families during the inspection. One service user said she was waiting to go out independently, at the beginning of the inspection. This person went off to her day club – something she looked forward to. There was a relaxed atmosphere throughout the course of the inspection visit. Service users were observed socialising in small groups throughout the home and appeared to be able to choose whether or not they joined in with group activities. Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 Page 13 Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16; 18 Unchanged since the previous inspection (April 2005)– Systems are in place to manage complaints and protect those living at the home from abuse. EVIDENCE: Discussions took place with the team leader, staff, a sample of resident service users and their visiting relatives. Observations of service user/staff interactions took place. A sample of care and support plans were seen. (Also see Stds 27-30 in this report). Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19; 20; 21; 22; 23; 24; 25; 26 The home was clean and generally well maintained. Improvements have been made since the previous inspection. The home was clean and there were no persistent unpleasant odours. Individual bedrooms are furnished according to the needs of their occupants. A range of equipment was available to assist mobility and promote independence. EVIDENCE: Discussions took place with the team leader, staff, a sample of resident service users and their visiting relatives. A tour of the premises including all communal areas and the majority of bedrooms were seen. The programme of building work to upgrade the accommodation started at the time of the previous inspection has now been completed. Bedrooms have been redecorated and re-furbished. Individual bedrooms seen varied, in terms of their décor and personal items on display. This reflected the differing needs of the people living in the home. Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 Page 16 For example, as would be expected, the highest degree of personalisation was found in the rooms of those residents who were in the home on a longer-term basis. Some rooms have telephones and this facility is available on an individual basis according to service users needs, preferences and ability to pay for the service. Telephones are also available for service user use throughout the communal parts of the home. Communal areas throughout the home were generally well maintained and pleasantly decorated and comfortably furnished. In contrast only one small area of carpeting (the entrance corridor to Deerhurst) appeared worn and faded. A small area of tiling in one of the bathrooms also needed replacing (a section of tiles were missing). Both of these issues were brought to the attention of the team leader at the end of the inspection. A good range of equipment to aid mobility and independence was seen throughout the home. The recently completed conservatory is currently being used for mobility training e.g. with a practice stairway Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27; 28; 29; 30 The home had sufficient staff on duty to meet the needs of the service user group. The staff receive training, which is an ongoing activity. EVIDENCE: Discussions took place with individual resident service users; staff were observed during the course of the inspection; a sample of care records; and a sample of staff records were seen. The staff on duty at the time of this inspection consisted of, a team leader; 2 rehab officers; 3 re-hab assistants; 1 cook; 1 kitchen assistant; 1 handyman; 1 clerical assistant; 4 domestics plus an agency member of staff (domestic) who arrived at the beginning of the inspection. Three of the Rehab. staff were off sick. The team leader commented that staff sickness is usually covered inhouse, by the existing staff team and that agency care staff are rarely used. Staff training records were seen. Since the previous inspection training has taken place in the following areas, First Aid; Stroke awareness; Health & Safety; Protection of Individuals from abuse; pre-retirement training (for staff retirees); basic food hygiene; Risk Assessment; supervision. It was difficult to tell from the records when some of the other training relating to Abuse; Stoke and First Aid had taken place, because it had not been dated. This was discussed with the team leader. Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 Page 18 She was able to confirm that responsibility for collating and updating records was currently being taken over by a member of staff. This task had previously been the responsibility of a recently retired senior member of the team. Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32; 33; 36; 37; 38 Records relating to medication; training; policies and procedures; discussions with the team leader; and observations of staff/resident service user interactions took place. Records are kept and generally well maintained – attention is needed to ensure they are consistently kept up to date. The home is run in the best interests of those living here. Policies and procedures are in place to protect service users. Systems are in place to protect the health and safety of those living and working in the home. EVIDENCE: Records relating to service user care and support; medication; staff recruitment; the global policies and procedures file were viewed. Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 Page 20 Discussions took place with the team leader. A tour of the premises took place and 1:1 discussions took place with service users. The manager was off duty at the time of the inspection. A number of gaps were found in the medication records – this was brought to the attention of the team leader who confirmed it would be addressed. The team leader was observed coordinating care during the inspection providing guidance and support to other members of the staff team. It was clear from observations and discussions with resident service users that the home was run in their best interests. Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 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 3 3 3 3 4 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 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 3 x x 3 2 3 Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 Page 22 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 OP19 Regulation 23(2)b Requirement Timescale for action 30/06/06 2 OP37 17(1)a The manager must ensure that worn carpeting is replaced and tiling within one bathroom area is repaired The manager must ensure that 30/06/06 medication records and staff training records are accurate and up to date. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Great Western Court DS0000031570.V282554.R01.S.doc Version 5.1 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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