Inspection on 14/11/06 for Green Gables

This inspection was carried out on 14th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Green Gables 13/01/06

Green Gables 06/07/05

Green Gables 10/03/05

Green Gables 14/09/04

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

CARE HOMES FOR OLDER PEOPLE Green Gables Green Gables 6 Northdown Avenue Cliftonville Margate Kent CT9 2NL Lead Inspector Christine Grafton – Link Inspector Sandra Crosby Unannounced Inspection 14th November 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 Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Green Gables Address Green Gables 6 Northdown Avenue Cliftonville Margate Kent CT9 2NL 01843 227770 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) Miss Annette Smith Carol Lewis Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home may, from time to time, admit persons between the ages of 60 and 65 years of age. 13th January 2006 Date of last inspection Brief Description of the Service: Green Gables is a detached three-storey property, providing 14 single bedrooms and 2 doubles. Five of the single bedrooms have en-suite facilities. There are stair lifts to the first and second floors. All bedrooms have a call bell point and television point. There are three lounge areas and a dining area, all of which are interlinked, plus a conservatory, where smoking is allowed. Green Gables is situated in a residential part of Cliftonville, close to shops and other local amenities. There is unrestricted parking on street, with one offstreet parking place. There is a well laid out back garden accessible to residents. The registered providers, Annette Smith and Carol Lewis, have run the home since August 2003 and both work full time. A team of carers who cover care, domestic and cooking duties, including two senior carers who cover when the registered providers are off duty. The staff team work a rota that includes one carer on waking duty at night and one carer sleeping in. According to its statement of purpose, Green Gables aims to provide a home from home environment to meet the needs of elderly service users within its care. Information recently received from the Registered Provider states that the fees range from £294.00 to £340.00 per week. Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection visit was unannounced and carried out on Tuesday 14 November 2006 between 09.30 and 14.30. The atmosphere of the home was welcoming, calm and relaxed, and the home was clean and orderly at the time of the inspection visit. The Pre-inspection Questionnaire completed by the home together with observational information and discussion with the Registered Providers, Service Users and staff at the time of the inspection, has been used when compiling this report. It was found that the management and staff at the home work hard to maintain the necessary systems in order to comply with the requirements of the regulations. The information in this inspection report indicates that the home provides a ‘homely environment’ and a good standard of care to Service Users. What the service does well: There is an enthusiastic workforce that is well motivated and works positively with Service Users to ensure that all their health and welfare needs are met. Staff training is ongoing at the home. Service Users benefit from a range of activities organised by an activities coordinator, who spends two hours a day at the home during the week. Green Gables provides a homely environment for residents and has a warm and friendly atmosphere. The home is pleasantly decorated and comfortably furnished with good quality items. The home has a thorough admission process that makes sure that the care needs of people can be met at the time of their admission. The majority of written records seen that are required to be maintained by regulation were comprehensive and up to date. Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose and Service User Guide provide Service Users and prospective Service Users with the information they need to make a decision about moving into the home. The assessment process is very thorough and makes sure that the needs of the person can be met at the home. The management can demonstrate through the home’s records, practices and staff competency that it can meet Service Users’ needs. It is not the general policy of the home to admit people for intermediate care, so standard 6 was judged as not applicable. Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 9 EVIDENCE: The Statement of Purpose and Service User Guide for the home were seen. Both documents were well presented and contained comprehensive and clear information about the service provided by the home as required by Regulation. It was evidenced that the home has a thorough admission process that makes sure that the care needs of people can be met at the time of their admission. This involves the Registered Providers visiting prospective Service Users prior to admission, to meet them, assess their needs, give them information about Green Gables and let them know what to expect upon moving in. New Service Users can therefore be assured that the home is right for them at the start of their stay. One of the Service Users that the Inspector chatted with confirmed how happy and settled they were since they moved into this home. One of the Service Users that has recently been admitted to the home was case tracked. There was much evidence to show that the Registered Providers had ensured that a comprehensive needs assessment had been completed. Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. 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. The care planning system is clear and consistent, providing staff with the information they need to meet Service Users needs and Service Users health care needs are well met. The systems for medication administration are mainly good with clear and comprehensive arrangements being in place to ensure Service Users medication needs are met. Personal care is offered in a way to protect Service Users’ privacy and dignity. Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 11 EVIDENCE: Two Service User plans were seen, and these contained all components as required by Regulation. The Service User Plans were comprehensive and maintained up to date with a Senior Carer designated to carry out and record the monthly reviews. All the information contained in the Service User plans indicates that Service User health care needs are closely monitored and action is taken to access health care services when necessary. It was seen that staff spend time with Service Users, talking to them and offering discreet assistance that respects dignity. The medication records were seen, and on the whole were well recorded and up to date. The Registered Providers were asked to ensure that staff administering medication indicate a reason if the medication is not administered on the MARS sheet. This they agreed to do. The medication storage was also seen, and it was indicated that only sufficient supplies of medication was stored to meet the needs of the current group of Service Users. The Registered Providers said that a more suitable facility for the storage of medication was part of the improvements detailed on the business plan for the home. Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. 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. Service Users spoken with confirmed they were happy with the lifestyle they had living at the home. Service Users are encouraged to maintain contact with family and friends. The meals in the home are good offering both choice and variety and catering for special diets. EVIDENCE: Two Service Users were spoken with individually in private, and several Service Users were chatted to during the course of the inspection visit. All had positive things to say about the home, for example the staff were kind and caring, the meals were good and alternatives are always available. It has been previously stated that Service Users call the Registered Providers and staff by their first names and said that this is a very friendly place. Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 13 An activities co-ordinator is employed to spend two hours a day at the home on weekdays, and the record of these activities was viewed. It has been previously stated that Service Users are asked each day what they would like to do and activities are tailored to suit their mood at the time. A record is kept of the activities and who participates. Entries were also seen in residents’ daily records. The meals seen served were well presented and it was seen that there are alternatives choices at each mealtime. The menus show that a varied and nutritious diet is offered at the home. The formatted form for the recording of the daily records of the food provided had not always been completed. The Registered Providers agreed to address this issue. Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. 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. The home has a satisfactory complaints system that indicates that Service Users feel that their views are listened to and acted on. Policies and procedures are in place to safeguard Service Users from abuse. EVIDENCE: The pre-inspection questionnaire completed by the Registered Providers stated that there had been no formal complaints made to the home, and the Registered Providers said that no complaints had been made. The complaints book was seen. It was seen at the last inspection visit that the policies and procedures file contains detailed guidance on abuse and what to do if abuse is suspected. The abuse policy is regularly discussed with staff in their supervision meetings, and the procedures are covered in the staff induction programme. Staff also confirmed that they had received training in this area, and it was also mentioned that is forms part of the NVQ training that staff have undertaken. The ‘whistle blowing’ policy has been seen at a previous inspection and there is also a policy on restraint and a management of aggression document. Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected 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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a home where the routine maintenance, decoration, and renewal of the fabric of the premises are exemplary. The addition of the new conservatory has enhanced the homeliness and comfort of the communal facilities provided for Service Users, offering extra choice. EVIDENCE: The Registered Providers have continued with their programme of improvements to the home. Since the last inspection, a new call bell system has been installed, and automatic door closures have been fitted as appropriate. The Registered Providers stated that plans are in hand to provide Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 16 new dining room furniture, and to re-carpet the lounge, together with improving the laundry facilities at the home. Re-decoration is ongoing, and it was seen that the bedrooms are furnished to a good standard, and that Service Users have individualised their room with their own personal possessions. The home was pleasant, clean and hygienic at the time of the inspection visit. Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. 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. Service Users needs are met at all times by the numbers and skill range of the staff. Service Users are protected by the home’s thorough recruitment procedures, and staff training is ongoing. EVIDENCE: It was indicated from the staff rota’s supplied with the pre-inspection questionnaire, and from observation at the time of the visit that the home has sufficient numbers of staff to meet the needs of the current group of Service Users. Two staff files were checked, and showed that a thorough recruitment procedure is in operation at the home. The staff files also contained completed induction information. The NVQ Assessor was visiting the home at the time of the inspection visit, and a number of staff was attending the NVQ session. Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 18 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): 31,33,35,36,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service Users are safeguarded by the accounting and financial procedures of the home. The quality of care of service users receive is enhanced because members of staff are appropriately supervised. Service users and staff can be confident that their health, safety and welfare are promoted and protected. EVIDENCE: Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 19 The Registered Providers are experienced in running a home, and have achieved an open, positive and inclusive atmosphere. The records of Service Users personal allowance monies were seen and a sound system of recording is in place. Regular supervision is undertaken with written records kept. The fire-log book was seen and indicated that all regular monitoring checks are undertaken, together with regular fire drills taking place. The accident book records were also viewed. The pre-inspection questionnaire states that training undertaken in the last twelve months includes training in relation to Medication, First Aid, Dementia, Fire, Basic Food and Hygiene, Moving and Handling, Health and Safety, Adult Protection, Nutrition in the Elderly and Care Planning Risk Assessment and Induction. The home has a quality assurance system in place, and it was seen that information in relation to the last audit had been included in the Statement of Purpose. Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 20 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 4 X 3 X X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 4 4 4 4 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 4 X 4 X 3 3 X 4 Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 21 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 home’s Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP15 Regulation 17(2)13 Timescale for action The registered person ensures 30/11/06 that service users receive a varied, appealing, wholesome and nutritious diet, which is suited to individual, assessed and recorded requirements, and that meals are taken in a congenial setting and at flexible times Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations Staff administering medication to ensure that a reason if indicated is a medication is not administered on the MARS sheet Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Green Gables DS0000047327.V306117.R01.S.doc Version 5.2 Page 23 - 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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