Inspection on 01/03/06 for Grey Gables

This inspection was carried out on 1st March 2006.

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

Grey Gables 07/09/07

Grey Gables 11/07/06

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

CARE HOMES FOR OLDER PEOPLE Grey Gables 1 Lodges Grove Bare Morecambe Lancashire LA4 6HE Lead Inspector Mrs Joy Howson-Booth Unannounced Inspection 1st March 2006 11:00 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 Grey Gables DS0000066324.V287122.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. Grey Gables DS0000066324.V287122.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Grey Gables Address 1 Lodges Grove Bare Morecambe Lancashire LA4 6HE 01524 425376 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) Ewood Residential Homes Limited Mrs Elaine Ann Wood Care Home 15 Category(ies) of Dementia (15) registration, with number of places Grey Gables DS0000066324.V287122.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 15 service users in the category of DE (Dementia) The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection Brief Description of the Service: Grey Gables is registered to accommodate up to 15 people who have dementia. The home is situated in a quiet residential area of Bare in Morecambe and is close to local shops and amenities. The home is a large detached dwelling, situated on a corner site, with a small car parking area in the ground to the front. In addition, there is a small, secure garden area to the rear and side of the building. The home is comfortably decorated and has adequate communal space. There is also a small extension on the ground floor with bedrooms. There are bathroom and toilets on this floor. The first floor houses bedrooms and a bathroom. The home has 11 single bedrooms and 2 double bedrooms, none of these have ensuite facilities. The home has recently changed hands – the new owner/manager being experienced and qualified in the care of people with dementia. Grey Gables DS0000066324.V287122.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced so the new registered owner/manager was aware of the visit. The inspection enabled the outstanding National Minimum Standards to be assessed. The home had very recently been purchased by the registered owner/manager and the purpose of this visit was to provide advice and guidance, although it was clear that the change of owners had unsettled the residents and a lot of time was being spent providing support and reassurance. At the time of the inspection, the new registered owner/manager was spoken with, along with the two staff on duty. A small number of residents were also spoken with and a lively but relaxed atmosphere was very apparent. Those residents who were not able to express their needs appeared comfortable and at ease but, as mentioned earlier, a couple of residents needed some additional one to one support which was provided by the registered owner/manager and staff. These interactions were kind and caring and dealt sensitively with people who were clearly unsettled. Some documentation was examined, although the visit primarily provided an opportunity to discuss the ideas and improvements the new registered owner/manager is intending to put in place. What the service does well: What has improved since the last inspection? This service has, for quite a while, been “ticking over”, with little change or training for staff to develop it further. The very recent change of ownership has brought, not only someone who is experienced and qualified in the care of people with dementia, but someone who has up to date knowledge of current good practices and clearly has high expectations of how they want the service to develop. It will be interesting to see these ideas put in practice over the coming months. Following the purchase, a small number of staff left, although the staff that remain are committed and caring and, from observations during this inspection, deal with the residents in a sensitive, caring and respectful manner. Grey Gables DS0000066324.V287122.R01.S.doc Version 5.1 Page 6 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. Grey Gables DS0000066324.V287122.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 Grey Gables DS0000066324.V287122.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): Standards 3 and 6 were assessed at the last inspection The current assessment system is to be reviewed to ensure full information is gained to enable an informed decision to be made over whether the home can meet the identified needs EVIDENCE: The new owner/manager is aware to undertake a full assessment prior to any decision being made regarding admission and is to review the current assessment procedure to ensure the requirements of the regulations and standards in relation to assessment are met. Other documentation and information relating to the home is to be reviewed to ensure it reflects the new owners’ values and attitudes for the service to be provided. Grey Gables DS0000066324.V287122.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): Standards 7, 8, 9 and 10 were assessed at the previous inspection The current care planning system is to be reviewed to ensure full information over residents’ needs and how these are to met by the home is recorded and available for staff to use EVIDENCE: The new owner/manager intends to review all the current care paperwork to ensure the requirements of the regulations and the standards are being met. Grey Gables DS0000066324.V287122.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, 13 and 14 Standard 15 was assessed at the last inspection Activities and lifestyles at the home should continue to be developed so that the residents’ social, cultural, religious and recreational interests are met. EVIDENCE: The new owner/manager is to review the current meals provision, over time, to ensure all dietary needs and preferences are met. The new owner/manager is intending to develop the activities within the home and is to approach relatives for information over likes, dislikes, interests, hobbies and social histories for the residents accommodated. This will provide a basis for activities and lifestyles to be developed and continued. From discussions with the new owner/manager the experience and knowledge she already holds is going to bring a ‘breath of fresh air’ to the service and it is anticipated the lifestyles of those people accommodated will vastly improve. Already there are a number of ideas being considered and further advice is also to be sought from other professionals who have expertise in the care of people with dementia. Grey Gables DS0000066324.V287122.R01.S.doc Version 5.1 Page 11 During the inspection visit, one resident was spoken with who went out on a shopping trip with a member of staff. This was clearly a very positive experience and one which was very much enjoyed. A small number of residents were spoken with and they appeared contented with the care provided. The interactions between the new owner/manager and staff were positive and provided a lively and friendly environment. It has previously been confirmed that there are no restrictions on people visiting the home and, through discussion, it clear the new owner/manager will continue to encourage the residents to have contact with their family and friends. During this inspection, it was clear that some residents have been made uneasy by the sale of the home and the change of owners but, from observations made, the new owner/manager and the member of staff on duty were both skilful, sensitive and caring when providing reassurance and support. Grey Gables DS0000066324.V287122.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): Standards 16 and 18 were assessed at the previous inspection EVIDENCE: Grey Gables DS0000066324.V287122.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 and 26 Grey Gables is a safe place for people to live in although some improvements are still required. Residents are safe and their accommodation is comfortable. EVIDENCE: A tour of the home found it to be clean and tidy. The new owner/manager felt that some rooms had “a slight odour” and is putting in place cleaning to address this. The new owner/manager has also purchased a stair lift which will be a useful facility for the residents to use. The temperature of the water was also discussed by the new owner/manager who has noted a low water temperature. At the time of the inspection this was being looked into and an action plan and timescale to address this is to be sent to the Commission. Grey Gables DS0000066324.V287122.R01.S.doc Version 5.1 Page 14 It was recommended that a maintenance record book be started so that staff can record if attention is needed to something in the building and this book can then be signed off once the work has been completed. The new owner/manager clearly has ideas to improve the fabric and fixtures of the home and it will be interesting to see these actioned over the coming months. Grey Gables DS0000066324.V287122.R01.S.doc Version 5.1 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 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): Standards 27, 28 29 and 30 were assessed at the previous inspection Staff recruitment procedures are being reviewed to ensure thorough checks are made on prospective staff and the vulnerable people at the home are protected Staff training to be developed to ensure residents are cared for by a competent and trained staff team EVIDENCE: Staff recruitment and training was discussed with the new owner/manager who is aware of the recruitment requirements of the regulations. The new owner/manager confirmed that no staff will commence work until all the required checks have been carried out. Advice was given that the home’s application form should be updated. The new owner/manager confirmed that although a number of staff left the home at the point of its sale, she is currently recruiting experienced staff, a number of which have already obtained National Vocational Qualification Level II training. Staff training was also discussed and the new owner/manager confirmed that the training needs for the members of staff at Grey Gables are to be identified Grey Gables DS0000066324.V287122.R01.S.doc Version 5.1 Page 16 and organised in the future, although recognition is made that training is dependent on the availability of courses. Some specialist training in the care of people with dementia is also to be organised as the new owner/manager is very keen to ensure the care provided by staff at the home reflects current good practices in the care of people with dementia. The new owner/manager is also aware of the need to ensure training records are maintained for staff and current ones are to be updated. Grey Gables DS0000066324.V287122.R01.S.doc Version 5.1 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 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, 35 and 38 Standard 31, 33 and 36 were assessed at the previous inspection The new owner is experienced and qualified and is bringing organisation and expertise to the service. This is of benefit to the vulnerable people who live at Grey Gables. Financial records need to be developed to ensure residents’ monies are safeguarded and accounted for. Facilities are available to safeguard resident’s property. Health and safety arrangements within the home are generally satisfactory although some changes and improvements are required EVIDENCE: Grey Gables DS0000066324.V287122.R01.S.doc Version 5.1 Page 18 A new owner/manager is now in place who, from discussion during both the registration interview and during this inspection, has clear ideas and enthusiasm over developing the service into one which provides a high quality of care and is in demand from commissioners. Although not assessed during this inspection, the new owner/manager recognises that a quality assurance system is essential and is to develop this over the forthcoming months. No financial records were available during this inspection as these are still with the previous owners. The new owner/manager is to begin financial records for both charges and payments and for personal allowance monies held immediately and is aware to keep both personal monies held and financial records separate for each resident. The home has a safe where valuables can be stored. The new owner/manager is aware of the need to ensure staff undertake mandatory training in moving and handling; first aid; food hygiene; infection control and fire safety and this training will be organised as a matter of priority. The pre-inspection questionnaire submitted by the previous owners of Grey Gables indicates that generally maintenance checks on facilities are carried out. However, confirmation is required that the home has an electrical certificate, PATT (portable appliances) certificate and gas maintenance certificate. Confirmation is also requested for the last test date for the nurse call system and fire drill check. The new owner/manager was also advised to review the home’s policies and procedures to ensure these reflect how she wishes the staff to deal with any given event. Staff could be refreshed over policies and procedures in the home during supervision or at staff meetings. The home has an accident book in place but this was not examined during this inspection. Advice was also provided to the new owner/manager over the Regulation 37 notifications which the Care Homes Regulations require to be sent to the Commission following an incident, accident, death or other occurrence in the home which affects the safety or wellbeing of the residents. Grey Gables DS0000066324.V287122.R01.S.doc Version 5.1 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. 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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 3 X X X X X X 2 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 X X X 1 X X 2 Grey Gables DS0000066324.V287122.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? N/a 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 OP25 Regulation 23 Requirement An action plan must be submitted to the Commission which addresses the low water temperature in the home Financial records for charges and payments and for personal monies held on behalf of residents must be implemented from the date of the new owner/manager’s registration Confirmation to be sent to the Commission for the electrical certificate for both the home and any portable appliances held Timescale for action 14/04/06 2 OP35 12 14/04/06 3 OP38 38 14/04/06 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 OP1 Good Practice Recommendations The registered owner/manager was advised to review the home’s Statement of Purpose, Service User Guide, complaints procedure and any other documentation to ensure it relates to them DS0000066324.V287122.R01.S.doc Version 5.1 Page 21 Grey Gables 2 3 2 3 4 OP7 OP29 OP30 OP38 OP38 The registered owner/manager is to review the assessment procedure and current care plans to ensure they provide the required information The registered owner/manager is to review the home’s recruitment procedure, in particular the home’s application form The registered owner/manager was advised to assess the training needs for staff and plan as identified, updating training records as needed The registered owner/manager was advised to review the home’s policies and procedures to ensure these reflect how she wishes staff at the home to be guided A maintenance record book may be helpful to record maintenance tasks which can then be signed off when completed Grey Gables DS0000066324.V287122.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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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