Inspection on 13/10/06 for Gurney House

This inspection was carried out on 13th October 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

Gurney House 09/07/07

Gurney House 16/10/05

Gurney House 09/05/05

Gurney House 07/02/05

Gurney House 09/09/04

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

CARE HOMES FOR OLDER PEOPLE Gurney House Upton Road Slough Berkshire SL1 2AE Lead Inspector Ruth Lough Unannounced Inspection 13th October 2006 10:30 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 Gurney House DS0000011284.V310408.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. Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gurney House Address Upton Road Slough Berkshire SL1 2AE 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) 01753 521060 01753 511868 gallos@bupa.com www.bupa.co.uk BUPA Care Homes (Partnerships) Limited Mrs Sheila Gallo Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th October 2005 Brief Description of the Service: Gurney House is a purpose built residential home for 35 older people situated in a quiet cul-de-sac, close to Slough town centre. The building is owned by Slough Borough Council and is managed by BUPA. Service users can only be admitted to the home through a local authority referral. Fees range from £400.00 to £499.00 Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection visit that took place over one day. The inspection included a review of information provided by the home and service user surveys returned prior to the visit. Twenty- three service user questionnaires were returned to the commission. The documents and records that were available on the day were used as part of the information gathering. Service users and visitors opinions of the service were also obtained during the day visit. Discussion with and observation of the management and care staff was also included. What the service does well: What has improved since the last inspection? What they could do better: The staff should ensure that they record all the required information when receiving medication into the home. The manager should implement an effective process to monitor and analyze any concerns and complaints made about the service. There should be greater care and attention to ensure that the armchairs and other seating in the communal areas are kept clean, hygienic and pleasant for service users to use. Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 6 The monitoring of the recruitment processes should be improved to make sure that all the necessary information and checks are carried out. The process for service users to access their monies that the home keeps on their behalf, should be accessible when they wish and not restricted to office hours. 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. Gurney House DS0000011284.V310408.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 Gurney House DS0000011284.V310408.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): 3 (6 is not applicable) 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 assessed appropriately before admission to the home. EVIDENCE: The home only takes service users who have been referred from Slough Social Services. Over 50 service users confirmed that they had received a contract and that they had sufficient information about the home before they came to live at the home. The care files of 2 service users most recently admitted to the home were reviewed. An in depth assessment is carried out by the care management process by the placing local authority. This is then passed to the home prior to admission. Included in this assessment is the service users health and social care needs, personal information and their mobility. The home then adds to this with the risk assessments for moving and handling, nutrition and falls. The Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 9 service users choices and consent, where able for them to provide, are also recorded. Gurney House DS0000011284.V310408.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 and 10 Quality in this outcome area is good. These judgements have been made using available evidence including a visit to this service. The service users’ health and personal care needs are met. The service users are not put at risk by the minor deficit in the recording of medication administration. Service users are provided with privacy and treated with respect. EVIDENCE: Over 90 service users who responded to the CSCI survey, agreed that they received the care and medical support they that they needed. Only one service user felt that they didn’t get the medical help that they should. Service users spoken to on the day stated that they felt well cared for and enjoyed living in the home. The care plans of 2 service users were assessed during the inspection visit. Each plan had comprehensive document tools that have been completed with detailed information to assist staff provide the care to service users with reference to the individuals choices of how they wish to live. The staff monitor Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 11 regularly the service users’ weight, skin condition and continence needs to ensure that they maintain the service users good health. The care plans are reviewed regularly with the involvement of the service users and relatives. Where a service user’s particular health needs are identified, the staff assist service users to obtain the necessary support such as hospital, podiatry, dental, hearing and sight consultations. District nurses visit the home where clinical needs are identified such as catheter care, dressings and treatments. A chiropodist visits the home on a regular basis for simple treatments for which the service users pay for themselves. All visits and appointments are recorded in the care plans. The staff record the daily outcomes, for the service users, well and use appropriate language. The medication, for the service users, are supplied to the home by a local pharmacy. One senior member of staff is responsible for auditing all the medication administration and storage. To assist with ensuring the staff have sufficient information, they record the relevant information about the individual such as swallowing difficulties and how the service user is able to take the medicine with the prescription. The staff follow medication procedures and record the administration of these well, with the exception of that they are not recording clearly the numbers of tablets received to the home for the controlled drugs. Senior staff are responsible for all medication administration and are provided with medication training when they commence working at the home and attend updates periodically. All service users have single room accommodation that offers them privacy for personal care and any treatment or consultations to take place. Service users also have the use of treatment room that is used for hairdressing, the District Nurse visits and chiropodist, if required. Service users can receive visitors in their own rooms or in the 3 communal lounges, dining room or conservatory. Staff appeared to interact with service users well on the inspection visit. Previously there has been some complaints received by the home about some staff’s attitude and rudeness to service users. However, this was not seen during the inspection visit and service users did not express any further concerns to the inspector. Gurney House DS0000011284.V310408.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 and 15 Quality in this outcome area is good. These judgements have been made using available evidence including a visit to this service. The home supports service users to be able to continue with their lives as they wish and according to their capabilities. Service users are supported to make choices and have control over their lives. Service users enjoy a varied and nutritional diet. EVIDENCE: Service users spoken to said they enjoyed the activities that are provided and especially the trips out and the musical events. One service user stated in a returned survey, that they wanted to be able to go on more walks outside the home. A relative did confirm that the staff made them feel welcome to visit their relative at the home, whenever they wished. Service users’ choices for activities and interests are recorded in their care plan. There is a personal profile of each service user that is created when they move into the home that assists staff to achieve this. There are usually a planned variety of activities going on the home that includes games, quizzes and crafts that is provided by the activities organiser and staff. Service users are supported to take part in day trips out, shopping and to attend local day Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 13 centres and clubs. Some service users had the opportunity to have a holiday to Devon this year. Entertainment is brought into the home includes regular musical performers. Staff put up the planned programme of entertainment and activities for service users to see on display around the home. Service users are enabled to bring some of their possessions into the home and have personalised and decorated their bedrooms as they wish. Service users who completed the survey confirmed that staff listened to and acted upon what they wished. However, some comments were added; “occasionally”, “depends on what I am saying” and “sometimes the staff appear deaf”. These comments were not reflected in discussion with the service users on the day of the visit. There is a newly created six week rotational menu plan that provides a mixture of traditional, vegetarian and seasonal meals. Choices are always planned and service users are able to have alternatives should they wish at the time of the meals. A variety of drinks and refreshments are provided throughout the day. Snacks such as sandwiches, bread biscuits and fruit are available at all times. Staff are reminded of special diets and allergies of the service users in the kitchen and staff areas. Service users commented that they enjoyed the meals provided and they “liked what was on the menu”. One service user stated “To many stews in one week and dumplings very hard. Could we please have sausage and fried onions sometimes and ham that is not too salty”. Staff were seen to assist service users sensitively with their meals. Service users are encouraged to have their meals in the dining room at tables in small groups. Service users are able to have their meals in their rooms if they wish or a too unwell or frail. Gurney House DS0000011284.V310408.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and concerns are listened to and acted upon effectively. Service users are protected by the staffs knowledge about abuse and the homes policies and procedures to keep them safe. EVIDENCE: The home’s complaints policy is provided to service users in the service users guide and is on display in the main areas in the home. The service users survey showed that the majority were confident of whom to speak to if they had concerns, and that these would be listened to and acted upon. The commission has not received any concerns, complaints or allegations about the home since the last inspection process. The home has received and investigated 6 complaints over the last 12 months. The records reviewed during the visit supported that these were investigated within the 28 days and action taken to rectify identified deficits that have occurred. Of the 6 complaints, 3 were regarding one member of staff’s attitude and their performance, the others (different staff members) were of a similar nature and included turning down a radio in the bedroom without asking whilst the client was in the room. Currently the home does not use a documented system for monitoring or analyzing concerns or complaints. Information about abuse and the protection of vulnerable adults is kept in the home for staff to use. Training is included in the induction process and they use videos for staff to update their knowledge. Formal training is provided in Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 15 the planned training programme. Staff spoken to, were able to confirm that they had an understanding of how to ensure that service users are protected from harm. Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and the majority of the home is kept clean, fresh and pleasant to live in. The home should ensure that the soft furniture/seating for service users are kept clean and hygienic. EVIDENCE: Service users said that they liked the home, enjoyed the options of the different communal spaces and that the home is kept fresh and clean. One service user stated that the “ staff work very hard to keep the place clean”. The building is purpose built and provides spacious accommodation and communal spaces over two floors. Each service user has a room to themselves and bathroom facilities placed in close proximity to the rooms. There are 3 communal areas plus a dining room and small conservatory attached for service users to enjoy. Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 17 There is a planned programme of maintenance and ad hoc should it be necessary such as carpet cleaning and renewal and decorating. The garden areas are kept accessible and have areas for service users to sit. The Laundry area has been reviewed and action taken to provide better space for staff to work in and reduce the risk of cross infection. This is because the sluice area previously located there has been removed and relocated to another part of the home. The home was very clean and tidy. Only one area of concern was the standard of cleanliness of the seating and chairs in the main lounge at the front of the building. The chair backs, seats and armrests appeared very soiled. Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 18 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The records to support that staff have been recruited safely are not always kept. Staff are employed in sufficient numbers and are provided with the necessary training to meet service users needs. EVIDENCE: Service users stated that they felt they received the care and support from staff and that the staff were usually there when they needed them. On arrival to the home at mid morning, all the service users were up and dressed and the majority of their bedrooms and bathrooms had been cleaned and tidied. Most of the service users were in the main sitting room, entrance hall, dining room and conservatory, accompanied by various staff. The rota indicates that a senior is on duty at all times except at night when they are on call in the building when two carers are providing the care overnight. The manager did state that this is increased if the need arises should a service user need extra care. The home have used agency staff for 38 days over the last 12 months this is usually due to sickness, annual leave and staff leaving. However, the manager stated that this has improved over the last few months. The staff recruitment process is carried out in the home using the corporate policy, procedure and document tools. The recruitment and employment of 3 Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 19 staff files were reviewed. Of which 2 staff had been employed since the last inspection, the other staff member in 2004. All applicants are required to complete an application form, copies of relevant training, proof of identity and to provide 2 referees. One employee’s file had a CV, and not a completed application form with all the necessary information and only one reference had been obtained. The application forms that were used did not request the full work history, and it is not recorded that this is explored in the interview process. The company has recognised this deficit and this has been rectified in the new application form that has been introduced. All interviews are carried out, by 2 of the senior staff in the home. The recording of the topics discussed in these interviews in some of the notes reviewed could be in greater detail. It is not noted in these records that the decision making of to employ the applicant and if they need specific training other than the core induction. The checks for a criminal record and inclusion on the and POVA list is carried out on all staff. All staff have an induction process that is recorded well and meets the required standards. Staff are issued with copies of the GSCC code of conduct and all have a probationary period before they are contracted to be employed. There is a training plan in place for all levels of staff and the home has provided a mixture of the core topics for health and safety, and specific training such as medication, dementia and catheter care. Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 20 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 and 38 Quality in this outcome area is good. These judgements have been made using available evidence including a visit to this service. The home is managed well and is run in the best interests of the service users. The safe working practices carried out protects Service users, staff and visitors. EVIDENCE: Service users were complimentary about the manager and staff during the inspection visit. One service user stated in the survey “that they can’t fault the place”. The manager has been working in the home for a considerable time. She has recently completed NVQ 4 and ensured that she maintains her knowledge for the core health and safety topics. Other training pertinent to her role such as Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 21 legislation updates and quality assurance has been obtained during the last 12 months. There are a number of quality assurances processes in place for monitoring the home and seeking service users’ opinion of the services provided. The company has a number of audit tools to review the care provided to service users that staff can use, including a review of the information recorded in service users care plans and the management and administration of medication in the home. The home usually carries out a yearly formal consultation with service users through questionnaires and through periodic service users’ meetings. The home has recently implemented the use of a comments/suggestions feedback slip for visitors and service users available in the entrance hall. There is a good programme of staff supervision and staff meetings are carried out regularly. Service users’ monies that are managed by the home are the responsibility of the administrator and the manager who are available to access the service users monies during office hours. The company has a policy of invoicing service users and families for any expenditure that is carried out on service users’ behalf. The usual extras that service users require are newspapers, hairdresser, chiropody and outings. The home does not currently have a very flexible system for providing service users with small amounts of cash at weekends or evenings should they suddenly wish to go out or purchase something. The current practice is that they request monies in advance. Any monies or valuables received are stored in the meds or office lockable spaces and a receipt is given. Service users are provided with lockable spaces should they wish. The home has a good programme of training for safe working practices that is aided by the ability to provide fire safety and moving and handling training on the premises by the manager. The company provides the home with a comprehensive policy and procedure manual for health and safety and staff are given summaries of these in the staff handbook. There is a routine programme of monitoring and maintenance for water temps, water safety, PAT, LOLAR, equipment, fire safety and hoists. These are carried out on weekly, monthly, 3 monthly and yearly programmes. RIDDOR is completed and a falls record has been carried out over the last 3 months as a high number of falls have occurred during the stay of some service users admitted for respite. Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 22 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 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2 Standard OP26 OP29 Regulation 23 19 Timescale for action That the chairs and other seating 30/11/06 are kept clean and hygienic for all service users to use. That the recruitment procedure 30/11/06 ensures that all evidence to support a robust process has been carried out is kept. 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 2 3 Refer to Standard OP9 OP16 OP35 Good Practice Recommendations That staff record the receipt of medications to the home with greater clarity. That an effective system is used to monitor and analyze the concerns and complaints made to the home. That the home review the current system of ensuring that service users have access to their monies out of office hours. Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Burgner House 4630 Kingsgate Cascade Way, Oxford Business Park South Cowley Oxford OX4 2SU 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 Gurney House DS0000011284.V310408.R01.S.doc Version 5.2 Page 25 - 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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