Inspection on 09/07/07 for Gurney House

This inspection was carried out on 9th July 2007.

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 13/10/06

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 Sally Newman Unannounced Inspection 10:20 9th July 2007 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 DS0000011284.V339294.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. DS0000011284.V339294.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 DS0000011284.V339294.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th October 2006 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 are £439.97 per week. DS0000011284.V339294.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an inspection that was conducted over the course of 3 days and included a visit to the service of just over 5 hours duration. Information provided by the service prior to the visit and data held by the Commission has been used in the evaluation of this service. In addition, time was spent discussing the service with the manager, staff on duty were spoken to and three service users were seen by the inspector in private. Service users were spoken to throughout the home and a visiting relative and health care professional were spoken to in private. Satisfaction surveys were sent to a variety of people by the Commission, and as a result three General Practitioners’ returned surveys, one legal representative and two relatives surveys were completed and returned to the Commission. All were very positive and included several comments of praise about the home and staff. One GP stated “I view Gurney House as one of the best care homes in the area”. Service users spoken to were happy living in the home and could not think of any areas that could be improved. A range of records were sampled whilst at the home, a tour of the premises was conducted and observation of interactions between staff and service users was undertaken throughout the course of the visit. Two requirements were made at the last inspection, which have been complied with. No requirements or recommendations have been made on this occasion. The home under the direction of the manager continues to provide a high standard of care for service users and continually strives to improve the service. The provider has a range of polices and procedures relating to equality and diversity. Care plans have been designed to take account of individual needs and cultural and religious choices. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service that meets the needs of individuals of various religious, racial or cultural needs. The Commission has received no complaints about the service since the last inspection and no concerns or allegations have come to the notice of the Commission. DS0000011284.V339294.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The service would like to improve the personalisation of care planning. Include monthly audit of care documentation. DS0000011284.V339294.R01.S.doc Version 5.2 Page 7 More involvement of staff in activities and greater recording of activities by staff. Provide more detailed up date for staff who have been off duty for several days. The service would like to improve the presentation of tea and coffee. The manager intends to improve staff training on handling of complaints. Ensure all service users have a lockable space in their bedrooms. Increase access to NVQ training for staff. 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. The summary of this inspection report can be made available in other formats on request. DS0000011284.V339294.R01.S.doc Version 5.2 Page 8 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 DS0000011284.V339294.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All prospective service users have their needs appropriately assessed prior to a place being offered. EVIDENCE: Six service user files were seen and of these information obtained prior to the recent admission of two service users was examined. It was evident that comprehensive information is gathered from Social Services, relevant others such as GP’s and hospitals, relatives and from the service users themselves, which is then used to provide an assessment of whether the service can meet that individuals needs. Some service users moving into the home on a permanent basis are well known if they had been previously using the respite service provided. This initial information is then used to formulate a care plan that is then expanded as more details come to light. DS0000011284.V339294.R01.S.doc Version 5.2 Page 10 One service user spoken to confirmed that she had visited the home prior to moving in. A visiting relative advised me that she had visited several homes in the area before deciding that Gurney House was appropriate for her mother. She advised that she had been welcomed and provided with sufficient information about the home. DS0000011284.V339294.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual plans set out service user’s health, personal and social care needs. The health care needs of service users’ is fully met. The medication arrangements are robust and mostly protect service users. Service users are treated with respect. EVIDENCE: Care plans have recently been transferred to a newly introduced company wide format. Six care plans were seen. These new formats are easy to read and provide comprehensive information covering a wide range of topics including past interests and life experiences, health and social care needs, cultural and religious needs and individually focussed risk assessments. Health care needs were clearly recorded with action plans in place to address individual assessed needs. Tools such as fluid charts and falls risk DS0000011284.V339294.R01.S.doc Version 5.2 Page 12 assessments are used where required to ensure timely intervention and to prevent deterioration in condition where possible. In discussion with staff, it was apparent that the promotion of tissue viability and prevention of pressure sores was given a very high priority and it was considered that the whole area of health care was a particular strength of the home. Interventions by a range of health care professionals were recorded and it was clear that the home enjoys a positive and professional relationship with District Nurses and GP’s. Of the three returned GP surveys all provided positive responses and were complimentary about the home. In addition, the relative spoken to and the returned relatives surveys indicated satisfaction with the care provided by the home. Information provided by the home prior to the visit confirmed that there are robust policies and procedures in place for the arrangements for handling medication in the home. The manager confirmed that they do seek advice from the local pharmacist who does visit the home on a periodic basis. A staff member authorised to administer medication explained the process as part of the last two service users to receive their medication prior to lunch being served. There was evidence that photographs of each service users are kept on medication administration sheets. One service user did not want to take his medication until he had eaten some of his lunch, which he was waiting to be delivered to his room. The staff member decided not to leave this service user with the medication until his lunch had been delivered and she could witness him taking his tablets. The service user appeared not to understand the staff members’ insistence on staying as he said medication was often left with him to take later. The manager confirmed that there are odd occasions when medication is left with a service user and she undertook to ensure that risk assessments are implemented to address such situations. Throughout the course of the visit staff were observed to interact with service users respectfully with light banter being enjoyed on both sides. Staff were seen to knock on service users doors before entering. It was apparent from the laundry room that service users’ clothes are kept separate after being laundered and it was confirmed that it was the responsibility of key workers to ensure that clothes were appropriately labelled. DS0000011284.V339294.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The lifestyle experienced by service users meets their expectations and preferences including social, cultural, religious and recreational interests and needs. Service users are supported to maintain contact with significant people and are helped to exercise choice and control over their lives. Meal times are enjoyed by service users and the food provided is wholesome and appealing. EVIDENCE: Records seen included information about service user’s interests and cultural and religious needs. Service users are encouraged and supported to continue their interests where possible and to follow their religious beliefs. An activities organiser is employed who arranges regular activities each morning and afternoon with the support of care staff. Service users indicated that occasionally activities have to be cancelled due to a shortage of staff. There is also a programme of ongoing events including tea parties, religious celebrations such as Easter, Christmas etc, garden parties, outings and holidays. DS0000011284.V339294.R01.S.doc Version 5.2 Page 14 All service users spoken to had family and friends that they remained in contact with. One service user was looking forward to a special birthday celebration to which all of her five children were attending including one living in America. A visiting relative advised that she visited her mother at least five times per week and was always made to feel welcome and no restrictions on the time she arrived was imposed. Service users are able to handle their own financial affairs if they wish to and where they are able. One survey was returned from a Solicitor who acted on behalf of a service user and he provided positive responses and stated that the home always inform him of significant events. There was evidence in the three bedrooms seen that service users are able to bring personal possessions with them into the home. All service users spoken to were complimentary about the food provided in the home. The cook was spoken to briefly and indicated that she enjoyed her job and liked to seek suggestions for meals from service users. It was indicated that the current group of service users were quite adventurous with food and a wider variety of meals were now on the menu. The cook confirmed that fresh fruits and vegetables were a regular feature of the menu and there was evidence of fresh fruit in service users’ bedrooms. The introduction of serving dishes at lunch-time had been well received and access to a small range of foods available to service users in the evening had been a success. A food safety inspection recently conducted by the local Environmental Health Dept confirmed the Bronze certificate previously awarded to the home. DS0000011284.V339294.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives are listened and their concerns and complaints are taken seriously. Service users are protected from abuse. EVIDENCE: The complaints record was seen and provided evidence that the home encourages feed back about the service it provides. The entries were clear and provided information about the action taken and the overall outcome of the complaint. Despite the compliments about the food there had been complaints about an occasion when vegetables had been considered as overcooked. This demonstrates assertiveness on the part of service users that was also confirmed when talking with them. Surveys from relatives stated that they did know how to make a complaint. The visiting relative confirmed that she had previously had concerns about her mother that were addressed appropriately by the manager. All staff as part of their induction training receive information about safeguarding adults. They are then all expected to attend training provided by the Social Services dept. Refresher training was already booked shortly following the inspection. Staff spoken to demonstrated a sound understanding DS0000011284.V339294.R01.S.doc Version 5.2 Page 16 of the potential for abuse and were clear about the action that needed to be taken when abuse or neglect were suspected or alleged. DS0000011284.V339294.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe, well-maintained environment for service users. The home is clean, pleasant and hygienic. EVIDENCE: A tour of the premises was undertaken. Throughout the home was clean and free from offensive odours. There are policies and procedures in place for the control of infection and staff are required to undertake periodic training. The laundry facilities were seen and were well organised and had an appropriate floor covering. Maintenance personnel are employed and undertake repairs and address general maintenance issues as they arise. A grant has been secured to DS0000011284.V339294.R01.S.doc Version 5.2 Page 18 refurbish the dining room, which will become a multi-function room for holding events, parties and group gatherings. There are plans to replace some lounge furniture and soft furnishings. One relative on a survey indicated that the wardrobe in the bedroom would not open properly. The manager advised that the maintenance man addresses such issues when they are brought to his attention. Overall the home provides a safe and well-maintained environment for service users that includes well tended out door space that provides a variety of seating and shelter for service users. DS0000011284.V339294.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 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 by appropriate numbers of staff, who are trained and competent at their jobs. Service users are in safe hands and are protected by the home’s recruitment policy and practices. EVIDENCE: Throughout the course of the inspection staff were observed going about their duties in a calm and professional manner. Staff are deployed in sufficient numbers to meet the needs of the current service users. The manager confirmed that additional staff are allocated when the need arises such as when a service user is particularly unwell. An ongoing programme of training for staff ensures that all core training is up to date. A full audit of staff training was not undertaken but the manager was confident that their training matrix ensured that staff received up dates when required. There is an NVQ training programme where staff are encouraged and supported to achieve these qualifications. Currently this training has been delayed due to the unavailability of an assessor but the service wishes to DS0000011284.V339294.R01.S.doc Version 5.2 Page 20 continue with this programme as soon as practicable to ensure that at least 50 of all staff are NVQ trained. Staff spoken to confirmed that they felt well supported and that they receive recorded one to one supervision approximately two monthly. There are also monthly staff meetings where staff are encouraged to raise issues. Staff meeting minutes were seen and a schedule of staff supervisions was clearly visible on the office wall. Six staff files were seen. They were clearly organised into sections and included all the required documentation as stipulated by the regulations. Staff supervision notes are kept separately as they follow a corporate format and do not include information of a personal nature. There was evidence from talking to visitors and from surveys that staff are highly regarded and were described as very friendly and helpful. DS0000011284.V339294.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 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 managed and is run in the best interests of service users. Service users’ financial interests are safeguarded and their health, safety and welfare and that of the staff are promoted and protected. EVIDENCE: The manager is very experienced and evidence from staff and surveys confirmed that she is well regarded. The service conducts a formal annual review of the service and uses questionnaires to obtain feedback from a wide range of individuals who have an interest in the home. This feedback is incorporated into a report that is made available to Social Services and others. DS0000011284.V339294.R01.S.doc Version 5.2 Page 22 In addition, the Social Services dept conducts a survey each year to evaluate the effectiveness of the service. The home receives verbal feedback on the results of this survey. There are regular residents meetings and in discussion with service users in the lounge two indicated that they attend these meetings on a regular basis to discuss different aspects of the home such as activities and meals. The minutes of these meetings were seen and the meetings occur approximately two monthly. The administrator for the home explained and demonstrated the procedures for safeguarding service users monies. All service users have their own accounts. They are discouraged from keeping money other than small change in their rooms. All purchases are receipted and accurate records are kept of all money received. One service user chooses to keep cash in his room, which he locks when not occupied. The manager undertook to arrange that this service user be provided with a lockable space in which to keep his cash. A financial audit is undertaken annually of all transactions undertaken within the home by personnel from head office. A range of health and safety checks are undertaken. The fire log provided evidence that the fire warning system, emergency lights and equipment is checked regularly. Hot water outlets and portable appliance checks were in evidence. Equipment is serviced to manufacturers instructions as confirmed by information provided by the service prior to the visit. It was noted that a recent accident involving a service user was noted in their daily notes but an accident form had not been completed. The manager undertook to address this and remind staff of the importance of accident records. DS0000011284.V339294.R01.S.doc Version 5.2 Page 23 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 4 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 3 17 X 18 3 3 X X X X X X 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 3 X 3 X 3 X X 3 DS0000011284.V339294.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 DS0000011284.V339294.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000011284.V339294.R01.S.doc Version 5.2 Page 26 - 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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