CARE HOMES FOR OLDER PEOPLE
Stone Gables Street Lane Gildersome Leeds West Yorkshire LS27 7HR Lead Inspector
Sughra Nazir Unannounced Inspection 12:30 1st March 2006 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 Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 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. Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Stone Gables Address Street Lane Gildersome Leeds West Yorkshire LS27 7HR 0113 252 9452 0113 2529452 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) Castlegrounds Limited Mrs Karen Lesley Birse Care Home 40 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (40) of places Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 12th September 2005 Brief Description of the Service: Stone Gables is a stone built converted and extended property, situated on the outskirts of the village of Gildersome it has a pleasant outlook. It is convenient for the bus service, which gives access to the surrounding area and Leeds city centre. Stone Gables provides residential care to 40 adults, accommodation is provided on 2 floors in 36 single bedrooms and 1 double bedroom. There are well-maintained safe gardens to the rear of the home. There are sufficient bathing facilities around the home. Toilets are located near to service users accommodation and communal areas; separate toilet facilities are provided for staff. The ground floor has large lounge areas with a separate smaller area for service users who wish to smoke. Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over the afternoon of 1St March 2006. It was the second and final inspection for this year and was carried out again without prior announcement. Copies of reports for this and previous inspections are available to read at the home and on the CSCI website. www.csci.org.uk The focus of the visit was to look at progress made since the last inspection. . Time was spent observing care provided over the teatime period. Medication records, staff files and care plans were also examined. What the service does well: What has improved since the last inspection?
A number of staff are attending courses on dementia. The small lounge at the front of the building is going to be used more for activities, allowing the home to develop individual and small group activities for service users with dementia. The room has a themed bookcase that currently contains books about the Royal family. All activities were discussed at a service users meeting and more activities are being developed such as a knitting programme and reminiscence work for those with dementia. The home is developing a photograph-based menu which will allow service users the opportunity to make an informed choice about mealtimes.
Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 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. Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 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 Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 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): Not assessed at this inspection EVIDENCE: Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 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): 7 and 9 Service users care plans are detailed and well-written and this helps staff to deliver the care according to identified needs. Medication records are not upto-date EVIDENCE: All service users now have very good service user care plans that are both detailed and easy to follow. The files contain all the required information including information about when service users had contact with health professionals gps. Opticians, dentists etc. Service user likes, dislikes and preferences in relation to food, activities and daily routines are included and are used to inform care decisions in the home. The home carries out risk assessments in relation to moving and handling, pressure areas and nutrition and monitors dependency levels Service users are being consulted about the contents of their care plans. There was evidence confirming that monthly reviews of care plans are taking place. Medication administration records were found to be incomplete and this has been made a requirement.
Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 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 and 15 Service users benefit from activities that meet their needs. They have a choice at mealtimes. EVIDENCE: The notes from a service user meeting were seen which confirmed that service users had been consulted about activities. The staff at the home are undertaking a distance-learning course on dementia and this has already helped them to develop a knitting programme and reminiscence activities for those with dementia. The front lounge has been redecorated and will now be used for individual and small group activities. Choice and consultation at mealtimes is being improved. Hot and cold drinks are available at mealtimes. The home is developing a photograph-based menu which will allow service users the opportunity to make an informed choice. This is good practice and should be extended to other areas of decision-making. Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 Page 11 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): Not assessed on this occasion EVIDENCE: Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 Page 12 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): Not assessed on this occasion. EVIDENCE: Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 Page 13 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): 29 Service users are supported and protected by robust recruitment practices and record-keeping EVIDENCE: Several staff files were examined and were found to be complete. Recruitment practice includes verifying identity, checking references and checking gaps in employment history. All required documents including 2 written references, completed application forms and terms and conditions were found to be in order. The home ensures that care staff are subject to statutory checks before employment is commenced. Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 Page 14 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): 38 Service user and staff safety is promoted through robust policies and procedures. EVIDENCE: Health and safety procedures and the home’s policies for safe working are documented and regularly revised. All staff have training in fire safety and health and safety at work. Risk assessments are in place for the environment. The manager is aware of responsibilities to report any accidents or incidents to appropriate organisations. Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 Page 15 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 4 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 3 Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? Yes 1 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 OP9 Regulation 13(2) 17(1)(a) Requirement All medication records must be completed fully Timescale for action 01/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Stone Gables DS0000001510.V271520.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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