Inspection on 12/09/05 for Stone Gables

This inspection was carried out on 12th September 2005.

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

Stone Gables 20/03/07

Stone Gables 01/03/06

Stone Gables 27/08/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Stone Gables Street Lane Gildersome Leeds LS27 7HR Lead Inspector Sughra Nazir Unannounced 12 September 2005 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 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 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 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 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 Karen Burse 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 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14th December 2004 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 bedrooms. There are wellmaintained 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 toliet 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 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by one inspector over 6 hours. No pre-inspection documentation was sent out. Comment cards and questionnaires were left for service users, relatives and health professionals to complete. The inspection focussed on service users and their experience. Seven service users, one relative, a community nurse and several members of staff were consulted as part of the inspection process. Their comments and views were considered alongside an inspection of 20 bedrooms and all communal areas. The inspector examined 4 service user care plans, medication administration records and the home’s policies and procedures. What the service does well: What has improved since the last inspection? What they could do better: The home has reviewed of all documentation making good use of Information Technology but it needs to make sure all handwritten records such as Medication Administration Records and staff files are fully completed. Stone Gables 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 Page 6 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 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Stone Gables 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 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 standard(s) 1, 2, 3, 4 and5 Service users are provided with information to enable them to make an informed choice about the home. The admission process is good and includes introductory visits. EVIDENCE: All service users have access to detailed information about the home. Much of the information in the service user guide and statement of purpose is displayed in the hall and the staff are aware that some revision is required to ensure that more service users can read what is displayed. The home is developing a website which will aid prospective users and their relatives in finding out about the home. A service user said that she had visited the home for a trial visit and that she had had a meeting before she decided to move in permanently. Service users receive a contract that sets out terms and conditions. Staff receive training in dementia care so they can respond to the increasing demand for dementia care within the home. Stone Gables 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, 10 and 11 Service users’ care needs are met by staff taking instructions from clear and detailed care plans. Medication documents are not filled in all cases. Staff show respect and uphold service users’ privacy. EVIDENCE: The home has developed very good service user care plans that are both detailed and easy to follow. The files contain all the required information including when service users had contact with health professionals doctors. Opticians, dentists etc. Service users’ likes, dislikes and preferences in relation to food, activities and daily routines are included and are used to inform care decisions. 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. A monthly audit of accidents and emergency admissions is now taking place as recommended at the last inspection. Stone Gables 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 Page 10 Staff interaction with service users was observed as respectful and several service users confirmed this view. Staff entering service users’ bedrooms were seen to knock and await a response before entering. Service users have the choice in deciding whether to receive visitors in their own rooms or in communal areas. Stone Gables 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12,13,14,15 The home offers a range of social activities and events but needs to do more to make sure that these activities meet the preferences and needs of its service users. Service users exercise choice in relation to daily living routines but need more information about menus and food choices. EVIDENCE: The inspector saw that service users were taking part in a game of skittles. Evidence was seen of other activities arranged including old time cds, bingo, exercise and crafts. A wine and cheese evening for relatives was being planned and notices were seen giving details of forthcoming events including parties for Halloween, Bonfire Night and Christmas. One service user said that she enjoyed being able to attend a local day centre. A large number of service users were seen to be sitting around the edges of the lounge with no social stimulation. The home should ensure that it organises activities taking into account the specific needs of service users with dementia as well as individual preferences such as swimming and not participating in group activities. Stone Gables 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 Page 12 A relative said that she and other visitors enjoy unrestricted access to the home with the option of staying for meals . Copies of the Gildersome newsletter were seen along with other evidence of local community information. A comments suggestions and complaints box is located in the hallway and information on advocacy services is available to service users. The inspector joined service users for lunch which was served in pleasant surroundings. The service users did not know what to expect for lunch and a menuboard showed details of meals served three days previously. The meal itself was served in generous portions and arrived warm to all service users. Staff providing assistance with eating did so sensitively and discreetly. Service users were offered a cold drink with their meal. Three service users stated that they would prefer to have a warm drink immediately after a fried meal. Service users were not sure if they could ask for alternatives and the home should look at ways of providing information about set meals and alternative options. Stone Gables 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16,17 and 18 Service users have their views listened to and acted upon. Complaints are taken seriously and resolved. Staff know about adult protection. EVIDENCE: A notice giving details of the Complaints’ policy was prominently displayed in the hall. Service users confirmed that they felt able to raise their concerns and get a response. Staff have all had training on Adult Protection. Stone Gables 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19,20,21,22,23,24,25, and 26 Service users live in a clean, safe environment and have access to adequate bedroom and bathroom facilities. EVIDENCE: All areas of the home were seen to be clean and well-maintained. Locks to individual bedroom doors have been fitted. All bedrooms show signs of personalisation. Staff confirmed that service users were involved in decisions about decoration and their living environment. The home had tried to move chairs away from the edges in the lounge to form smaller informal seating areas and the service users had moved chairs back. The low level bath in one upstairs bathroom has been adapted with equipment making it more accessible for independent bathing. The home is considering plans to provide a shower facility. Stone Gables 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 Page 15 Laundry facilities were inspected and found to comply with infection control guidelines. The home uses red bags for soiled laundry and staff have stopped carrying soiled laundry through the dining room. Stone Gables 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30 Recruitment procedures and documents kept on staff files do not show that all necessary checks are carried out. Staff training is good EVIDENCE: Staff rotas were considered and staffing levels found to be adequate for service user dependency levels. Additional staffing hours have been provided to cover lunchtimes and night care needs. The recruitment files for two staff examined were incomplete. There was only one reference on one file and the other showed no evidence of a completed application form, leaving the home without a checkable employment history. 9 staff are qualified to NVQ (National Vocational Qualifications) level 2 with a further 5 staff undertaking this training currently. A training programme is prominently displayed giving full details of all training courses attended by staff. This includes training such as Health and Safety as well as specialist training on dementia care. Stone Gables 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36, The home is managed well by management that gives open-door access to staff, service users and relatives to air their views. EVIDENCE: The management of the home has changed over the past year and new systems and processes have been introduced. More use is being made of Information Technology for paperwork and a website for existing and prospective service users. Service users said that the new manager was very open and shared information. A relative said “there was a different, less institutional and more homely feel to the place”. The manager has appointed a Principal Administrator who has implemented improvements to care plans and other documentation within the home. She was very knowledgeable and demonstrated a strong commitment to the efficient running of the home. Financial procedures have been revised so that two signatures confirm each transaction on service users’ monies. Stone Gables 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 Page 18 Staff are supervised regularly and a supervision timetable is clearly displayed on the staff notice board. Stone Gables 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 x x Stone Gables 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 Page 20 None Are there any outstanding requirements from the last inspection? 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 OP9 OP12 Regulation 13(2) 17(1)(a) 16(2) Requirement All medication records must be completed fully Service users must be consulted about social activities and arrangments made to enable them to engage in activities to suit their expectations, preferences and capacities. Activities suited to the needs of those with dementia must be provided. Two written references must be obtained and kept on file together with all other documnetation as specified in Schedule 2 of the regulations. Timescale for action On receipt of report 1.03.06 3. OP29 7,9,19 SCH2 5. On receipt of report 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 OP15 Good Practice Recommendations Hot and cold drinks should be available at all times. The manager should make sure there is a menu offerng a choice of meals in written or other formats to suit the capacities of all service users. This should be given, read or explained to service users. 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 Page 21 Stone Gables Stone Gables 20050912 Stone Gables V248585 S1510 J52 Stage 4.doc Version 1.40 Page 22 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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