Inspection on 13/06/07 for The Gable

This inspection was carried out on 13th June 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

The Gable 23/02/06

The Gable 13/10/05

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 The Gable 75 Albion Street Burnley Lancashire BB11 4LY Lead Inspector Mrs Julie Playfer Unannounced Inspection 13th June 2007 09:30 The Gable DS0000064382.V332542.R01.S.doc Version 5.2 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 The Gable DS0000064382.V332542.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 Adults 18-65. 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. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Gable Address 75 Albion Street Burnley Lancashire BB11 4LY 01430 872183 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) Alliance In Care Limited Mrs Diane Wilkinson Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for 6 service users in the category of Learning Disability 23rd February 2006 Date of last inspection Brief Description of the Service: The Gable is registered with the Commission for Social Care Inspection to provide accommodation and personal care for six adults with a Learning Disability aged between 18 and 65 years. The home is an end terrace property, providing accommodation in five single rooms and one shared room, none of the rooms have an ensuite facility. The communal space is provided in a lounge/dining room and kitchen. The home also has one bathroom and a shower room. The home is located approximately half a mile from Burnley town centre. There is a yard at the rear of the property, which has a seating area. The home has a statement of purpose and service users guide, which informs the current and prospective residents about the services and facilities available at the home. According to information submitted by the home the scale of fees was £349.00 to £362.50 per week. Additional charges were made for activities, toiletries and haircuts. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at The Gable on 13th June 2007. During the visit the inspector looked at written information including policies, procedures and records, spoke to the residents, registered manager and staff and conducted a partial tour of the premises. As part of the inspection process the inspector used “case tracking” as a means of gathering information. This process allows the inspector to focus on a small group of people living at the home. Prior to the inspection satisfaction questionnaires were sent to the home. Six questionnaires were returned from the residents and three questionnaires were returned from relatives. The registered manager also completed a detailed factual questionnaire about the home. Information from the questionnaires was collated and used as evidence throughout the inspection process. At the time of the inspection there were 6 people accommodated in the home. What the service does well: The residents were provided with useful information in a format suitable for their needs, so they could read about the services and facilities available in the home. The residents’ needs were properly assessed and reviewed at regular intervals. This meant the staff were aware of the residents’ current needs and how best to provide care and support. Care and support was planned effectively to ensure the residents’ needs were met. The residents pursued a range of activities both inside and outside the home. This approach enabled the residents to participate in the life of the home and gave them the opportunity the meet other people. Appropriate policies and procedures were in place to ensure the residents were listened to and protected from harm. All the residents spoken to felt confident any concerns would be listened to and taken seriously. The residents were provided with a clean, safe and comfortable home, which they enjoyed living in. Staff were provided with a broad range of training opportunities, which gave them an understanding of the needs of the residents. Relationships in the home were positive and the atmosphere was open and friendly. One person commented on the questionnaire “All staff are only to happy to help in any situation – no job is too small, they are very courteous”. Appropriate systems were in place to monitor the quality of the service and planned developments were based on the views and wishes of the residents. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home were provided with useful and appropriate information about the services and facilities provided in the home and their needs were properly assessed and reviewed. EVIDENCE: Written information was available for residents in the form of a service users guide and statement of purpose. Both documents were written in a suitable format and the guide had been distributed to all the residents. Since the last inspection the service users guide had been updated in line with the changes in staff. The residents spoken to were familiar with service users guide and had a copy in their bedrooms. All the residents had lived at the home many years and were well established. Care records indicated that the residents’ needs had been assessed prior to admission by a Social Worker and at periodic intervals by the registered manager and staff in the home. All the people living in the home had been issued with a contract with the company, which covered the terms and conditions of residence. However, it was noted the contract did not include details about the level of fees. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples’ individual needs were addressed and they were supported to participate in all aspects of life in the home. EVIDENCE: The case tracking process demonstrated that each person had an individual plan, which reflected their health and welfare needs. Guidance was set out for staff to ensure all needs were met. All residents had been allocated a keyworker and of their choice and from discussions with the residents, it was apparent they had been consulted about their care plan. The care plans were written in a suitable format for the staff and residents to read. The residents had also completed person centred plans with the assistance of the their keyworker. The people living in the home were supported to take responsible risks. Detailed risk assessments and management strategies covered activities indoors and in the wider community and were included in the residents’ care The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 10 plan documentation. The registered manager had also devised individual missing person’s procedures. During conversations with residents, it was evident they were consulted both formally and informally and they were able to fully participate in the life of the home. Residents meetings were held in the home on a regular basis and it was evident a wide variety of topics were discussed. Minutes of the meetings demonstrated that the residents fully contributed to the agenda and discussions. It was also noted that one resident was invited to attend a part of each staff meeting. This role was offered to each resident in turn. The residents were supported with their financial affairs and detailed written records were maintained of all transactions. A random check of money deposited with the home for safe keeping corresponded accurately to the records. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were able to make choices about their life style and activities were supported to develop their life skills. EVIDENCE: Individual plans and records demonstrated that residents had opportunities to maintain and develop practical life skills. Residents were encouraged and supported to participate in the life of the home and carried out domestic tasks commensurate with their abilities and interests. These tasks included tidying the bedrooms, helping in the kitchen, going to the local shops and light domestic chores. The residents spoken to explained there was a rota in the kitchen, which set out each person’s tasks for the day to ensure everyone took a turn washing up. The residents said they enjoyed participating in the tasks and keeping their own rooms tidy. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 12 It was part of the ethos of the home to encourage and support the residents to engage in a variety of community activities. The activities outside the home included going to the local shops. Cinema, pubs and leisure centres. One resident explained he had plans to visit London for a few days with another resident and two members of staff. The resident said he was “really looking forward to the trip”. On the day of inspection, the residents were pursuing a variety of activities. Two people attended a gardening course, one person visited the local library, one person attended the day centre and one person went swimming. On their return home, everyone said they had enjoyed their day. The residents were supported to maintain good contact with their families. As such friends and family were welcome to visit the home at any time convenient to the residents. All the relatives who completed a questionnaire prior to the inspection were satisfied with the level of care provided and all felt the needs of their relative were met. One person commented, “the manager of the care home cares for the welfare of all the residents and their welfare is paramount. She encourages the staff to do likewise and they provide a homely and stimulating environment as far as resources allow”. All residents were entered onto the electoral register and exercised their right to vote by attending the local polling station or by entering a postal ballot. The residents had unrestricted access to the home and they were able to use their room at any time should they wish to spend some time in private. One resident was spending time in his room during the inspection. The residents said the routines were flexible and were designed around their arrangements for the day. As such, the routines differed throughout the week and weekends. The residents said they enjoyed the food provided in the home. The residents were consulted on a weekly basis about their choice of menu and a shopping list was drawn up. The residents assisted the registered manager to purchase the food at a local supermarket. Meals were provided three times a day and a range of drinks and snacks were available at all times. The residents were supported to prepare and serve the meals in the kitchen. The record of meals served was complete and up to date. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ health and personal care needs were met. EVIDENCE: The residents’ individual care plans set out their personal care needs and provided details of how this support was to be delivered. Residents spoken to confirmed personal support was provided in private and their rights to privacy and dignity were respected. The registered manager and staff ensured consistency and continuity for residents by the use of the key worker system. The residents felt the staff were approachable and supportive, one person commented in the questionnaire “Staff always help me and treat me as I would expect – I can always have a chat with them.” Healthcare needs were appropriately assessed and were included in the care plans. There was evidence in the care records that the residents had access to NHS services, as necessary. In addition to the care plans each resident had a The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 14 health action plan, which had been completed by the manager, staff and residents. All residents were registered with a General Practitioner. There was a set of policies and procedures in respect of medication and appropriate records were maintained of receipt, administration and disposal of medicines. The home operated a monitored dosage system for the administration of medication dispensed into cassette trays. Since the last inspection all staff designated to administer medication had received accredited training. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents were able to express their concerns and had access to an effective complaints procedure. Written procedures and practice protected the residents from abuse and neglect. EVIDENCE: Both informal and formal arrangements were in place to ensure the registered manager and staff listened to and acted on the views and concerns of the residents. This was achieved during daily conversations, one to one discussion with residents and their key workers and residents’ meetings. The complaints procedure was included in the service users guide and had been produced in a simplified pictorial format to supplement the full procedure. The residents spoken to were familiar with the picture format and were aware they could raise a concern should they wish to. The registered manager had received no complaints since the last inspection. A copy of “No Secrets in Lancashire” (The Joint Strategy for the Protection of Vulnerable Adults) was available, along with a specific procedure setting out the required response in the event of any allegations or suspicion of abuse. The staff were aware of the procedure and had received appropriate training, as part of their induction and NVQ training. The staff also had access to a whistle blowing procedure. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Gable provided homely and clean accommodation. Residents were able to personalise their room and create an individual space suitable for their needs. EVIDENCE: The Gable is an end-terraced property located approximately half a mile from Burnley town centre. The premises are in keeping with the local community. Accommodation is provided in five single bedrooms and one shared room. There is also one bathroom and one shower room. On a partial tour of the home it was evident the residents had personalised their rooms with meaningful possessions. Since the last inspection, a new settee had been purchased for the lounge, new kitchen units and worktops had been fitted, and three bedrooms had been decorated and fitted with a new carpet. One resident said he had chosen the colour of the walls and had helped to decorate his room. Extensive repair work had also been undertaken on the roof. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 17 Established arrangements were in place to carry out general maintenance and repairs and records were maintained of the work carried out. An environmental check was made on a regular basis in order to identify repairs and potential risks. At the time of the inspection, the premises were comfortable, clean and free from offensive odours. Arrangements were in place for the residents to do their own laundry. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment and selection procedures were thorough and ensured the protection of the residents. Staff were well trained and skilled to meet the needs of the residents. EVIDENCE: Staff had been issued with a job description, which was commensurate with their role, as part of the recruitment process. From discussions with the staff during the inspection, it was evident they had a good understanding of the needs of the residents and knew the residents well. Staff referred to the residents in respectful terms and were observed to interact in a positive and pleasant way. Since the last inspection the recruitment and selection procedure for new staff had been updated to include details of all current legal requirements. The recruitment process included completion of an application form, face-to-face interview, obtaining two written references and a POVA first and CRB check. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 19 The file of one member of staff was inspected. This showed that the procedures had been followed and all relevant details had been obtained. An induction training package was available for new staff, which covered the “Skills for Care” standards. Each member of staff had a training assessment and profile and there was an overall training development plan for the staff team as a whole. It was evident the staff had access to a broad range of training courses. At the time of the inspection, five members of staff had achieved NVQ level 2 or above. This equated to 70 of the staff team, which was an increase of 45 since the last inspection. Staff meetings were held on a regular basis. The meetings gave the staff the opportunity to share experiences and develop teamwork. Minutes of the meetings were seen during the inspection. The registered manager ensured staff received supervision at least six times a year and had annual appraisal of their work performance. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management approach promoted positive relationships between the staff and the residents and the overall atmosphere was open and friendly. Systems were in place to monitor and develop the quality of the service and the health and safety of the residents was promoted and protected. EVIDENCE: The registered manager had overall responsibility for the management of the home and had a job description, which reflected the aims and objectives of the home. The manager had completed an NVQ level 4 in Management and Registered Manager’s Award and since the last inspection had achieved an NVQ level 4 in Care. The management approach was consultative and there were established systems were in place to consult staff and residents on an ongoing basis. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 21 Relationships within the home were positive and staff spoke to and about the residents with respect. In January 2006, the registered provider was awarded an Investors in People Award. The registered manager had established systems to monitor the quality of the service, which included monthly audits of the care plans and the environment. Satisfaction questionnaires had been distributed to the residents, relatives, staff and professional staff in October 2006. The results of the survey were collated, published and fed back to interested parties. An annual development plan based on the outcomes of the monitoring processes had been produced, which identified the planned developments for the service. There were policies and procedures covering all aspects of health safety in the home. The staff received health and safety training, which included food hygiene, first aid and fire safety. According to the pre-inspection questionnaire and documentation during the inspection the electrical, gas, heating and fire systems had been serviced at regular intervals. In addition to the central valve fitted to the main hot water system, a preset valve was fitted to the bath. Hazardous substances were store securely. The registered manager had carried out risk assessments of the environment and there was a procedure in place for the reporting of any accidents or incidents. Since the last inspection a health and safety review had been undertaken by an external company and action had been taken in response to the recommendations resulting from the audit. The Gable DS0000064382.V332542.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 Adults 18-65 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 3 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 4 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 23 No 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. 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. 1 Refer to Standard YA5 Good Practice Recommendations The contract should include details about the level and payment of fees, to ensure the residents are aware of the charge for the service and how these charges will be met. The Gable DS0000064382.V332542.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 The Gable DS0000064382.V332542.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!