Inspection on 13/10/05 for The Gable

This inspection was carried out on 13th October 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Gable 13/06/07

The Gable 23/02/06

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 October 2005 13:00 The Gable DS0000064382.V252887.R01.S.doc Version 5.0 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.V252887.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 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.V252887.R01.S.doc Version 5.0 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.V252887.R01.S.doc Version 5.0 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 26th October 2005 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. The staffing level provided at the home is in accordance with guidance issued by the Local Authority. The Gable DS0000064382.V252887.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over five hours on 13th October 2005. The previous inspection took place on 26th October 2004. No additional visits have been made to the home since the last inspection. On the day of inspection there were 6 residents accommodated at the home. Information was obtained from staff records, care records and policies and procedures. The inspector also spoke to the residents, the staff on duty, the registered manager and the registered person. A partial tour of the premises was also undertaken. What the service does well: What has improved since the last inspection? Since the last inspection the statement of purpose and service users guide had been updated in line with the change of ownership. The registered manager had updated the medication administration records and any discrepancies between the records and prescription labels had been checked with the Pharmacist. The Gable DS0000064382.V252887.R01.S.doc Version 5.0 Page 6 All free standing wardrobes had been secured to the wall. A new television and “free view” box had been purchased for the living room and several areas had been redecorated including the shower room and hallway. The registered manager had assessed the training needs of the staff and had developed a plan for future training. 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 Gable DS0000064382.V252887.R01.S.doc Version 5.0 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.V252887.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5. Residents were provided with useful and informative information about the services and facilities provided in the home. Resident’s 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 presented in a suitable format and the service users guide had been distributed to all residents. However, the service users guide did not contain information about the qualifications of the registered provider, manager and staff. All residents had lived in the home for sometime. Care records indicated that the residents’ needs had been assessed before admission by a social worker and at periodic intervals by the staff in the home. The registered manager had also recently carried out a comprehensive assessment of needs with individual residents, following a new format. All residents had been issued with a contract/terms and conditions from Alliance in Care Ltd, which covered all the elements listed in the National Minimum Standards. The Gable DS0000064382.V252887.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 The care planning system fully addressed the needs of the residents and provided clear guidance to staff on how these needs were to be met. Relationships within the home were good. The established consultation arrangements ensured residents were able to participate in all aspects of life in the home. EVIDENCE: From the case files seen, it was evident each resident had a plan of care, based on an assessment of needs. The plans set out in detail the action needed to be taken by staff to ensure all needs were met. All residents had been allocated a key worker of their choice and from discussions with residents, it was apparent they had been consulted about their care plan. Further to this, it was noted that one resident had partially completed his care plan himself. The care plans were comprehensive and were written in a suitable format for both the staff and residents to read and understand. It was the practice of the home to support responsible risk taking and policies and procedures supported this approach. Detailed risk assessments and management strategies covered activities indoors and in the wider community The Gable DS0000064382.V252887.R01.S.doc Version 5.0 Page 10 and were included within the residents’ plans. The registered manager had also devised individual missing person’s procedures. During conversations with residents, it was evident they were consulted both informally and formally and they were able to participate in life in the home. From the minutes seen of the resident’s meetings, it was evident a wide variety of topics were discussed and contributions had been made by the residents. 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.V252887.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Residents were provided with good opportunities to engage in a wide range of leisure activities and were supported to use community facilities. The residents maintained strong links with their families and enjoyed positive relationships within the home. Arrangements were in place to ensure the residents participated in the life of the home and their rights were respected. EVIDENCE: Individual plans and care 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 bedrooms, helping in the kitchen, going to the local shops and light domestic chores. The residents explained there was a rota in the kitchen which set out each person’s tasks for the day to ensure everyone had a turn at washing up. It was part of the ethos of the home to encourage the residents to engage in a variety of community activities. The activities outside the home included going to the shops, cinema, pubs and leisure centres. The residents said they The Gable DS0000064382.V252887.R01.S.doc Version 5.0 Page 12 particularly enjoyed a recent meal out at a local restaurant. Staff provided assistance with activities as necessary and had knowledge of events in the nearby area. Since the last inspection all the residents had been on holiday to Skegness. The residents said they had a “great time”. The residents also pursed a number of educational activities, which included attending the local college. One person had achieved Student of the Year Award 2005 at Burnley College. Two people were also volunteers at a local centre and helped to prepare the meals at the luncheon clubs. The residents were supported to maintain relationships with their families. As such friends and family were welcome to visit to the home at any time convenient for the residents. The residents had unrestricted access to the home and grounds. The residents were also able to use their room at any time should they wish to spend some time in private. All residents were entered onto the electoral register and exercised their vote by attending the local polling station or by entering a postal ballot form. The residents said the routines in the home were flexible and were designed around their arrangements for the day. As such, there were different routines at the weekend. The registered manager maintained a record of meals served to residents, which included variations served to the main menu. The residents said they liked the meals and there was always plenty to eat. On the day of the inspection one of the residents had prepared and cooked the main meal. The residents described the meals as “very good” and “wonderful”. The Gable DS0000064382.V252887.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. The residents’ healthcare needs were identified and met. Personal support was provided in a manner, which respected the residents’ rights to privacy and dignity. Appropriate systems were in place to handle medication. EVIDENCE: The residents’ individual care plans set out the personal support each resident required 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 a key worker system. The residents felt the staff were approachable and one person said, “I can to talk to any of the staff”. Healthcare needs were appropriately assessed and were included in the care plan. There was evidence to indicate the residents had access to NHS services and the advice of specialist services had been sought as necessary. In addition to the care plans each resident had a health action plan, which had been completed by the manager, staff and residents. All the residents were registered with a General Practitioner. The Gable DS0000064382.V252887.R01.S.doc Version 5.0 Page 14 Appropriate policies and procedures were in place to manage medication in the home. The home operated a monitored dosage system for the administration of medication, which was dispensed into individual cassette trays. Records were maintained for the receipt, administration and disposal of medication. Since the last inspection the registered manager had updated the medication administration records and any discrepancies between the records and prescription labels had been checked with a Pharmacist. Not all staff designated to administer medication had received accredited training. The Gable DS0000064382.V252887.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Systems were in place to ensure any concerns of residents would be acted upon. Appropriate policies and procedures were available to respond to any allegations or suspicions of abuse. EVIDENCE: Both informal and formal arrangements were in place for the registered manager and staff listen to and act on the views and concerns of residents. This was achieved during daily conversation, one to one discussion with residents and their key workers and residents’ meetings. There was a complaints procedure included in the service users guide, however, this was very detailed and had to be read carefully. A simplified procedure was displayed in the hallway, but this had not been distributed to each resident. The home had a copy of “No Secrets in Lancashire” and a specific procedure for responding to any suspicions or allegations of abuse. There was a whistleblowing policy and procedure in place for the reference of staff. The Gable DS0000064382.V252887.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26 and 30 The Gable provided pleasant and clean accommodation. Residents were able to personalise their bedrooms and create an individual space suitable for their needs. EVIDENCE: The Gable is an end terrace 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 rooms and one shared room. The home also provides one bathroom and one shower room. The furnishings and fittings were domestic in character and of a good quality throughout. Since the last inspection the freestanding wardrobes had been secured to the walls and several areas had been decorated, including the hallway and shower room. A new television and free view box had been purchased for the living room and a partition had been fitted in the shared room. At the time of inspection, the premises were comfortable, clean and free from offensive odours. There were systems in place for the maintenance and renewal of fabric and decoration. The Gable DS0000064382.V252887.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36 The home had sufficient staff on duty to meet the needs of the residents. However, the staff recruitment process must be improved to protect the people living in the home. EVIDENCE: Staff were issued with job descriptions, which set out their roles and responsibilities. It was evident the job descriptions were linked to meeting the needs of the residents. From discussions with staff and registered manager during the inspection, it was evident they had a good understanding of the residents’ needs and knew the residents well. Staff referred to the residents in respectful terms and were observed to interact in a positive and pleasant way. The staff rotas indicated that the staffing levels were regularly reviewed and additional staff were placed on duty, where necessary, to meet the needs of the residents. There was a recruitment and selection procedure, but this had not been updated to take into account the amended regulations and the implementation of the POVA scheme. One file was inspected of member of staff new to the The Gable DS0000064382.V252887.R01.S.doc Version 5.0 Page 18 home. The person had completed an application form and attended an interview. However, there was only one written reference on file. All new employees undertook an in house induction and a LDAF induction training course. Each member of staff had a training and development plan and had attended various external training courses, which included disability awareness, risk assessment and challenging behaviour. At the time of the inspection one person had completed NVQ level 2, one member of staff was waiting for accreditation and one person was working towards NVQ level 2. This equated to 20 of the care staff trained to this level of qualification. Staff meetings were held on a regular basis. The meetings gave the opportunity to staff to share experiences and develop teamwork. The registered manager ensured staff received supervision at least six times a year and had an annual appraisal of their work performance. The Gable DS0000064382.V252887.R01.S.doc Version 5.0 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 40 and 42 The management approach promoted positive relationships between the staff and the residents and the overall atmosphere was open and friendly. Effective systems were in place to protect the health and safety of residents. EVIDENCE: The registered manager had the 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 the Registered Manager’s Award and was working towards NVQ level 4 in Care. The management approach was consultative and there were systems in place to consult both staff and residents. Relationships within the home were positive and staff spoke about the residents with respect. In turn the residents described the staff as supportive and approachable. There was a full set of policies and procedures, which had been devised and The Gable DS0000064382.V252887.R01.S.doc Version 5.0 Page 20 implemented by the previous registered providers. However, the registered manager explained that all the policies and procedures will be reviewed and updated, in line with the change of ownership. Staff received health and safety training, which included food hygiene, first aid and fire safety. Information was available on infection control and three staff including the registered manager had completed a training course on this topic. The electrical and heating systems were serviced at regular intervals. In addition to a central valve fitted to the main hot water system, a preset valve was fitted to the bath. Hazardous substances were stored in the cellar. The registered manager had carried out risk assessments of the environment and there was a procedure in place for the reporting of any incidents or accidents. The Gable DS0000064382.V252887.R01.S.doc Version 5.0 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x 3 Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x x 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 2 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Gable Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x 3 x DS0000064382.V252887.R01.S.doc Version 5.0 Page 22 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. 1 Standard YA1 Regulation 5 Requirement The service users guide must contain details about the relevant qualifications of the registered provider, manager and staff. Two written references must be obtained prior to employment for all new members of staff. Timescale for action 01/12/05 2 YA34 18 & 19 Sch 2 &4 13/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard YA20 YA23 YA32 YA34 Good Practice Recommendations All staff designated to administer medication should receive accredited training. All residents should be issued with a simplified version of the complaints procedure. 50 of the care staff should achieve NVQ level 2 by 2005. The recruitment and selection procedure should be updated to take into account the recent amendments in the Care Homes Regulations 2001 and implementation of the POVA scheme. The registered manager should achieve NVQ level 4 in Care by 2005. DS0000064382.V252887.R01.S.doc Version 5.0 Page 23 5 YA37 The Gable Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Gable DS0000064382.V252887.R01.S.doc Version 5.0 Page 24 - 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!