Inspection on 23/02/06 for The Gable

This inspection was carried out on 23rd February 2006.

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 13/06/07

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 23 February 2006 11:45 rd The Gable DS0000064382.V276098.R01.S.doc Version 5.1 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.V276098.R01.S.doc Version 5.1 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.V276098.R01.S.doc Version 5.1 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.V276098.R01.S.doc Version 5.1 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 13th 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 previously issued by the Local Authority. The Gable DS0000064382.V276098.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place at The Gable over five hours on 23rd February 2006. The previous inspection was carried out on 13th October 2005. No additional visits have been made to the home since the last inspection. The purpose of the inspection was to assess important areas of life in the home and check the progress made to meet previous requirements and good practice recommendations. On the day of inspection there were 6 residents accommodated in the home. Information was obtained from care records, staff records and policies and procedures. The inspector spoke to the residents, the registered manager and the staff on duty. A partial tour of the premises was also undertaken. What the service does well: Residents were provided with useful information in a format suitable for their needs. Residents’ needs were properly assessed and reviewed at regular intervals. A contract had been issued to all residents, which clearly set out the terms and conditions of residence. Care and support was planned effectively to ensure the residents’ needs were met. Residents pursued a range of activities both inside and outside the home. This approach enabled residents to participate in the life of the home and gave them the opportunity to meet other people. The residents and staff shared good relationships and there was a friendly atmosphere in the home. Residents spoken to said the staff were “really good” and “always approachable”. Systems and policies and procedures were in place to ensure residents were listened to and protected from harm. The residents were provided with a clean, safe and comfortable home. All residents spoken to said, it was a good place to live. Staff had access to a range of training opportunities, which gave them a good understanding of their role and the needs of the residents. The Gable DS0000064382.V276098.R01.S.doc Version 5.1 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 Gable DS0000064382.V276098.R01.S.doc Version 5.1 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.V276098.R01.S.doc Version 5.1 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. Since the last inspection the service users guide had been updated to include 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 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.V276098.R01.S.doc Version 5.1 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 and 8 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 two residents had partially completed their care plan. 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.V276098.R01.S.doc Version 5.1 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 Gable DS0000064382.V276098.R01.S.doc Version 5.1 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): 11, 12, 13, 14, 15 and 16 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.V276098.R01.S.doc Version 5.1 Page 12 particularly enjoyed going out for meals at local restaurants. Staff provided assistance with activities as necessary and had a knowledge of events in the nearby area. The residents also pursed a number of educational activities, which included attending the local college. 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. One resident was visiting his family at the time of the inspection. 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 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. 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 Gable DS0000064382.V276098.R01.S.doc Version 5.1 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, “they are all good, they understand me”. 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.V276098.R01.S.doc Version 5.1 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. However, not all staff designated to administer medication had received accredited training. The Gable DS0000064382.V276098.R01.S.doc Version 5.1 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. Since the last inspection the complaints procedure had been produced in a simplified format to supplement the detailed complaints procedure contained in the service users guide. All residents had been issued with the new procedure. The residents were aware that they could raise a concern at any time and said they would talk to the registered manager. 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.V276098.R01.S.doc Version 5.1 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 and 30 The Gable provided homely 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. On a partial tour of the premises it was evident the residents had personalised their rooms and other meaningful possessions. At the time of the inspection work was being carried out to upgrade the bedroom doors in line with advice from the Fire and Rescue Authority. Whilst systems were in place to maintain and repair the building, a planned maintenance and renewal programme for the fabric and decoration was not available. At the time of inspection, the premises were comfortable, clean and free from offensive odours. The Gable DS0000064382.V276098.R01.S.doc Version 5.1 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 residents benefited from well supported and supervised staff, who were in sufficient numbers to meet the needs of the residents. 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. Since the last inspection the staffing structure had been reviewed and one member of staff had been promoted to the role of a senior support worker. This person acted as manager in the absence of the registered manager. There had been no recruitment of new staff. The recruitment procedure had been updated, however, the procedure did not refer the POVA list or the The Gable DS0000064382.V276098.R01.S.doc Version 5.1 Page 18 requirement to obtain a reference from previous employment, which involved work with vulnerable adults or children. 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, which equated to 25 of the staff team. Two members of staff were working towards NVQ 2. 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.V276098.R01.S.doc Version 5.1 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 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. Results of satisfaction surveys should be collated and published to demonstrate the residents’ views underpin the development of the home. 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 waiting for accreditation on a recently completed 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. The Gable DS0000064382.V276098.R01.S.doc Version 5.1 Page 20 In January 2006, the registered provider was awarded an Investors in People Award. The registered manager carried out monthly audits of the care plans and the environment. Satisfaction questionnaires had been distributed to the residents, families and stakeholders in the local community. However, the results of the survey had not been collated and fed back to all interested parties. 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.V276098.R01.S.doc Version 5.1 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 Standard No Score 1 3 2 3 3 X 4 X 5 3 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 2 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 2 X X 3 X The Gable DS0000064382.V276098.R01.S.doc Version 5.1 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. 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. 2. 3. 4. Refer to Standard YA20 YA24 YA32 YA34 Good Practice Recommendations All staff designated to administer medication should receive accredited training. A planned maintenance and renewal programme for the fabric and decoration of the premises should be developed. 50 of the care staff should achieve NVQ level 2. The recruitment and selection procedure should be updated to include reference to the POVA list and the requirement to obtain a reference from previous employment, which involved contact with vulnerable adults or children. The results of satisfaction surveys should be collated and published and made available to all interested parties. 5. YA39 The Gable DS0000064382.V276098.R01.S.doc Version 5.1 Page 23 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.V276098.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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