Inspection on 10/08/06 for The Gables

This inspection was carried out on 10th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Gables 12/09/08

The Gables 12/09/07

The Gables 28/02/06

The Gables 18/08/05

The Gables 21/02/05

The Gables 04/10/04

Similar services:

Ashlea Mews Residential Home

Eastwood

West Lodge

Arran House

Avenue Community Nursing Home

Cosin Lodge

Farmborough Court

Cragston Court

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

CARE HOME ADULTS 18-65 The Gables 7 Park Terrace Bedlington Station Northumberland NE22 7JY Lead Inspector Allan Helmrich Key Unannounced Inspection 10th August 2006 10:00 The Gables DS0000000533.V290771.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 Gables DS0000000533.V290771.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 Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Gables Address 7 Park Terrace Bedlington Station Northumberland NE22 7JY 01670-826639 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) Mrs D Brown Mrs D Brown Care Home 11 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (4) The Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two named service users have a Learning Disability. No further admissions should take place for category LD without prior consultation with CSCI. 28th February 2006 Date of last inspection Brief Description of the Service: The Gables is a converted domestic detached house. Care may be provided for 7 adults and 4 older people with a mental disorder. The home is in Bedlington Station near to shops and other community facilities. Accommodation is provided over two floors, 7 bedrooms are single and 2 are doubles. None of the bedrooms have ensuite facilities. A bathroom and toilet are available on each floor. On the ground floor there is a kitchen, dining room and a lounge used by smoking and non-smoking residents. There are 2 yards, one has access from the kitchen that is used for bin storage and the other with seating is used by residents and for domestic purposes. There is no lift in the home making it unsuitable for anyone with a physical disability. The home’s weekly fees are £370 The Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s first annual unannounced key inspection visit. Time was spent talking to the homeowner and other staff members on duty. The home’s care records were inspected and each of the residents spoken to either individually or in groups. Questionnaires were returned from three residents and one visitor prior to the inspection. Information from these is used in the report. What the service does well: 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 Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 6 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 Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 7 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): 2. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. New service users requirements are assessed before admission to the home. EVIDENCE: A system involving the proprietor and appropriate professionals is in place for new referrals to reduce the possibility of accepting an unsuitable placement. The proprietor always takes account of the effect on her existing residents when reviewing a placement. A case record is produced with information needed by staff to ensure appropriate care is provided. The Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 8 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, 9. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Although residents are involved in decision-making and supported to take risks, the case records do not reflect this. EVIDENCE: Residents confirmed they are involved in deciding what to do and where to go. The proprietor and staff talked about good work they do with residents to support them and encourage them to live fulfilling lives. A case record is in place for each resident and some improvements have been made to the information in them. However, much more information is available by talking to the proprietor or staff members. Assessments are not dated, the plans are not regularly reviewed and 1-1 sessions between staff and residents to review goals are not recorded. Risks associated with daily living are identified and recorded. Any necessary strategies to reduce the risks are recorded. Any restrictions agreed with the residents are recorded. The Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 9 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, 15, 16, 17. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents are supported to live a normal life in the community. They have access to a range of community facilities and receive encouragement and support to enable them to be in control of their own lives. EVIDENCE: In conversation with residents they confirmed they choose what to do and where to go. The majority of residents are in regular contact with family and friends. The social life of each resident is different although three residents go to a day service and two attend church each Sunday. During the inspection residents were seen leaving the home to use community services both supported by staff and unsupported. Residents are provided with keys to the home and their own rooms to allow them freedom of movement and privacy. As described previously, not all of the good work done with residents is recorded or developed into goal plans. The Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 10 Staff promote healthy eating with fresh fruit and vegetables included in the daily menus but residents choice is respected. Nutritional assessments are conducted and professional guidance is obtained when necessary. Residents assessed as able have access to the kitchen to prepare snacks and drinks. Support is provided whenever necessary by staff. The Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 11 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, 20. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Staff provide good support that does not take away the independence of residents. Staff deal with sensitive issues well. This is generally done without clear written instruction. Medication procedures should be improved. EVIDENCE: Staff are sensitive to the mental health needs of each resident; this was demonstrated throughout the inspection. Privacy and dignity are respected at all times. Whenever specialist assistance is required, this is obtained but records do not adequately reflect this. A specific record of health visits is not kept and it is difficult to ascertain whether residents receive annual health checks. Any changes in the health of residents is recorded. The home’s policies and procedures for recording and dispensing medicines are well written and have been signed by staff as read. Some staff who dispense medicines have not received accredited training. Medication records contain hand written instructions that are not signed. Medicines dispensed are not signed for immediately. Residents who self medicate are not identified in the The Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 12 records; although they have been assessed as competent and these details are recorded in care plans. These elements should be addressed for the safety and wellbeing of the residents. The Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 13 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, 23. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents’ opinions are valued and staff are trained in abuse awareness but appropriate written guidance is not available to them. EVIDENCE: Residents confirmed they are aware of how to complain and that staff listen to them. The home has a complaints process and a log to record any complaints made. No complaints have been received since the last inspection. Staff have received training in abuse awareness and the proprietor is fully aware of the system for protecting vulnerable people. Department of health guidance for staff regarding abuse awareness is not available to staff in the home. The Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 14 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, 30. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Residents live in a comfortable environment but the standard of appointment is poor. EVIDENCE: The residents all enjoy living at the gables and are proud of their house. Bedrooms are decorated to individual tastes. However carpets in the communal areas are stained and should be cleaned or replaced. The curtains in the first floor bathroom are too wide for the window and are not held on with sufficient hooks. The temperature of the water in the ground floor bathroom fluctuates between 37 and 50°c, this should be serviced to ensure residents are safe. A visitor to the home commented in a questionnaire that the home has deteriorated in recent years and also that it is not clean. Although some redecoration has taken place in the recent past, there is no plan of improvement for the home. The Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 15 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): 32, 34, 35. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. A competent trained staff team supports residents. Recruitment procedures are not good. EVIDENCE: Staffing levels on the day of the inspection met the agreed standards. Residents spoke highly of staff. 50 of the staff team have achieved a National Vocational Qualification in care and other training is ongoing to ensure residents’ needs are well met. The proprietor maintains a training plan detailing the training received and the date. This is used to plan future training. Two staff files were requested, one was not available in the home and the other did not contain; a photograph, details of induction or any 1-1 sessions with management. Recruitment and induction processes must be in place to ensure the safety of residents. The Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 16 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, 39, 42. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. A knowledgeable caring proprietor supports residents. Administration processes are poor. Some processes require improvement to ensure residents are safe in the home. EVIDENCE: The proprietor has managed the home since 1987 and she has the Registered Managers Award. She is very knowledgeable about the individual needs of the residents and is respected by the staff team. Administration processes are not good. 1-1 supervision sessions with staff are infrequent and any discussions with residents are not recorded. Staff meetings do not take place. When the proprietor is not on duty other senior staff are not aware of specific information requested by the inspector. The proprietor has no system for assessing the quality of care provided and does not demonstrate that she reviews work done by staff in the home. The Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 17 Residents are vocal and are happy to inform the proprietor and staff if they are not content. There is no maintenance or improvement programme for the home although works of improvement are done with water heating systems having been replaced and some decoration work been done. The home is reasonably safe although water in one bathroom fluctuated up to 50°c before settling at a comfortable temperature. The home’s certificate of registration is outdated. Fire checks are conducted regularly but fire instruction is not. Accidents to residents are well recorded but not followed up with any action taken. Appropriate maintenance certificates are in place. The Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 18 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 x 2 X 2 X X 2 X The Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 19 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 YA6 Regulation 15(2)(b) Requirement The manager must review the home’s case records and ensure the following actions take place; • Date each assessment after ensuring the information contained in them is correct. • Staff must review the plans on a monthly basis and record any agreed actions. Reviews should be signed by the staff member and resident to confirm agreement. • All agreed goals should be detailed and reviewed as stated above. The process of improving care plans is ongoing, however these specific areas of improvement should be addressed. The manager must record details of all healthcare appointments in a way that identifies when appointments are due. Produce a sheet that identifies healthcare appointments and visits from; G.P. and community nurses, Dentists, Opticians and Chiropodists. DS0000000533.V290771.R01.S.doc Timescale for action 30/09/06 2. YA19 12(1)(a) 30/09/06 The Gables Version 5.2 Page 20 3. YA20 13(2) 4. YA24 23 5. 6. YA30 YA34 23 19 The manager must review the home’s medication procedures; • The process of dispensing medicines should be reaffirmed with staff. The medication chart should be signed immediately following dispensing and should not be interrupted by any other event. • All staff handling medicines should be trained. • The writer must sign hand written entries in medication records. • Residents who selfmedicate should be identified on the medication administration record. • The manager must produce an improvement plan for the home, identifying work to be done. All work to be done within the financial year should be costed with implementation dates. A copy of this plan should be forwarded to the Commission for Social Care Inspection by 31 October 2006. • Badly fitting curtains in the first floor bathroom should be altered and re-hung or replaced. The carpets in the ground floor communal areas should be cleaned or replaced. The manager must have good recruitment processes; • A staff file must be in place for each staff member containing all those elements detailed in Schedules 2 and 4 of The Care Homes Regulations. DS0000000533.V290771.R01.S.doc 30/09/06 31/10/06 31/10/06 30/09/06 The Gables Version 5.2 Page 21 7. YA37 24 8. YA39 24 9. YA42 13(4)(a) A formal induction should be conducted for each new staff member and this should be signed off as competent. • Staff should receive 1-1 sessions with the manager at least 6 times a year. The manager must review her 30/11/06 administration systems in the home to ensure information is available to staff in charge and to ensure systems are being maintained. A pro forma identifying the items to be checked and the frequency should be forwarded to The Commission for Social Care Inspection by 30 November 2006 In addition to the information 30/11/06 detailed in standard 37 the manager must produce a system for reviewing the quality of care provided. This should include obtaining the views or residents, their visitors and professional people who visit the home. Ensure the water temperatures 10/08/06 in the home do not exceed 43°c. After fluctuating the water temperature remained constant within the safe comfortable range. • 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 YA23 Good Practice Recommendations The manager should obtain the Department of Health guidance ‘No Secrets’ to support staff in dealing with abuse awareness. DS0000000533.V290771.R01.S.doc Version 5.2 Page 22 The Gables The Gables DS0000000533.V290771.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Gables DS0000000533.V290771.R01.S.doc Version 5.2 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. 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