Inspection on 12/12/06 for The Gables

This inspection was carried out on 12th December 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Gables 11/09/07

The Gables 17/05/06

The Gables 16/02/06

The Gables 01/12/05

The Gables 11/02/05

The Gables 07/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 The Gables 2/4 Blackheath Park Blackheath London SE3 9RR Lead Inspector Keith Izzard Unannounced Inspection 12th December 2006 10:00 The Gables DS0000006760.V320185.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 DS0000006760.V320185.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 DS0000006760.V320185.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Gables Address 2/4 Blackheath Park Blackheath London SE3 9RR 020 8852 8799 020 8297 2782 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) http/www.milburycare.com/home.html Milbury Care Services Limited Mrs Audrey Grehan Care Home 27 Category(ies) of Learning disability (24), Learning disability over registration, with number 65 years of age (3) of places The Gables DS0000006760.V320185.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 3 places registered for LD(E) are for named service users only. Date of last inspection 17th May 2006 Brief Description of the Service: The Gables consists of 2 linked houses that were built in the late 19th Century, and are situated in a pleasant residential area of Blackheath. They are located within walking distance of Blackheath village, near to shops and other amenities. A railway station and local bus routes are easily accessible. The Gables is one of several care homes owned and run by Milbury Community Services Ltd., all of which are located in the London Borough of Greenwich. The houses are divided internally into 4 flats - 2 on the ground floor, (flats 3 and 4) and 2 on the first floor (flats 1 and 2). One of the ground floor flats (flat 3) was formerly used for service users receiving respite care, but the respite service has now been transferred to another unit in Greenwich. The other flats have different numbers of bedrooms (4, 5,and 6), and therefore allow space for up to 15 service users. Each flat is entirely self-sufficient, with it’s own lounge, dining-area, kitchen, laundry area and bathrooms. There is a large garden at the rear of the property that is available for all service users. The Gables DS0000006760.V320185.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection of this home in the current inspection year and took place on 12/12/06 over a period of 2.5 hours. The previous inspection took place on 17/05/06 and both reports should be read in conjunction as this report both updates and upgrades some of the outcomes for this inspection year, 01/04/06 – 31/03/07. The primary focus of the inspection was to check on compliance with a large number of long outstanding requirements to do with the building and also the progress made to update care records. The Inspector examined records in relation to service users and staff members, reassessed all previous Standards in relation to the previous requirements made and undertook a full tour of the building. Three members of staff assisted the inspection as well as an external auditor. On this occasion no service users were present as all fifteen were attending their day centres, but many of them were seen on the last occasion. What the service does well: What has improved since the last inspection? What they could do better: There are four outstanding requirements in respect of the building and three partially outstanding requirements in respect of the updating of care plans, health care assessments and health care monitoring. The manager has given The Gables DS0000006760.V320185.R01.S.doc Version 5.2 Page 6 a firm undertaking to the Inspector that that the latter will be completed by 01/04/07. 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 Gables DS0000006760.V320185.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 Gables DS0000006760.V320185.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standards 1-5 These Standards were not assessed on this occasion as they were assessed and reported on at the previous inspection on 17th May 2006 and were found to have been met, within the current inspection year. The Gables DS0000006760.V320185.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standard 6 This was reassessed on this occasion, as the Standard was not met at the previous inspection. It was noted that progress had been made on updating care records and that approximately 75 had now been completed. It was acknowledged by the Inspector that the current shortfall related to one particular unit where there had been staff shortages (permanent staff) since the previous inspection. The manager stated that staffing was now improved and that this outstanding requirement would be complied with by 31/03/07 and that reviews are now scheduled on a six monthly basis. This Standard is now almost met. See Restated Requirement 1. The Gables DS0000006760.V320185.R01.S.doc Version 5.2 Page 10 Standards 7 & 9 These Key Standards were not assessed on this occasion as they were assessed and reported on at the previous inspection on 17th May 2006 and were found to have been met, within the current inspection year. The Gables DS0000006760.V320185.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standard 11 A previous requirement to ensure that behavioural guidelines were put into operation in respect of one service user had been complied with. This Standard is now met. Standards 12 &13 These Key Standards were not assessed on this occasion as they were assessed and reported on at the previous inspection on 17th May 2006 and were found to have been met, within the current inspection year. The Gables DS0000006760.V320185.R01.S.doc Version 5.2 Page 12 Standard 14 This Standard was reassessed in response to a previous requirement. The staff team have implemented weekly activity planners entitled “Keeping Track” that have been constructed using the “widget system”, thus facilitating understanding by those service users with communication difficulties. This has facilitated monitoring of whether participation has taken place thus enabling staff and others to be aware of any possible shortfalls in provision of activities and outings for individual service users. As a result clearer evidence is now available that service users are provided with an adequate level of activities and this Standard was met. Three individual records were seen that were comprehensive covering activities throughout the day and which day of the week. The manager had also reorganised the staffing rota to better facilitate the availability of staff at key times to promote activities with service users. This Standard is now met. Standards 15-17 These Key Standards were not assessed on this occasion as they were assessed and reported on at the previous inspection on 17th May 2006 and were found to have been met, within the current inspection year. The Gables DS0000006760.V320185.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standards 18 & 19 In conjunction with Standard 6, two corresponding requirements were made at the previous inspection to update nursing care plans and nursing assessments. As stated in Standard 6, progress has been made on updating care records and that approximately 75 had now been completed. It was acknowledged by the Inspector that the current shortfall related to one particular unit where there had been staff shortages (permanent staff) since the previous inspection. The manager stated that staffing was now improved and that this outstanding requirement would be complied with by 31/03/07. See Restated Requirements 2 & 3 Standard 20 A previous requirement to arrange a new contract for the disposal of unused medication was complied with and this Standard is now met. The Gables DS0000006760.V320185.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standard 22 This Key Standard was not assessed on this occasion as it was assessed and reported on at the previous inspection on 17th May 2006 and was found to have been met, within the current inspection year. Standard 23 Since the previous inspection in May 2006 an incident of alleged verbal abuse toward a service user was reported to CSCI under Regulation 37, as required. The member of staff is still subject to an ongoing investigation by the Community Learning Disability Team under adult protection procedures. This member of staff currently only works with service users under close supervision of other staff and, appropriately, does not work with the service user who made the allegation. The outcome of the investigation will be reported on in the next inspection of the home. During the inspection finances of the home were also being independently audited, by a member of staff from Milbury’s head office. The Inspector witnessed the audit of service users’ monies and was told by the auditor that The Gables DS0000006760.V320185.R01.S.doc Version 5.2 Page 15 the system was well organised, accountable, and with a clear and accurate audit trail. The Gables DS0000006760.V320185.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standard 24 This Standard was reassessed as six restated requirements were again outstanding at the previous inspection in May 2006. Considerable progress had been made in respect of four of them. However, Flat 2 still requires a new lounge and hallway carpet and the kitchen refurbished. Flat 4 still requires a new lounge carpet and requires a new shower screen and flooring in the shower room. See Restated Requirements 4 & 5 Standard 30 The Gables DS0000006760.V320185.R01.S.doc Version 5.2 Page 17 The home was clean and hygienic on the day of inspection. However, Flat 1, laundry facilities remain unsuitable, the manager has discussed this with the Responsible Person but an action plan still needs to be submitted to CSCI as to how this will be addressed. Restated Requirement 6 The previous requirement to provide a sluicing facility for both the emptying and cleaning of commodes was complied with. The Gables DS0000006760.V320185.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standards 32 & 35 These Key Standards were not assessed on this occasion as they were assessed and reported on at the previous inspection on 17th May 2006 and were found to have been met, within the current inspection year. Standard 34 This Standard was assessed as four new staff members had been appointed since the previous inspection. All four personnel files were examined for the new staff and recruitment practice was found to be in accordance with the requirements of Regulation 19 and Schedule 2 of the National Minimum Standards. The required documentation and checks had all been carried out and retained in confidential files that were locked away accessible only to the manager. The Gables DS0000006760.V320185.R01.S.doc Version 5.2 Page 19 The Gables DS0000006760.V320185.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standards 37 & 39 These Key Standards were not assessed on this occasion as they were assessed and reported on at the previous inspection on 17th May 2006 and were found to have been met, within the current inspection year. Standard 42 The previous requirement made to fit magnetic door closure mechanisms to three service user’ bedroom doors was complied with. The Gables DS0000006760.V320185.R01.S.doc Version 5.2 Page 21 The previous requirement to lag exposed hot water pipes had partially been complied with, there remains an area in Flat 4, still to be done. See Restated Requirement 7 The manager informed the Inspector that there had been an ongoing problem with the alarm system resulting in weekly testing of fire call points being deferred pending repair. The manager had been informed that an engineer would attend on the morning of the inspection, as this did not occur the manager phoned head office and was told the matter would be resolved. Given the urgency of the situation, the manager undertook to inform the Inspector if this matter was not satisfactorily resolved quickly. The Gables DS0000006760.V320185.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 X 2 X 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 X 23 3 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 X 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 X X X X X X 2 X The Gables DS0000006760.V320185.R01.S.doc Version 5.2 Page 23 Yes 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 Requirement Care plans must continue to be updated to reflect changing needs. All care plans should be reviewed to ensure they have been appropriately updated. Restated Requirement, previous timescale not met 31/08/06. To ensure that care plans specify in detail the personal and nursing care that needs to be given. Restated Requirement, previous timescale not met 31/08/06. To ensure that care plans specify in detail the personal and nursing care that needs to be given. Restated Requirement, previous timescale not met 31/08/06. Timescale for action 01/04/07 2. YA18 12 (1-3) 01/04/07 3 YA18 12 (1-3) 01/04/07 4. YA30 23 (2) Flat 2 - kitchen to be refurbished. DS0000006760.V320185.R01.S.doc 01/04/07 The Gables Version 5.2 Page 24 Restated requirement, previous timescale of 31/08/06 not met. 5. YA24 23 (2) Flat 4 requires a new lounge 01/04/07 carpet and requires a new shower screen and flooring in the shower room. Restated Requirement, previous timescale not met 31/08/06. Flat 1 - laundry facilities are unsuitable. To produce an action plan for a more suitable laundry area which meets infection control criteria. . Restated Requirement, previous timescale not met 31/08/06. 01/03/07 6 YA30 16 & 23 (2) 7 YA42 13 (4) c Any remaining exposed areas of hot water piping in the building must be effectively lagged to prevent injury to service users. Restated Requirement, previous timescale not met 31/08/06. 01/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Gables DS0000006760.V320185.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Gables DS0000006760.V320185.R01.S.doc Version 5.2 Page 26 - 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. 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