Inspection on 12/09/07 for The Gables

This inspection was carried out on 12th September 2007.

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 5 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 10/08/06

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 12 and 21 September 2007 10:00 th st The Gables DS0000000533.V343930.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.V343930.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.V343930.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 Dianne Joan Brown Mrs Dianne Joan 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.V343930.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. 10th August 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. 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 has a Service User Guide and a copy of the inspection report is available in the home. The home’s weekly fees are £383. The Gables DS0000000533.V343930.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 periodic unannounced key inspection visit. The inspection was conducted over two days. Time was spent talking to the homeowner and other staff members on duty. The information about the people who live in the home was reviewed to see if their needs are met. Each of the residents who live in the home were spoken to either individually or in groups. Other records that must be kept were reviewed and a tour of the building took place to see if it met the needs of the residents. Questionnaires were returned from all nine residents and three visitors prior to the inspection. Information from these is used in the report. What the service does well: What has improved since the last inspection? Many of the systems in the home are still not good, however the proprietor/manager has worked to improve the administration. Care plans are improving to identify the needs of residents and how these should be met. The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 6 Some improvements have been made in the home to benefit residents but much work is still to do. The proprietor/manager has completed an annual quality assessment and in this has identified many of the issues that affect the standard of care provided to the residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Gables DS0000000533.V343930.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 DS0000000533.V343930.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a range of information for prospective residents but this is not always offered. The information should also be updated. A system is in place to enable the proprietor to be confidant the needs of people admitted to the service can be met. EVIDENCE: The home has a statement of purpose and service user guide but these have not been updated to reflect changes in personnel. The newest resident was not offered a copy of this information before she moved into the home. A system involving the proprietor and appropriate professionals is in place for new referrals, to reduce the possibility of accepting an unsuitable placement. The newest resident was only offered a place in the home after some short stays and a pre-admission assessment involving appropriate professional people. The proprietor always takes account of the effect on her existing residents when reviewing a placement. The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 9 The latest resident stated that she enjoys living in the home and that she was made very welcome by the staff and other residents. She said it was her choice to live in this home following some overnight stays. The home’s records showed the manager had asked the resident for information about her lifestyle to assist staff in providing appropriate support. A record of information provided by care management was also in place. The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Case records are in place that demonstrate residents are involved in how and when staff provides support. But regular evaluations with residents does not take place. Residents are involved in decision-making and they are supported to take risks. 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 a fulfilling life. During the day residents were seen going out alone and supported by staff where appropriate. The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 11 Three care plans were reviewed that showed work has been done by the manager to improve the information to staff to be used in supporting residents in their daily lives. However, some of the information was not reviewed regularly and when issues are identified they are not always progressed. One resident’s goal to ‘walk for health’ was not reviewed for 3 months. A good plan to motivate a resident to go out more was in place. A system is in place for residents to meet with their key worker on a regular basis but management checks have not been done to ensure this system is working for the benefit of the resident. The manager has produced a range of risk assessments to ensure residents involved in daily living tasks are safe. Residents are supported to manage their finances and a system of recording is in place that monitors this so that an audit can be done. The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to live a normal life in the community and have access to a range of community facilities. Residents receive encouragement and support to enable them to be in control of their own lives. Residents are supported to meet with family and friends. Residents choice with respect to meals is provided and staff encouragement is provided to eat healthy meals. The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 13 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 and they are supported by staff if required. All three responses to a questionnaire were content with the support provided by staff in the home. The social life of each resident is different. Some residents go to a day service. two attend church each Sunday and another two go to a local drop-in centre each week.. 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. Goal plans have been developed to support residents to be active but as described previously, not all of these plans are regularly evaluated and followed up. 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.V343930.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff do not promote good personal care but rather respect each residents independence. Staff obtain appropriate professional support to maintain residents emotional and physical healthcare needs. The home has medication procedure appropriate to the size of the home but recording should be improved to ensure residents are safe. EVIDENCE: Staff are sensitive to the mental health needs of each resident; this was demonstrated throughout the inspection. The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 15 Each residents care plan includes details of regular appointments with appropriate professional people who monitor the health and wellbeing of each person. The care plans included details of mental health and wellbeing, some of these were regularly monitored but some had no assessment done for three months. One plan identified an issue with weight but this was not followed up with any action to be taken. Care plans that are regularly evaluated ensure that residents’ health and wellbeing is maintained. Each resident’s right to privacy is respected but by respecting each residents right to maintain their own standards for personal hygiene, dignity may be compromised. An agreement relating to standards of personal care is not in place to prompt residents should mental health issues affect their normal standards. The home’s policies and procedures for recording and dispensing medicines are well written and have been signed by staff as read. Residents who self medicate have been assessed as competent and these details are recorded in care plans. Five of the six staff who dispense medicines have completed the accredited training course. The following elements should be addressed for the safety and wellbeing of the residents. Whiteout has been used to correct medication records and a prescribed medicine is given in different doses. The manager stated this is agreed by the GP but not recorded properly in the records. The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ opinions are valued and staff are trained to protect them from abuse. 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 available to staff in the home. The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents enjoy living in the home but the standard of maintenance is not good and some improvement is required in the standards of cleanliness. EVIDENCE: The residents all enjoy living at The Gables and are proud of their home. Bedrooms are decorated and personalised to the individuals taste. The manager has produced an improvement plan for the home and some redecoration in the lounge and residents bedrooms has taken place. The manager employed someone to relay a bathroom floor but this has since been re-lifted as water was affecting the adhesion to the floor making it dangerous for residents. Pull chords in the bathrooms were dirty and should be The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 18 replaced. Generally the cleanliness in the home was not of a suitable standard. The manager is aware of this and is producing a new cleaning schedule to address this. The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 19 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): 32, 34, 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A system is in place to ensure a well-trained staff team supports residents. Recruitment procedures ensure residents are well protected. EVIDENCE: Staff are employed in appropriate numbers to provide support for the residents. Staff were praised by the residents for the care and support they provide, both during the inspection and in the completed questionnaires. Most of the staff team have a National Vocational Qualification (NVQ) in care and the manager monitors the training to ensure it meets the needs of the resident group. The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 20 The manager is aware of issues of equality and diversity and two staff in the home have recently completed this training. This helps to ensure residents rights are maintained. Two staff files were reviewed to identify whether the manager has robust procedure to ensure residents are safe. Effort was made to ensure appropriate references were obtained and criminal record bureau checks were in place. Each new staff member has an induction and they provided with a copy of the GSCC codes of conduct to ensure residents receive appropriate levels of care. The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A knowledgeable caring proprietor supports residents and directs staff to ensure a good standard of care is provided. There has been some development in quality monitoring and administration processes are improving. Systems are being improved to ensure the home is clean and safe for the residents. The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 22 EVIDENCE: The proprietor has managed the home since 1987 and she has obtained the Registered Managers Award. This demonstrates her competence to manage a care home for vulnerable people. She is very knowledgeable about the individual needs of the residents and is respected by the staff team. Administration processes have been improved recently. Staff 1-1 supervision sessions take place and some auditing of systems is taking place, although this has not been regular of late. Senior staff are still not aware of the home’s systems and these can fail when the manager is not on duty. For consistency senior staff must be involved in the maintenance of all systems used to support residents. The proprietor does not have a system for assessing the quality of care provided. However, training plans are in place for staff, improvements have been made to care records and residents confirmed they are asked to comment about the care provided. Residents told me they are very happy in the home and if they have concerns the manager is informed. The manager has identified improvements she wants to make in the home but these have not been costed or programmed. Certificates are in place to show the electrical and gas systems are safe. Fire records are in place and staff training is regular. The home is safe but the standard of hygiene is not good. The manager is currently reviewing the cleaning rotas to improve this area of care. The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 23 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 2 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 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 3 33 X 34 3 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 2 2 2 X 3 X 2 X X 2 X The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 24 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 YA18 YA19 Regulation 12(1)(a) Requirement The manager must ensure that all healthcare issues such as weight monitoring are followed up regularly and that personal care standards are promoted to ensure the dignity of the resident is promoted. Timescale for action 31/10/07 2. YA20 13(2) 3. YA30 YA42 23 The manager must ensure that 31/10/07 any changes made to medication by the G.P. are detailed on the medical administration record. Accredited training must be obtained for all staff administering medication. Errors in recording should be crossed out and not removed with whiteout. The manager must ensure the 31/10/07 home is clean and systems are in place to control infection. Pull chords must be replaced in bathrooms and toilets and a cleaning programme must be produced to ensure good hygiene standards are in place. The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 25 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 YA1 Good Practice Recommendations The manager should update the Statement of Purpose to reflect staff and management changes in the home. Each new referral or new resident should be offered a copy. The manager should ensure the key worker and resident review the plan of care each month and agree any changes to be made. The manager should continue to improve the premises to achieve a pleasant environment. Continue reviewing the standards in the home. Produce a plan identifying areas of improvement and any timescales applicable. Use questionnaires; to involve residents, their visitors and professional people in the process. 2. 3. 4. YA6 YA24 YA39 The Gables DS0000000533.V343930.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 DS0000000533.V343930.R01.S.doc Version 5.2 Page 27 - 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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