Inspection on 13/09/07 for The Gables

This inspection was carried out on 13th September 2007.

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 Gables 02/09/08

The Gables 19/07/06

The Gables 12/01/06

The Gables 11/10/05

The Gables 07/02/05

The Gables 28/07/04

The Gables 29/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Gables, The 161 Morley Road Oakwood Derby Derbyshire DE21 4QY Lead Inspector Angela Kennedy Key Unannounced Inspection 13th September 2007 09:30 X10015.doc Version 1.40 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 Gables, The DS0000001975.V341479.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 Older People. 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. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gables, The Address 161 Morley Road Oakwood Derby Derbyshire DE21 4QY 01332 280106 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) www.gableshome.co.uk Ms Margaret Valerie Morris Ms Margaret Valerie Morris Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 4 Day Care places Date of last inspection 19th July 2006 Brief Description of the Service: The Gables is a 28 bedded home for older people situated in the residential area of Oakwood in the suburbs of Derby. The property was originally a farm, which has been converted into a care home. Residents’ bedrooms are located on the ground and first floor and are accessed by a shaft passenger lift. There are 28 single rooms, 16 are en suite and 12 are non-en suite, 1 of which is a double room used as a single. There is an attractive garden area with garden furniture. A wide range of health services are available including a choice of General Practitioner, district nurse, chiropody, dentist and optician. Staff training takes place to inform and enable staff to care for service users appropriately. A programme of leisure activities and social events are in place. The current scale of charges at the home at the time of this inspection were: en suite rooms £380 per week and non-en suite rooms £360 per week. Items not covered by the weekly fee included: Newspapers, hairdressing services- price list available within home, chiropodist at £8.00 per visit, dentist at £15.90 per visit, personal clothing, personal toiletries, telephone costs/calls and personal transport arrangements. Further information regarding the home can be provided by contacting the registered provider- Mrs Margaret Morris on Tel: 01332 280106 or by email at: jayne@gableshome.co.uk Information regarding the home and the services provided are also available on the homes website at: www.gableshome.co.uk Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection visit was unannounced and took place over 7 hours. Key inspections take into account a wide range of information and commence before the site visit by examining previous reports and information such as any reported incidents. The site visit is used to see how the service is performing in practice and to meet with residents and their representatives. The inspection was focused on assessing compliance with defined key National Minimum Standards. The commission had requested the service to complete an Annual Quality Assurance Assessment and the information provided within this assessment has also been used within this inspection report. The registered manager was present at the inspection. Staff opinions were also sought to ascertain their views of the service and their opinion of the training and support provided to them. Three residents were case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at care plans and other documents relating to that persons care, talking to staff regarding the care they provide, talking to the resident if they are able to communicate or observing the care they receive. One visitor was also spoken with to gain their views on the services and care provided at a The Gables. What the service does well: The Gables is maintained to a high standard and provides attractive and comfortable indoor and outdoor facilities for the people that live there. The information gathered regarding each resident from individuals and their representatives demonstrates that the service endeavours to provide a person centred approach to residents care. Efforts are clearly made to engage residents in activities and events to ensure their social needs are met and various leisure activities are provided for residents who wish to participate. The food provided is of a good quality, well presented, varied and nutritionally well balanced. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 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. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 7 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. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Admissions to The Gables were not made until a full needs assessment had been undertaken, to ensure the service was confident that staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. EVIDENCE: The written information provided by The Gables prior to this inspection stated that: Before the services users move into the home, their needs are assessed, documented and comunicated to other senior members of staff, to ensure their needs are met. We make sure that every service user feels comfortable by building a good rapport with them and their families. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 10 Our assessment and care plans are up-to-date, along with every service users wishes, difficulties and needs. On the day of the inspection visit: Pre admission assessments were in place within the three residents files seen. These assessments addressed all areas of personal, health and social care needs and recorded medication prescribed on admission and past medical history. Fire risk assessments were also undertaken on admission. Which assessed each resident in relation to his or her ability to evacuate the home in the event of a fire. These assessments instructed staff on the support that was required by staff in order for each resident to evacuate the building safely. The Gables does not provide intermediate care; therefore standard 6 was not assessed. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents health,personal and social care needs and how they are to be met are set out in their plan of care, with resident involvement . The homes medication practices in general protect residents but require further detail to demonstrate that residents safety is enhanced. Residents were treated respectfully and their right to privacy maintained. EVIDENCE: The written information provided by The Gables prior to this inspection stated that: We train all our staff to treat every service user with respect and dignity, and to give them privacy at all times. Care plans and records relating to their health and personal care are kept constantly up-to-date and treated with confidentiality. These records reflect Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 12 any changes in their condition, which we then act upon and review on a continuing basis. Service users have access to specialist medical services, we involve service users in discussions that affect their well-being. We support families as well on a daily basis, and show compassion when it is needed, and when their relative is ill or dying. We endeavour to make sure that senior staff are well trained and competant with the handling and administration of medications. On the day of the inspection visit: Within the three residents files seen all had care plans in place that had been developed from the pre- admission assessment of need. Each care plan seen looked at the area of need/support and the goal to be achieved, and stated the intervention/support that was required for this goal to be achieved. Each care plan was reviewed on a monthly basis or more frequently if required. Care plans not only looked at the resident’s health care needs but also included spiritual, religious and cultural needs. Bibles were also provided to residents upon admission if they wished to have one, and records were in place to demonstrate that this was done. ‘Getting to know you’ forms were also in place for staff to gather information about each individual’s life history, likes and dislikes and interests and hobbies. Staff gathered this information over a period of time on and following admission, and as provided by each individual or their representatives. This allowed staff to gain a greater understanding of each individual and their preferences. This demonstrates that the home strives to get to know residents on a personal and individual level, which inevitably will ensure that a more person centred approach to their care, can be maintained. Assessments were also in place that looked at the residents mental health, moving and handling, pressure areas, continence needs, personal care needs, supervision inside and outside of the home, activities and keeping occupied and socialising. Although assessments had been undertaken regarding each persons mental health, discussions with the manager confirmed that assessments regarding rights to choice, freedom and decision making had not been undertaken for any resident whose ability to make decisions might be impaired. Assessments regarding dental care and nutrition were in place and reviewed each month. Monthly weighing was also in place within the residents files seen and all health care professional visits were also recorded. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 13 There was no evidence within the care plans seen to demonstrate that residents had been given the opportunity to be involved or consulted in the formulation of their care plans. This was discussed with the manager and discussions took place as to how this could be achieved. It was confirmed by the deputy manager that care reviews took place for each person living at the Gables. Care managers held annual reviews for all residents funded by the local authority and for residents that were self-funding the home undertook six monthly care reviews. It is therefore recommended that one review per year be also undertaken by the home for residents who are funded by the local authority. This would ensure that all residents’ care is formally reviewed on a six monthly basis. On the day of this inspection visit a care review was being held at The Gables and the resident and their representatives were involved within this review. The medication practices of the home were also examined, this included looking at all of the medication stored, which was correctly stored and labelled, and the medication administration records which had been signed and administered appropriately, this included controlled drugs. One resident had chosen to self-administer their medication. A disclaimer was in place and had been signed by the resident to demonstrate their agreement to do so and their agreement to store their medication safely. The deputy manager also confirmed that the resident’s G.P was aware that they were self administering their medication and were in agreement with this. However no written risk assessment had been undertaken regarding the individual’s ability to carry out this agreement. Discussions took place with the manager and deputy regarding residents who chose to self-administer their medication and the need for each person to have a written risk assessment in place. This was to demonstrate that they had been assessed as having the capacity to store and administer their medication safely and as prescribed. It was also noted that equipment such as pill counters were not available for staff to count medication such as some controlled drugs. This was discussed with the deputy manager and it was recommended that such equipment be purchased to ensure medications that need to be counted can be done so following the correct guidelines. Residents spoken with were very complimentary regarding the care and support provided to them by the staff team. Comments included “the staff are very nice, I’ve no complaints” and “ the staff are very good, it’s a nice home, I’m happy to be here”. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 14 All of the residents spoken with said that they were treated respectfully by the staff and confirmed that their privacy and dignity was maintained. Observations of staff with residents on the day of this inspection visit also demonstrated a courteous and respectful attitude was afforded to residents. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel that the daily routines and the range of activities meet their needs. Relatives are made welcome so that important contact for residents is maintained. There is a varied menu provided so that residents enjoy their meals. EVIDENCE: The written information provided by The Gables prior to this inspection stated that: Service users are encouraged to take part in various activities that we hold in house, we also arrange events outside the home. We help and support service users to make choices and gain independence in their everyday lives, families are involved and encouraged to take their relatives out to continue their nornal social activities. We run a home with a good, happy environment and take into account the service users capabilities and needs to make sure that we make their surroundings and daily livings as comfortable as possible. We provide good nutrional meals with choices seven days a week. We have an advoccay service that we subscribe to plus other outside agencies. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 16 We also provide a monthly newsletter to inform everyone of results of questionnaires and other forthcoming events etc. On the day of the inspection visit: At the time of this inspection there was no activities coordinator in post, although the manager confirmed that the home was seeking to employ an activities coordinator. Despite the lack of a designated coordinator for activities there was evidence to demonstrate that a programme of activities was in place. This included quizzes, bingo, and movement to music sessions, film and video sessions, manicures, hairdressing services, clothes shows and coffee mornings. Monthly services from The Church of England and The Roman Catholic denomination were held at The Gables for any residents who wished to participate. A library was also available at The Gables for residents and one resident attended the local luncheon club. Activities were also arranged outside of the home such as trips and meals out and the weekend before this inspection visit the home had held a garden party for the residents and their friends and relatives. Discussions with the residents were generally very positive regarding the activities and events provided by the home and included “ I go out twice a week and I find there’s always things to do, if you want to join in” and “ I try and join in with everything, I think the days seem to go very fast, there’s always something you can do if you want to”. Another resident stated that although there were activities available, they did not always want to join in with them, and stated that they would like more quizzes to be available. This information was fed back to the manager. One of the relatives spoken with said they felt there always seemed to be activities planned and discussed the recent garden party, which they confirmed was very enjoyable. The home had an open visiting policy and residents spoken with confirmed that they were able to entertain their visitors within their private accommodation or within the communal areas, as they preferred. Several of the residents had visitors on the day of this inspection, residents and their relatives were also seen within the attractive gardens of the home and some of these residents were seen going out with their family and friends. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 17 Advocacy services were advertised within the home for any resident or their representative who wished to use this service. Residents were able to vote and used postal votes to do so. Within the residents files looked at, the residents were given the option to attend their local polling station, if they preferred. The dining area was attractively decorated and tables were presented in an attractive manner. The Chef worked from 7.30am until 2pm and of the three kitchen assistants employed, one was on duty each day from 8am until 2pm and from 4pm until 6pm. At least two choices were provided at the main lunchtime meal and residents spoken with confirmed that if they did not want the meals on offer they were able to chose an alternative. Some members of staff spoken with felt the dishes provided were not to the tastes of many of the residents and stated that more ‘old fashioned’ meals would be preferred. However of the residents spoken with the majority stated that they enjoyed the meals and thought they were of a very good quality. One resident stated “ I have a cooked breakfast every day which I thoroughly enjoy and just have a pudding at lunch as I’m not really that hungry. I do think the teatime choices could be more adventurous such as take- a -ways or spaghetti Bolognese, rather than salads or something on toast.” This was discussed with the deputy manager who stated that she was aware of this resident’s preferences and confirmed that alternatives were offered including the option to order take – a -way meals. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes complaints procedure was clear and accessible to residents and visitors of the home. Resident’s protection was enhanced by the homes policies, practices and training. EVIDENCE: The written information provided by The Gables prior to this inspection stated that: We demonstrate to everybody that we are committed to an open culture policy. We observe closely and make everybody aware we do not tolerate any form of abuse to anyone staying at, working at or visiting our home. We take great care in only employing people who have a caring demeanor and attitude. We have not had any complaints but have a good complaints procedure in place and understand the process should they arise. Most of our staff are now NVQ trained. On the day of the inspection visit: Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 19 The homes complaints procedure was seen and found to be satisfactory. The complaints log was seen and provided a good description of each complaint, including any precipitating factors and gave a detailed description of the action taken for each complaint and how each complaint was resolved. No complaints had been made since the last inspection. Discussions took place with the manager regarding any informal concerns that had been raised such as items of missing clothing and the manager confirmed that such concerns were always addressed promptly. To demonstrate this, it is recommended that informal concerns are recorded, including the actions taken and outcome. These records could be held within each individual’s personal file. Residents and relatives spoken with were aware of the complaints procedure, although everyone spoken with said they had no complaints. Residents spoken with said that if they had any concerns they would speak with the manager and confirmed that they were confident that any issues they had would be promptly addressed. The homes safeguarding adults policy made reference to Derbyshire’s local authority procedure, and staff spoken with were aware of this procedure. The majority of the staff team had undertaken safeguarding adults training and one member of staff was due to attend this training within the near future. No safeguarding adults referrals have been made at the home since the last inspection. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Gables is furnished, cleaned and maintained to a good standard, providing residents with a safe, pleasant and comfortable place to live. EVIDENCE: The written information provided by The Gables prior to this inspection stated that: It has always been important to ensure that we run a well maintained environment, and a happy home. We always make our home a safe comfortable and clean home for our service users. We always listen to service users and carry out any requests they have to the best of our ability. We strive to improve facilities for all staff, service users and families. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 21 Everybody works to a high standard of hygiene to control infections. Our house keeper is in charge of the laundry to ensure a good service is received when dealing with the service users clothes. On the day of the inspection visit: A tour of the building was undertaken and all areas seen were well maintained and decorated to a good standard. The bathrooms seen were clean and attractively decorated, giving a homely feel, but were spacious enough to provided sufficient room for moving and handling equipment. The laundry area housed two washing machines and one of these had a built in sluicing facility for the sluicing of any soiled items prior to washing. A member of staff was employed to manage the laundry requirements of the home. The laundry area was sited so that no soiled articles had to be carried through any food storage, preparation or eating areas. Residents spoken with were happy with the laundry services provided and comments included “ the laundry service is very good. Someone collects my laundry bag and my clothes are returned clean and ironed, its lovely not having to do it yourself” and “ my clothes are always returned nicely ironed, its very good”. Some resident’s private rooms were seen and were personalised with their own belongings and maintained to a good standard. Residents spoken with were very happy with their private accommodation and confirmed the home was always kept clean and tidy. The home and grounds are set away from the main road and allowed privacy to residents who wished to sit outside. The grounds of the home were maintained to a high standard and were attractive in design. Resident were able to access the grounds and many residents and their relatives were seen within different areas of the grounds on the day of the inspection. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Gables had staff in sufficient numbers and with appropriate training to meet the needs of the residents. There were appropriate recruitment procedures to safeguard residents. EVIDENCE: The written information provided by The Gables prior to this inspection stated that: We make sure staff are competant and understand the aims of the home. By this we have a good team who are long standing and well trained to NVQs 2 and 3. Staff are carefully picked for their caring disposition and competence. We reward staff for their achievements and make them feel valued. We also have a good staffing structure in place, and encourage staff who wish to become more qualified and multi-skilled. On the day of the inspection visit: The manager, deputy and team manager were available during office hours, to support the staff team. One senior member of staff and a minimum of two care Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 23 staff were on shift in the morning and afternoon and two staff were on duty each night. The deputy manager confirmed that herself and the team manager shared the on- call service available to the staff team during evenings and weekends. The home also employed a maintenance person and an administrator who worked Monday to Friday. The kitchen was staffed throughout the day until 6pm . Housekeeping and domestic staff were also on duty from Monday to Saturday. Of the twenty four care staff employed, twenty one members of staff had achieved a National Vocational Qualification (NVQ) at level 2 or level 3 in care and six staff were presently undertaking training at NVQ level 2 or level 3. This demonstrates that the homes achieved the national target of 50 of the care team achieving a NVQ at level 2 or above. The recruitment practices of the home were examined in three staff files and the records seen demonstrated thorough recruitment checks were made prior to employment.This included the home’s application for employment forms which now requested a full employment history and written confirmation as to any gaps in employment. This was a requirement at the last inspection, which has now been met. Staff training records were examined and evidence was in place to demonstrate that mandatory training such as moving and handling, fire training and first aid, and training specific to residents needs, such as skin and pressure area care was undertaken on an ongoing basis. Staff spoken with confirmed that the training opportunities provided were good. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. In general the home was well managed, however safe working practices regarding moving and handling procedures were not being followed, which potentially puts residents and staff at risk of injury. EVIDENCE: The written information provided by The Gables prior to this inspection stated that: We have a good management team consisting of four main people. We consistently look at our performance and work together to improve our knowledge and skills. As part of a management team, we work together well to Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 25 make sure that standards are met to ensure the best possible outcome for the service users. We all have a great input into the quality assurance. Part of this being listening to people and drawing up realisitic and constructive plans to improve our service, whether it be for the individual or the home itself. We have a good system in place for handling service users money, to safeguard and protect their interest. We work hard to ensure the health, saftey and welfare of sevice users and staff by training everybody to know what their responsibilities are as well as ours. On the day of the inspection visit: The registered manager/provider has worked in care since 1986 and has owned/managed the Gables since 1990. She has achieved an NVQ 4 in care and a management certificate and presents as competent and approachable. The quality assurance practices of the home were examined, questionnaires were sent out every six months to residents, relatives and visiting professionals. At the last inspection it was noted that the home had no formal method of feeding back the results and actions taken from the audit of their satisfaction surveys. A newsletter has now been produced and the September issue was seen that provided information on the information gathered from the recent resident survey, including the suggestions made to improve the service and the actions taken. Information obtained from the relatives and friends survey was also included in this newsletter. This demonstrates that a proactive approach is used in ensuring residents opinions and wishes are sought, and enables the service to be run in the best interests of the people who live there. The newsletter also provided information on the services provided at The Gables such as hairdressing, chiropody and manicure services and looked at recent activities and events undertaken, including verbal feedback received from residents and their friends and family. Apart from being interesting reading for residents this also provides an additional insight into the services and events provided at The Gables, for any prospective residents. The financial transaction records of the resident’s case tracked were checked against the monies held for them. All records held corresponded with the monies held and two signatures were provided at each transaction. This was a recommendation at the last inspection, which has now been met. Resident were able to retain their own finances if they wished to, and were able to, this included small amounts of money which could be kept within Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 26 residents own private accommodation and secure facilities were provided for this purpose within residents rooms. During a tour of the building two staff were observed transferring a resident from their wheelchair, to an armchair in the lounge area. The two staff did not use any moving and handling equipment and assisted this resident by holding the resident under their arms. This practice is not acceptable and could harm the resident and the staff undertaking this procedure. Any resident who is unable to stand unaided must have suitably assessed moving and handling equipment in place to ensure safe procedures are followed. The staff spoken to regarding this stated that there was insufficient equipment available to use. Discussions took place with the manager and deputy manager regarding this and it was confirmed that moving and handling equipment was available for staff use and that staff had received training in the use of this equipment. The manager confirmed that three moving and handling belts were available for staff use. However clearly these were not being used on the day of inspection .It was therefore suggested that moving and handling belts be made available to all staff and be worn as a compulsory part of their uniform to ensure they are available at all times. Although a hoist was available it was confirmed that residents who required use of the hoist had not been assessed to do so, this included the sling size that was to be used for hoisting each individual. Discussions took place with the manager regarding the importance of ensuring each individual is assessed by the appropriate professional to ensure safe practice is maintained. Only 50 of the catering team had undertaken training in food hygiene. Discussions with the manager confirmed that the 50 of staff that had not undertaken this training were not involved in food preparation or cooking, but dealt with pot washing and cleaning tasks. However all staff that work within a food preparation area must undertake appropriate training to ensure safe practice is maintained. The guidance regarding care homes providing first aid has recently been amended and allows services to undertake a first aid risk assessment specific to their individual service. Information pertaining to the factors that can be taken into account and the criteria for who can be regarded as a qualified first aider were given to the manager at this inspection visit. However if a risk assessment is not in place the Commission will require that someone who has undertaken a suitably approved first aid at work qualification be on duty at all times. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 27 Some service/maintenance documentation was looked at and indicated that residents are protected by robust procedures, with all evidence of gas and electrical services having been suitably checked/maintained. Fire drill records were in place that indicated that fire alarms were tested weekly, to ensure that any faults in the system were detected and rectified. Measures were in place to reduce the risk of Legionella, and a hot and cold water valid sterilisation certificate was in place. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 1 Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? NO 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 OP9 Regulation 13 Requirement Timescale for action 21/12/07 2 OP9 13 (2) 3 OP38 13 (5) 4 OP38 19 (5) (b) Risk assessments must be undertaken for all residents who wish to retain and selfadminister their medication to demonstrate that they have the capacity to do so safely. Pill Counters should be 21/12/07 purchased to ensure medication is handled in accordance with pharmaceutical guidelines. Suitably assessed moving and 01/12/07 handling equipment must be in place and used for residents who are unable to stand or move unaided. All staff working within food 31/01/08 preparation areas must undertake appropriate training to ensure safe practice is maintained regarding food hygiene. Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 30 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 OP7 Good Practice Recommendations Residents who are unable to make any or all decisions regarding their life should have an assessment in place that demonstrates the assessment has been formulated with the resident and/or their representative. The assessment must state the designated representative to be consulted regarding decisions for that resident, and that all decisions made will be documented, including the reasons for the decision. Records must demonstrate that any decisions made are done so in the best interests of the resident. Evidence should be in place to demonstrate that residents and or their representatives are given the option to be involved in the formulation and review of their care plans and any other assessments relating to their care. Formal 6 monthly reviews of care should be undertaken for all residents. Those attending the review should include the resident, their relatives and representative, and staff from the home. Where Social Services Departments carry out annual reviews of care this could be one of the 6 monthly reviews. Informal concerns should be recorded including the actions taken and outcome. 2. OP7 3 OP7 4 OP16 Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Gables, The DS0000001975.V341479.R01.S.doc Version 5.2 Page 32 - 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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