Inspection on 19/12/05 for The Gables

This inspection was carried out on 19th December 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Gables 14/12/09

The Gables 05/07/09

The Gables 07/05/09

The Gables 02/11/07

The Gables 06/06/07

The Gables 13/06/06

The Gables 06/04/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Gables 1 East Park Street Chatteris Cambridgeshire PE16 6LA Lead Inspector Alan Buttery Unannounced Inspection 19th December 2005 09:40 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 The Gables DS0000063700.V263401.R01.S.doc Version 5.0 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. The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Gables Address 1 East Park Street Chatteris Cambridgeshire PE16 6LA 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) 01354 639858 01354 696400 Stargate Partnership Ltd Lois Hall Care Home 41 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (23), of places Physical disability over 65 years of age (1) The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th April 2005 Brief Description of the Service: The Gables is an old largely Georgian house in the centre of the small Cambridgeshire town of Chatteris, which has been updated and extended to provide accommodation for up to 41 older people. The accommodation is split over two floors. On the ground floor, there are bedrooms and communal areas, which provide secure accommodation for 17 older people with dementia, and on the first floor facilities for up to 24 older service users without dementia. There are bathroom and toilet facilities on both floors, and a large enclosed rear garden The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second inspection of The Gables for the inspection year 2005/6. Two inspectors undertook this unannounced inspection on the 19th December 2005. The inspectors spent 3 hours in the home and spoke to service users, staff and the manager. A tour of the home was undertaken and documentation was read. At the time of the inspection there were two service user vacancies. What the service does well: What has improved since the last inspection? What they could do better: The previous inspection report stated that ‘a monthly report must be provided by the registered person’. This has not been addressed and has been carried forward. The manager stated that the registered person does visit the home on a weekly basis but does not leave a report on the findings of his visit at the home or forward a report to the Commission for Social Care Inspection. The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 7 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 The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Detailed information about the home and services avaialable is available to service users and their representatives to help them to decide if the home is suitable for them. EVIDENCE: The home has a satisfactory Statement of Purpose and Service User Guide. Service users spoken to stated that they had received a copy of the Service User Guide. Since the previous inspection both of these documents have been revised to reflect the changes in the ownership of the home. The number of service users accommodated in the home has recently increased from 40 to 41 and the manager stated that she is currently amending the Statement of Purpose and the Service User Guide and will forward copies of these documents to the Commission for Social Care Inspection. A recommendation following the previous inspection was that ‘all preadmission assessments should be signed by the person carrying out the assessment’. Pre assessment documentation in respect of the two most recently admitted service users was seen and was noted to be signed. This recommendation has been satisfactorily addressed. The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Systems are in place to ensure that the healthcare needs of the service users are met. EVIDENCE: The care plans and related documents of four service users were seen during this inspection and all showed that the information gathered by the home is satisfactory. Care plans give clear guidance to staff about how to meet the needs of the service users and there was evidence that the care plans were being reviewed at least monthly. Care plans are kept in service users bedrooms to ensure that they are easily accessible to the service user and members of staff. The manager stated that the home has a good relationship with the local GP’s and District Nurses. Training in administering insulin has been provided by the District Nurses and completed delegation forms are maintained. At the time of the inspection no service users had pressure sores and those service users at risk of developing sores had appropriate documentation and guidance to staff in place. The manager informed the inspectors that the previous recommendation that ‘the manager should discuss a programme of falls The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 10 prevention with one of the falls prevention nurses from the local PCT’ had been addressed. The falls prevention nurse has provided training to staff and has also provided an assessment tool for the home to use. The manager stated that direct referrals can also be made to the nurse. Service users have access to other health care professionals such as dieticians, dentists and opticians. The home uses a Monitored Dosage System of drug administration and the manager stated that all staff who administer medication have received training. The next training session has been arranged to take place on 11 January 2006. None of the service users currently accommodated in the home administer their own medication. The records of medications received into the home, administered and disposed of were seen and were satisfactory. All medication is securely stored. Service users confirmed that staff always knock and wait before entering their bedroom. This was also observed by the inspectors. Service users stated that they are addressed by their preferred name and one service user stated that ‘ staff are very kind and nothing is too much trouble for them’. The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 15 The Gables offers a particularly wide variety of social activity and a varied and balanced diet ensuring that service users have a choice in all areas of their lives. EVIDENCE: A number of service users spoken to during this inspection praised the quality and variety of activities available. The manager stated that although the home employs two activity organisers all staff have a responsibility to undertake activities with service users. Group and individual activities are provided on a daily basis and entertainers visit the home regularly. On the afternoon of this inspection a Christmas party was due to be held. Other festive activities included a Christmas quiz, carols by candlelight, a visit by the church choir, Christmas bingo and a visit by a singer. A Christmas bazaar had recently been held at the home. A newsletter was on display at the home and this provided details of other events that had recently taken place in the home. These include a ‘Halloween Bad Hair day’, Trafalgar celebrations, Remembrance Day service at the home and a quiz night. A copy of the newsletter is distributed to all service users and this also contains a quiz and word search for service users to complete. Regular religious services are held in the home and one service user stated that she attends the local church service each week. Service users meetings are held monthly. The most recent meeting was held on 9th The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 12 December and mince pies were provided. Topics discussed included the winter social programme, improvements to the home, menus, new staff and new service users. Minutes of the meetings are displayed in the home. The home has a hairdressing room and a hairdresser visits the home each week. Service users stated that visitors are welcome at any time and can be entertained either in the bedroom or the communal areas of the home. Service user were complimentary about the food provided and stated that alternatives to the menu are always available. A four weekly rolling menu operates in the home. On the day of the inspection there was a choice of either pork or chicken casserole and various desserts available for the main meal of the day. Menus are displayed in the home and a Christmas and New year menu was displayed in the hallway. The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed during this inspection. EVIDENCE: The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 25 Service users live in a well-maintained, comfortable and clean home. EVIDENCE: A tour of the home was undertaken and it was noted that all areas were clean and well maintained. The manager stated that the programme of refurbishment is continuing and that there are plans to refurbish several of the bathrooms shortly. Since the previous inspection several carpets and new items of furniture have been purchased. As bedrooms become vacant they are redecorated. Several bedrooms were seen and it was noted that service users have personnel effects such as pictures and small items of their own furniture in their rooms. The home was decorated with Christmas decorations and there was a very homely feel. Since the previous inspection the Commission for Social Care Inspection has registered an additional bedroom. The home can accommodate 41 service users (24 on the first floor and 17 on the ground floor). Apart from one double bedroom on the ground floor all of the rooms are single rooms. The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 15 None of the rooms have en-suite facilities but the home has an adequate number of bathrooms and toilets to meet the needs of the service users. Bedroom doors are lockable and toilets and bathrooms have appropriate locks. The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 The procedures for the recruitment of staff are robust and offer protection to people living in the home. The deployment and number of staff available is appropriate to meet the needs of the service users. EVIDENCE: The manager stated that at the time of this inspection there were no staff vacancies. Photographs of all members of staff are on display in the hallway. The previous requirement that ‘all staff files must contain the required information’ has been satisfactorily addressed. Four staff files were inspected and contained all of the information required by the Care Homes Regulation 2001. It was noted that three references were not written on headed paper. It is recommended that the manager confirms the validity of references with the referee when they are not written on headed paper. Staff sign to confirm that they have received a copy of the code of conduct and practice written by the General Social Care Council. The staffing rotas were inspected and it was noted that there is always a minimum of 6 care staff on duty in the morning, 5 in the afternoon and 4 at night (on waking night duty). At least two of the staff on duty on each shift are senior care staff. The manager stated that all staff providing personal care are at least 18 years of age and that staff left in charge of the home are at least 21 years of age. The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 17 All members of staff receive a full induction and during their induction staff receive training in a number of topics including food hygiene, infection control, dealing with allegations of abuse, moving and handling, first aid and fire training. All staff are required to sign a document stating that they have received a fire manual and fire fighting instructions. Additional training is provided to all staff. Recently all staff have received dementia training which was accredited by the Alzheimer’s Society. The course consisted of three six hour sessions and at the end of the course staff had to undertaken an exam. The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 36 and 38 The home is well managed and staff receive leadership, guidance and direction to ensure that the service users receive consistent quality care. Service users are kept safe by attention to matters of health and safety. EVIDENCE: During the inspection it was apparent that the registered manager was aware of her responsibilities as required by the Care Standards Act 2000 and that she had a good understanding of the Care Homes Regulations 2001 and the National Minimum Standards. Service users and staff confirmed that the manager is approachable and that they would not hesitate to contact her if they had any concerns. The previous inspection report stated that ‘a monthly report must be provided by the registered person’. This has not been addressed and has been carried forward. The manager stated that the registered person does visit the home The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 19 on a weekly basis but does not leave a report on the findings of his visit at the home or forward a report to the Commission for Social Care Inspection. All staff apart from the manager receive formal supervision at least six times a year. The manager stated that a staff appraisal system will commence shortly. Policies and procedures are in place to manage the health and safety of service users in the home and regular checks of equipment are made. All accidents and incidents are recorded and risk assessments are carried out for all safe working practices. The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 20 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 3 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X 3 X STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 2 X 3 The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP36 Regulation 26 Requirement The provider must visit the service at least once a month and a report of this visit must be left in the home and a copy sent to the CSCI. Carried forward as timescale of 30 June 2005 not met. Timescale for action 31/01/06 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 OP29 Good Practice Recommendations References not written on headed paper should be verified. The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Gables DS0000063700.V263401.R01.S.doc Version 5.0 Page 23 - 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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