CARE HOMES FOR OLDER PEOPLE
The Gables 29 Leicester Road Market Harborough Leicestershire LE16 7AX Lead Inspector
Steve Hunnybun Unannounced 2 June 2005 at 14:00
nd 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 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 DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service The Gables Address 29 Leicester Road Market Harborough Leicestershire LE16 7AX 01858 464612 01858 8469101 none Niscar Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Vacant Care Home 10 Category(ies) of OP Old Age - 10 registration, with number of places The Gables DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: To be able to admit the person of category SI(E) identified in correspondence from the previous registration authority dated 9th May 1997. Date of last inspection 19th January 2005 Brief Description of the Service: The Gables is a care home registered for up to ten people who require support due to age related needs. the home is on the outskirts of Market Harborough. the property comprises of a lounge, dining room and quiet room. Bedrooms are situated on the ground and first floors. The first floor is accessible with a stair lift. Outside is a small garden to the front and patio to the rear of the property. The Gables DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over four hours and was the first statutory unannounced inspection this year. Three residents cases were tracked; their files were examined they spoke with the inspector and he saw their rooms. Comments from the residents were positive; the home was described as lovely, residents felt they were well looked after and they feel the staff are very helpful. One lady stated that she only has to press her call bell and staff are there, if they cannot help her they always offer a reasonable explanation. All three residents described the food as good. The premises are clean, tidy, well maintained and pleasantly decorated. Residents have well appointed and personalised rooms. What the service does well: What has improved since the last inspection?
The statement of purpose now contains all the information necessary to meet the requirements of national minimum standard 1. The Gables DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Gables DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Gables DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 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 standard(s) 1,3 Residents are provided with the necessary information when they move into the home and their needs are assessed on arrival. EVIDENCE: The home has a statement of purpose and service users guide that meets the requirements of this standard. These are in folders that are given to prospective residents when they enquire about the home. All residents’ files contained assessments. These comprised of an initial activities of daily living assessment and a moving and handling assessment. These were useful assessments and in two cases had been signed by the resident. The Gables DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10 All residents have a care plan that sets out their care needs. Residents’ health needs are met and their medication is stored, recorded and administered appropriately. EVIDENCE: All files tracked contained comprehensive care plans. These contained information regarding areas such as mobility, hygiene, toilet and spiritual needs. Two of the plans had been reviewed in April 2005 one in August 2003. All plans need to be regularly reviewed to ensure that they are up to date. Medical needs were clearly recorded in all files. Residents are supported to access a GP and any specialist healthcare. All appointments and any outcomes or advice are recorded in residents’ files. Medication records were examined and found to be accurate and up to date. Medication is kept in a locked cupboard and was found to be stored appropriately. All staff attend medication training. The pharmacist that supplies medication also carries out spot checks and the reports for these were positive. All residents who spoke with the inspector stated that their privacy and dignity are upheld at all times. Staff were observed knocking on residents’ doors and all residents were asked before the inspector was shown into their rooms. Files contained records of
The Gables DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 Page 10 residents’ preferred form of address. with respect. Residents feel that they are treated The Gables DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15 Residents’ social, cultural and religious needs are satisfied, they are able to maintain contact with their families and they are able to make decisions and exercise choice. Residents receive a nutritious diet and are able to choose their food. EVIDENCE: All residents who spoke with the inspector stated that they are happy with the activities and lifestyle offered to them. They all enjoyed reading and TV and one gentleman likes to go for a long walk every day and is able to do so. Residents are able to receive visits at any reasonable time and all said that their families are made very welcome. Residents were asked about choice and control and all stated that they are able to make decisions in their lives and exercise a degree of control. One resident stated that she likes to keep herself to herself rather that join in with the rest of the group and this is respected although the acting manager stated that she is always offered activities when they occur. All residents stated that the food is good. Residents are offered choice and their dietary needs are recorded in their files. One lady has quite definite tastes and is able to eat her preferred diet. The Gables DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 Page 12 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 standard(s) 16,18 Residents feel able to complain and are protected from abuse. EVIDENCE: The complaints procedure is clear and concise. It is included in the statement of purpose and residents’ guide. All residents who spoke with the inspector stated that they would feel able to raise any concerns they might have. The home uses the Multi-Agency Vulnerable Adult Protection document No Secrets and the manager stated that she was due to collect an updated version of it. Residents who spoke with the inspector appeared to feel safe and protected. The Gables DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 Page 13 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 standard(s) 19,26 Residents live in a safe, homely and well-maintained environment that is kept clean and tidy. EVIDENCE: The home is well maintained and pleasantly decorated. The premises are fully accessible having a stair lift to the first floor. The home has a lounge, dining room and quiet room and has pleasant gardens to the front and rear of the property. All three residents who spoke with the inspector stated that they liked their rooms. The inspector was shown all three rooms and they were pleasant, well appointed and personalised with furniture, belongings and décor. The home was clean and tidy on the day of the inspection. The Gables DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,30 Residents’ needs are met by staff that are sufficient in number and competent. EVIDENCE: Staffing numbers are set out in the statement of purpose. The home has a rota system that ensures that sufficient staff are on duty at all times to meet residents’ needs. The acting manager stated that she has recently changed rotas to ensure more cover is available at weekends. The home has a comprehensive staff training programme including medication, food hygiene and dementia awareness. All staff are registered for appropriate NVQ courses. The Gables DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Residents’ views are sought to inform how the home should be run. EVIDENCE: The home now has a quality assurance system. The acting manager showed the inspector questionnaires that appeared useful. The Gables DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x x x x The Gables DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 Page 17 no 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 Regulation Requirement Timescale for action 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 7 Good Practice Recommendations It is recommended that all care plans are reveiwed monthly. The Gables DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection 1st Floor, Newland House Campbell Square Northampton NN1 3EB 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 DC51.C08.S1774.The Gables.V231371.02.06.05.Stage 4.doc Version 1.30 Page 19 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
