Inspection on 02/11/07 for The Gables

This inspection was carried out on 2nd November 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 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 06/06/07

The Gables 13/06/06

The Gables 19/12/05

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 2nd November 2007 11:30 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 The Gables DS0000063700.V354925.R02.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. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 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 693858 01354 696400 Stargate Partnership Ltd 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.V354925.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th June 2006 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. On the day of the inspection the services’ area manager said that the fees ranged from £340 to £465.75. A copy of the last CSCI inspection report is in the entrance hall. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection, and looked at the key minimum standards for older people. A number of issues were identified at the last key inspection, and two random inspections have taken place subsequently, details of which are available. Since the last inspection, the registered manager of the home has left, and at the time of the visit, the area manager of the Stargate Partnership was managing the home, with support from the deputy manager and a senior carer, pending the appointment of a new manager. The inspection was undertaken by two inspectors from the CSCI, and during the visit, the views of the people living in the home were gathered. An annual quality assurance assessment was sent to the home, but has not been returned, which is in breach of Regulations. What the service does well: What has improved since the last inspection? Since the last key inspection, care plans have been revised, and now provide a better guidance for the care staff. Further work is still needed on the plans to ensure the views of the people they relate to are included, and aim and objectives shown. Some changes have been made to the home, improving the environment, and further improvements are planned which will further enhance the lives of the people living there. Management changes have been made, and these now need to be consolidated. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 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.V354925.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Information will be obtained on anyone wishing to move into the home to ensure his or her needs can be met. EVIDENCE: Since the last key inspection, the home has not been able to admit any new residents, and although a policy and procedure are in place to manage the process, this was not evidenced further. Providing the existing procedures are followed, the home should have sufficient information available to ensure that they are able to meet the individual needs identified. People spoken to during the inspection confirmed that they had details of the services’ complaints procedures, and as part of the admissions process, copies of the Service user guide are given to people moving into the home. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 9 The home does not offer intermediate care. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 10 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): Standards 7, 8, 9 and 10 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Individual plans are in place to guide staff in meeting identified health and social care needs, although further improvements are needed to ensure that all of the persons needs are recorded. EVIDENCE: Following concerns raised at the last key inspection regarding care plans, these were again looked at in some details. Since the key inspection, a new format has been introduced, and staff have received training in completing the forms. It was encouraging to note that the care plans now contain more detail, and provide care staff with sufficient detail to ensure identified needs are met appropriately. The care planning improvements need to continue, ensuring that people living in the home are fully involved wherever possible, and that the plans include all areas of their day-to-day lives. The plans should also detail the outcomes that the plans aim to meet. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 11 The format used is satisfactory for the purpose, but the service needs to ensure that the plans do not become unwieldy, and older notes and documentation needs to be archived regularly. We felt that information was recorded in various different parts of the plans, sometimes making it difficult to find what we were looking for. The plans include detail on the healthcare needs of the individuals living in the home, and how these needs should be supported, and again evidence must be available to demonstrate how the views of the people in the home are gathered to ensure these needs are met in a way the individuals prefer. The service has a policy to ensure medication is managed appropriately, and procedures are in place should anyone living in the home be able to manage their own medication, although at the present time, this does not apply to any of the residents of the home. The people living in the home that were seen during the visit all felt that the staff treat them very well, and their privacy and dignity is upheld at all times, and this is included in staff training, which is considered further later in this report The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 12 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): Standards 12, 13, 14 and 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A good range of activities and events are available to the more able people living in the home, but a wider range needs to be available to those with dementia. EVIDENCE: A range of activities is available to the people living in the home, and during this visit, the people we spoke to said that they were very happy with the range of activities available, and the choices offered to them. For example, a group of about 8 of the people living in the home had been on a day trip to Hunstanton recently, which they all enjoyed. A local hairdresser visits weekly, and church services are held regularly, and one lady spoken to said she was assisted in attending a prayer meeting every week. Daily newspapers are always available, and staff sit and discuss the days news when they have time. An artist is visiting the home, painting murals to screen the blocked in fireplaces, and will also be doing artwork with some of the people in the home, and the home has an activity worker who works for 4 hours daily, helping plan and co-ordinate activities. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 13 Families are able to visit at any time, and made welcome by the home, and one relative we spoke to said that they had chosen the Gables over a number of other local homes, because of ‘the atmosphere and feel of the home’ It is important that the activities available in the home extend to everyone, including those in the dementia care unit. Following recent improvements, meals are served in one of two dining areas, and people we spoke to were happy with the food they were offered and the choices available. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 14 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): Standards 16 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Procedures are in place to ensure concerns, or allegations of abuse are dealt with quickly and efficiently EVIDENCE: The service has an appropriate complaints policy, which should ensure that any concerns raised are appropriately managed. At the time of the visit there were no complaints outstanding, but in the absence of the annual quality assurance statement, no further detail was available regarding previous complaints raised. As mentioned earlier, people living in the home are all given information on how to make concerns known. Training is now provided to all staff in the area of safeguarding adults, ensuring any concerns raised will be dealt with appropriately, and in line with local procedures. Additional training is in place to ensure that any staff that have missed earlier training course will receive the necessary training by the end of November. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 15 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): Standards 19 and 26 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. In spite of significant improvements, and plans, further areas within the home need to be addressed to provide greater comfort and safety for the people living in the home. EVIDENCE: Since the last inspection, a number of improvements have been made to the home, including the covering of fireplaces, reducing the risk of injury. The fireplaces have been boarded over, but attractive murals painted on the boards, one of a fire and the other a fish tank, which still provide a focal point for people to look at. New carpets have been ordered for a number of parts of the home and were due to be fitted within the next two weeks, and plans for further work include new fencing to provide a safer garden area for residents, new lounge furniture and continual redecoration work. The home has two ground floor lounges, and they are now making better use of the second, smaller room. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 16 On the day of our inspection, the home was clean, however, there was an unpleasant odour noted in the downstairs lounge and dining room. We did however note that the main entrance door is in urgent need of repair or replacement, it does not close properly, and presents a possible security risk as it is difficult for staff and visitors to close it properly. When we arrived, the door was not properly closed, and we could have entered the building without anyone being aware of our presence. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 17 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): Standards 27, 28, 29 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A good mix of staff, who have received appropriate training and recruitment checks are available to meet the needs of the people living in the home. EVIDENCE: During the inspection, we looked closely at recruitment and staffing records. Previous inspections had noted a number of poor practices in the recruitment of staff, and the training they receive, and we were therefore pleased to note that these had improved considerably. Records examined showed that new staff being employed were now having all the necessary checks undertaken, and that the required training was being provided, or planned for shortly. It is clearly important that these checks continue to be made, and the recruitment and training policies of the organisation are followed. Although the majority of staff have now received the required mandatory training, some gaps were noted and discussed with the area manager, and it was agreed that the required action would be taken to ensure that all staff receive this training. One member of staff has failed to attend a number of pre booked training sessions and this must be addressed with the person concerned. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 18 During the inspection, several staff were observed during the lunchtime period, and in particular the manner with which they interacted with the people in the home. This was generally good, with one carer in the dementia unit particularly good, explaining top people at every opportunity what she was doing and why. This is an example, which should be used to demonstrate to all staff how people living in the home can benefit from good interaction with them, and how this reflects their dignity better. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 19 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): Standards 31, 33, 35, 36 and 38 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Management arrangements have improved, but further action is needed to ensure the service to people living in the home is better. EVIDENCE: As explained at the beginning of this report, the registered manager has recently left the service, and temporary management arrangements are currently in place. It is clearly important that a suitable appointment is made to the vacant position as soon as possible, and that the improvements noted in this report are maintained, and built upon. The health and safety procedures and better training have ensured that the people living and working in the home are not at risk, and record keeping in general has improved. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 20 The individual records of three people living in the home were examined, which met the requirements of the National minimum standard, although as mentioned earlier in the report, the individual care plans are difficult documents to read easily, with information potentially in a number of places. The current management team must ensure that all staff are regularly supervised, as it was noted that 13 staff had received no formal supervision for at least two months. During discussions with the area manager, it appears that the provider did not receive a copy of the last random visit report, they have recently moved offices, but to date the CSCI locally have still not received formal notification of the new contact details. From observations made during the inspection, and discussions with people living in the home, the management and staff are clearly putting the interests of the people living in the home to the fore, and people we spoke to were very happy with the care and support they receive. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 21 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 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 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 2 X X 3 3 2 X 3 The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 22 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 OP7 Regulation 15(1) Requirement The individual care plans must show how people moving into or living in the home have been involved, and include all aspects of their care. This requirement has been carried forward, and must now be addressed. A range activities and social events must be available to everyone living in the home. This requirement has been carried forward, and must now be addressed. Measures must be taken to ensure the security and safety of people living in the home The home must be clean and hygienic at all times, and free from offensive smells. A suitably qualified and experienced manager must be appointed, and an application for registration submitted to the commission. Appropriate supervision must be provided to all staff to ensure they are able to undertake duties in a suitable manner DS0000063700.V354925.R02.S.doc Timescale for action 31/01/08 2. OP12 16(2)(n) 31/01/08 3. 4. 5. OP19 OP26 OP31 23(2)(b) 13(3) 8(1) 31/12/07 31/12/07 31/03/08 6. OP36 18(2) 31/01/08 The Gables Version 5.2 Page 23 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 Care plans should show the desired outcome for the person receiving support. The Gables DS0000063700.V354925.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Inspection Team Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 DS0000063700.V354925.R02.S.doc Version 5.2 Page 25 - 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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