Inspection on 02/09/08 for The Gables

This inspection was carried out on 2nd September 2008.

CSCI found this care home to be providing an Adequate service.

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 13/09/07

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 30/01/2009.

CARE HOMES FOR OLDER PEOPLE The Gables 161 Morley Road Oakwood Derby Derbyshire DE21 4QY Lead Inspector Janet Morrow Unannounced Inspection 10:00 2nd September & 4 September 2008 th 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 DS0000001975.V371216.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 DS0000001975.V371216.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Gables 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 The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 4 Day Care places Date of last inspection 13th September 2007 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 £400 per week and non-en suite rooms £380 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 The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection visit took place over two day for a total of 7.5 hours and concentrated on all the key standards and on the progress made towards achieving the requirements and recommendations made at the last inspection. The manager/owner, seven staff, three sets of relatives, two visiting professionals and nine people currently accommodated in the home were spoken with during the inspection visit. One visiting professional and one relative were contacted by telephone after the inspection visit. Sixteen surveys were received prior to the inspection visit, one from a visiting professional, five from staff and ten from people living in the home. Care records, a sample of policies and procedures and staff information were examined. A partial tour of the building took place. Written information in the form of an annual quality assurance assessment was received prior to the visit and informed the inspection process. What the service does well: The Gables was maintained to a high standard and provided attractive and comfortable indoor and outdoor facilities for the people that lived there. Visitors commented favourably on the appearance of the home and its level of cleanliness and one visitor spoken with said they were ‘very impressed’ with the standard of the building and that it had been a key reason why their relative had chosen to live there. The information gathered regarding each person from them and their representatives demonstrated that the service endeavoured to provide a person centred approach to peoples’ care. Efforts were clearly made to engage people in activities and events to ensure their social needs were met and various leisure activities were provided for those who wished to participate. One person living at the home described it as ‘perfect’. The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 6 Meals were well presented, with a choice offered and the food received very positive feedback from people living in the home. Staff had positive relationships with the people living in the home and this was evident on the day of the visit. There was a stable staff group, many of whom had worked at the home for several years, which helped to ensure consistency of care. A survey from a visiting professional commented that ‘they care for each person as an individual’ and one spoken with stated that communication and liaison with the home was ‘good’. What has improved since the last inspection? What they could do better: Medication practice needs to improve to ensure that all medication administration record (MAR) charts are completed accurately and the controlled drugs record must be completed consistently to ensure it is clear how much medicine is in stock. Two people should sign handwritten medication administration record (MAR) charts to make sure the information on them is correct. Although all people living in the home should be encouraged to retain their independence, it is important to ensure their safety is maintained. Therefore anyone who chooses to self -administer and retain their medication must be assessed as being safe to do. This was raised as an issue at the previous inspection visit in September 2007 and has not been addressed. Recruitment procedures must ensure that all staff employed at the home have the relevant documentation in place prior to starting work. This must include a Protection of Vulnerable Adults (POVA) First check, two written references and an up to date Criminal Record Bureau (CRB) check. Failure to do so has the potential to put people’s safety at risk. An immediate requirement notice was issued at the inspection visit to ensure that the process of obtaining this documentation was commenced. All care plans must include details on how to prevent pressure sores where this is identified as a problem. The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 7 Food hygiene training must be provided to all staff who work in the kitchen. This was raised as an issue at the previous inspection visit in September 2007. All staff must also be up to date with their moving and handling training to ensure correct procedures are followed. Training should be provided to all care staff on issues related to care as well as health and safety issues. Safeguarding training should also be carried out every two years. Risk assessments for falls and pressure sores should be carried out for everyone at the point of admission. 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 DS0000001975.V371216.R02.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 The Gables DS0000001975.V371216.R02.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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was sufficient admission information in place to establish that the home was able to meet peoples’ needs. EVIDENCE: The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 10 Three peoples’ care records were examined and showed that there was sufficient information to establish that needs could be met. There was a completed assessment document and information available from the assessment and care management process on all three files examined. Risk assessments were in place on all files for nutrition and moving and handing but there were no assessments for risk of falls and pressure sores. A visiting professional spoken with stated that they were confident that the home was able to meet the needs of the person they were involved with and a relative said that they were ‘very happy’ with the service provided. All ten surveys received from people living in the home stated that they received enough information about the home before deciding to move in. The Gables did not provide intermediate care; therefore standard 6 was not assessed. The Gables DS0000001975.V371216.R02.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 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Inaccuracies on medication recording did not ensure the health and safety of people in the home. EVIDENCE: Three care files were examined and all had a care plan in place. These covered a range of areas such as cultural needs, physical needs, social needs and mobility needs. 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. The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 12 The care plans recorded visits from professionals such as General Practitioners (GP), dentists and opticians. Weight was recorded monthly. One person had specialist health needs and these were recorded in their care plan. The main omission for care documentation was risk assessments in relation to falls and pressure sores. One person spoken with was using pressure relieving equipment but there was no care plan stating what to do to minimise the risk. One mobility care plan had information to prevent falls but a specialised tool to assess the risk was not in use. All five staff surveys responded that they were ‘always’ given up to date information about peoples’ needs. All ten surveys received from people living in the home responded that they ‘always’ received the care and support they needed and ‘always’ received the medical support they needed. One relative spoken with described the one to one care as ‘brilliant’ and stated their relative had improved in ‘leaps and bounds’ since living in the home. The survey from a visiting professional stated ‘they recognise when they need extra health care input’ and one spoken with stated that the staff ‘seem very good’. Another stated that the home had done everything needed at the point of admission ‘straight away’. Medication administration record (MAR) charts were checked for accuracy of recording. A random examination of six records showed that charts were generally signed accurately and the amount of medicines received were recorded. However, there was inconsistent practice in signing handwritten charts as two people were not signing all charts. The written information supplied by the home stated that ‘we endeavour to make sure that senior staff are well trained and competant with the handling and administration of medications’. However, there were some anomalies noted when three peoples’ charts were examined in more detail. There was one medicine that was not signed for but had been administered and there was one controlled drug in stock, Oromorph, and there appeared to be less of this liquid medicine than was recorded. The controlled drug written record was unclear on the total amount of medicine that should have been available as staff were not completing the running total of medicines consistently. There was secure storage for controlled drugs. There was also no risk assessment in place for those people wishing to selfmedicate. Although one person had signed a declaration to say they were keeping their own medicines, there was no assessment to say they were competent to do so. This was raised as an issue at the previous inspection visit in September 2007. The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 13 All of the people spoken with said that they were treated respectfully by the staff and confirmed that their privacy and dignity was maintained. One relative spoken with described the staff as ‘very respectful’. Observation during the visit confirmed that staff practice was respectful. The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 14 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Well managed meals and activities enhanced the quality of peoples’ lives. EVIDENCE: ‘Getting to know you’ forms were 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 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. The home produced a monthly newsletter that showed religious services, musical entertainment and a film and cream tea afternoon occurred on a regular basis. The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 15 The written information supplied by the home stated that ‘we have started organising regular quiz nights with the families and the service users, which has made it a real sociable event with cheese and wine’ and ‘we have organised flower arranging to take place once a month’. Outings were also arranged and people spoken with confirmed they enjoyed the range of activities on offer. Seven of the ten surveys received from people in the home responded that there were ‘always’ activities arranged. The written information supplied by the home stated that the home subscribed to an advocacy service. The home had an open visiting policy and people spoken with confirmed that they were able to entertain their visitors within their private accommodation or within the communal areas, as they preferred. Visitors spoken with said they were able visit when they pleased and a visiting professional spoken with described the home as ‘welcoming’. Feedback from people in the home was positive about the quality of meals at the home and all people spoken with described the food as ‘good’ and stated that they enjoyed the food on offer. There were two choices were provided at the main lunchtime meal and people spoken with confirmed that if they did not want the meals on offer they were able to chose an alternative. The serving of the lunchtime meal was observed; this showed that food was well presented and the dining room was pleasant with tables attractively decorated. One relative commented that it was ‘like a restaurant’. Standards in the kitchen indicated that purchasing, storage, stock managing and cooking arrangements were satisfactory. Food stocks were good with a wide range of fresh fruit and vegetables. Nine of the ten surveys received from people living in the home responded that they ‘always’ liked the meals and one responded that they ‘usually’ did. The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 16 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures for handling complaints and safeguarding people were comprehensive and ensured that peoples’ concerns were listened to and that they were safeguarded. EVIDENCE: The home had a clear complaints procedure and to ensure that everyone was aware of this, it had been printed out as part of the monthly newsletter. It was also on display in the foyer of the home. It stated that complaints would be addressed within twenty-eight days and had the up to date contact details of the Commission for Social Care Inspection. The written information supplied by the home stated that four complaints had been received in the last twelve months and all had been addressed within twenty-eight days. There had been no complaints received at the office of the Commission for Social Care Inspection. The complaints record was examined and it was clear from this what action had been taken in response to issues raised. Eight of the ten surveys from people living in the home said they knew how to make a complaint and two said they did not know. The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 17 The written information supplied by the home stated that there had been no allegations of abuse in the last twelve months and that ‘we always discuss with staff about recognising and reporting any form of abuse, should it be suspected, and the importance of any open door culture’. There was comprehensive information on safeguarding vulnerable people available in the home and this inculded ‘whistleblowing’. All staff spoken with were aware of their responsibilty to report any suspicions of abuse. The training matrix, however, showed that only seven of thirty-one staff had undertaken safeguarding training in the last two years. The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 18 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, 24 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Gables continued to be furnished, cleaned and maintained to a high standard, providing people with a safe, pleasant and comfortable place to live. EVIDENCE: The written information supplied by the home stated that ‘within the last 12 months we have re-decorated an extensive part of the home. We have had a new laminate flooring laid in the dining room. We have employed a new gardener and we have been working closely with him to improve the The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 19 appearance of the garden’.It also stated that plans during the next twelve months were to develop a sensory garden.The garden area was pleasant and accessible and provided a lovely external space for people during summer. A partial tour of the building was undertaken that included the laundry, two peoples’ bedrooms, the kitchen and communal lounges. All areas seen, with the exception of the kitchen, were well maintained and decorated to a good standard. The kitchen was in need of refurbishment and areas for improvement had been identified by a recent environmental health inspection. Three peoples’ bedrooms were seen and showed that rooms were personalised and attractively decorated. Three people spoken with stated that they were ‘pleased’ with their rooms. The home maintained high standards of cleanliness and hygiene and there was no odour. Most people spoken with commented on the cleanliness of the home: for example, one visiting professional said the environment ‘always looked nice’; one relative commented that the cleaners and laundry staff were ‘always doing their job and they know everyone’, and that ‘they are always on the case, there is never any odour’, which they felt contributed to the high standard; another relative said they were ‘impressed’ by the environment and it had been a key reason why they had chosen The Gables. All ten surveys received from people living in the home responded that the home was ‘always’ fresh and clean. A staff survey responded that something the home did well was to ensure ‘a very high standard of cleanliness’. The home is therefore commended for its efforts in maintaining the high standards of cleanliness and décor. Staff spoken with were knowledgeable about infection control procedures and confirmed that there was a plentiful supply of protective equipment such as gloves and aprons. The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 20 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Shortfalls in recruitment practices and training did not ensure that people were safeguarded. EVIDENCE: The staff rota for week beginning 1st September 2008 was examined and showed that there were four care staff, including the deputy manager and a senior, on the morning and afternoon shift and two care staff at night. There was a chef and kitchen assistant in the morning and a kitchen assistant at teatime. There were also three domestic staff and a housekeeper on shift each day. This was consistent with the number of staff on duty during the inspection. No –one spoken with, including people living at the home, relatives, staff and visiting professionals, indicated that there were any issues with staffing and all said that there were sufficient staff to meet the peoples’ needs. Three staff files were examined. These showed shortfalls in recruitment practice, as follows: one file did not have any identification information, an explanation of a gap in employment history, a Criminal Record Bureau (CRB) check, or two written references; a second file showed that the staff member concerned had commenced work before a Criminal Record Bureau (CRB) or The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 21 Protection of Vulnerable Adults (POVA) First check had been obtained. Schedule 2 of the Care Homes Regulations 2001 legally requires this information and failure to obtain it puts people living in the home at risk of harm. An immediate requirement notice was therefore issued to commence the process of obtaining the required documents. National Vocational Qualification (NVQ) training took place. The written information supplied by the home stated that ‘ 57 of care staff have NVQ Level 2 and we have a further 21 training. All of our senior care staff have achieved NVQ Level 2 and 83 have ascertained their NVQ Level 3.’ This meant that the home had achieved the target of having a minimum of 50 of care staff with an NVQ2. Staff spoken with also confirmed that this training took place. All five staff surveys responded that they received training relevant to their role. Three responded that they ‘always’ had the right support, experience and knowledge to meet needs and two responded that they ‘usually’ did. Training information was examined and showed that there was a programme in place that covered mandatory health and safety training. Staff spoken with confirmed that this took place, although some of these had not taken place yet in 2008. The administrator stated that they were in the process of organising the training with a new provider. There was no information available in the staff files examined that indicated training relevant to care needs had taken place in the last twelve months. However, one member of staff spoken with stated that they had received training in caring for people with dementia and in catheter care. One staff survey received commented that one way the home could improve was to provide ‘more training’ and that mental health, skin care and nutrition would be useful areas to cover. A survey from a visiting professional also commented that a way the home could improve was to ‘keep up with training’. The administrator stated that the home was concentrating on arranging care related courses between November 2008 and March 2009. A relative spoken with also commented that the home did not always know the best way to deal with someone with visual problems. The written information supplied by the home stated that ‘we would also like to bring in more specialised training for the staff to be able to understand more conditions of the service users we have in the home’. The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 22 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 and 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 and run in peoples’ best interests but shortfalls in recruitment and health and safety training had the potential to adversely affect peoples’ safety. EVIDENCE: The registered manager/provider had worked in care since 1986 and had owned/managed the Gables since 1990. She had achieved an NVQ 4 in care and a management certificate and presented as competent and approachable. She was supported by a deputy manager and an administrator. The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 23 However, one of the key management shortfalls that had the potential to impact on peoples’ health and safety was the inadequate recruitment practices referred to earlier in the report. There were also some shortfalls in health and safety training with not all staff being up to date in food hygiene and moving and handling. There was a quality assurance process in place that sent out surveys to people living in the home and their relatives. The survey covered the appearance of the home, meals, activities, staff attitude and management. Feedback from these was positive with people being ‘happy’ and ‘satisfied’ with all aspects of life at the home. An analysis of the findings was provided in the home’s monthly newsletter. ‘Thank you’ cards and letters were also seen that gave positive feedback; some of the comments were: ‘thank you for your dedication, care and kindness’, truly providing a home from home’ and ’mum was so happy with you’. The manager stated that she was not acting as appointee for anyone’s finances. Personal allowance transactions were recorded. Three peoples’ financial records were examined and corresponded accurately with the cash held. Receipts were available for individual purchases. The cash held was stored securely. The written information supplied by the home stated that maintenance checks were up to date. It stated gas safety was checked in July 2008, hoists in July 2008 and portable electrical appliances in September 2007. There was safety information on products relating to the Control of Substances Hazardous to Health (COSHH). The written information also stated that policies and procedures had been reviewed in October – December 2007. Although mandatory health and safety training took place, there were a number of staff who had not been updated in certain areas. For example, the written information supplied by the home stated that only 40 of kitchen staff had received training in food hygiene and the training matrix confirmed this. This was discussed with the manager who stated that this was because new staff had started during 2008 who had yet to complete the training and they were waiting for dates from a new training provider. Moving and handling training had taken place in 2007, although sixteen staff were identified on the training matrix as being due for updating in this. The administrator stated this training was in the process of being organised with a The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 24 new training provider. Staff were observed using the hoist. This was done satisfactorily. One visitor spoken with stated that the hoist was always used when moving their relative. Improvements to moving and handling practice had therefore occurred since the last inspection visit in September 2007. Fire safety training had occurred in April and June 2008 and first aid training had also occurred in 2008. All staff spoken with confirmed that health and safety training in the key areas occurred. The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 25 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 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 4 X X X X 3 X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 26 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 All care plans must have information on how to prevent pressure sores where this has been identified as an issue. This will make sure that any problems are dealt with appropriately and peoples’ health maintained. The controlled drug record must be accurately completed to ensure an audit of the drugs used and to ensure peoples’ safety. Risk assessments must be undertaken for all people who wish to retain and selfadminister their medication to demonstrate that they have the capacity to do so safely. Previous timescale of 21/12/07 not met; timescale extended by one month from inspection visit. Medication administration record (MAR) charts must always be signed accurately and correspond with the dispensing pack to ensure people receive DS0000001975.V371216.R02.S.doc Timescale for action 01/11/08 2. OP9 13 (2) 01/11/08 3. OP9 13 (2) 01/10/08 4. OP9 13 (2) 01/11/08 The Gables Version 5.2 Page 27 their medication when needed and to maintain their health and safety. 5. OP29 19 (1) (b) & Schedule 2 Recruitment practices must 06/09/08 ensure that all the necessary documentation required by Schedule 2 of the Care Homes Regulations 2001 is in place before a member of staff commences work. This includes identity information, an explanation of gaps in employment history, two written references, a Criminal Record Bureau (CRB) check and Protection of Vulnerable Adults (POVA) first check. This is to ensure the safety of people living in the home. Immediate requirement notice issued. All staff working within food 01/11/08 preparation areas must undertake appropriate training to ensure safe practice is maintained regarding food hygiene. Previous timescale of 31/01/08 not met; timescale extended by two months from inspection visit. All staff must be up to date with moving and handling training to ensure their own safety and that of people living in the home. 01/12/08 6. OP38 19 (5) (b) 7. OP38 13 (5) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 28 No. 1. Refer to Standard OP3 Good Practice Recommendations Risk assessments for falls and pressure sores should be undertaken on admission for all people coming to live in the home. All staff should receive training in safeguarding adults every two years. The kitchen should be refurbished and the recommendations of the Environmental Health department carried out. Training in areas related to care should be arranged; for example in skin care, nutrition and visual awareness. 2. 3. OP18 OP19 4. OP30 The Gables DS0000001975.V371216.R02.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team 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 DS0000001975.V371216.R02.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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