Inspection on 20/05/05 for The Gables

This inspection was carried out on 20th May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Gables 01/02/07

The Gables 17/01/06

The Gables 09/12/04

The Gables 12/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE The Gables 22 Post Office Road Dersingham Kings Lynn PE31 6HS Lead Inspector Jenny Rose Unannounced 20th May 2005 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 I55 s27426 the gables v228541 200505(4).doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Gables Address 22 Post Office Road, Dersingham, Kings Lynn, Norfolk, PE31 6HS 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) 01485 540528 01485 540528 www.lyndamcinerney@aol.co.uk Miss Lynda McInerney Miss Lynda McInerney Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th December 2004 Brief Description of the Service: The Gables is a care home providing personal care and accommodation for sixteen older people. It is privately owned by Miss Linda McInerney.The home is a large detached house located in the village of Dersingham and is in close proximity to the shops, library and other facilities of the village.The home was opened in 1987. It consists of accommodation on the ground and first floors, with the majority of bedrooms being on the ground floor.Fourteen of the homes bedrooms are single and there is one shared room. The home does not have a passenger lift, but there is a stair lift providing access to the four bedrooms, which are on the first floor. The home has grassed areas to the front and rear of the property, which several of the bedrooms look onto. The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, taking place on a weekday over four and half hours. Preparation had taken place in the CSCI Office. The Proprietor, Miss Lynda McInerney was present during the inspection. A tour of the building was undertaken and many records were viewed. Three service users were spoken to privately, as well as a group of service users in the dining room. Discussions took place with three members of staff privately. What the service does well: What has improved since the last inspection? What they could do better: * * * * The appointment of a replacement Care Manager should further strengthen the leadership of the staff team to meet the service users’ changing needs. Refurbishment of the laundry area would further promote measures for infection control to protect service users. Attention needs to be given to the outside paintwork and general appearance of the building. Improvements could be made to the approach and gardens to the entrance to the building, to provide more attractive views from service users’ rooms. I55 s27426 the gables v228541 200505(4).doc Version 1.30 Page 6 The Gables 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 I55 s27426 the gables v228541 200505(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 I55 s27426 the gables v228541 200505(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) 2,3,5 The home takes good information concerning the service users’ needs and gives detailed information of what the home can provide. This ensures that the prospective service user can make an informed choice as to whether the home can meet his/her needs. EVIDENCE: On first enquiry to the home, pre-assessment details are taken. Prospective service users then visit the home, if possible, with relatives, when a more detailed assessment is made. Available on that visit, are albums of photographs of various activities and events, which have taken place in the home and a copy of the home’s Policies and Procedures. On admission the service user is given a copy of the Agreement of Terms and Conditions, the Complaints Procedure, a Statement of Purpose and a Statement of Care. Also, staff have access to the service user’s needs assessment upon admission, which is then under regular review. A month to 3 months is considered as a trial period and formally reviewed to become permanent. The new service user also receives a newsletter, which is published regularly in-house, giving news of in-house events, such as birthdays, or new members The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 Page 9 of staff; as well as contributions from service users, or visitors, with such items as poems and topical anecdotes. This newsletter also informs service users and their families of any updating of Policies and Procedures. The home is to be commended for this. At the close of the inspection a prospective service user was making a visit to the home, with a view to admission. The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 The care plans give clear information as to service users’ needs, from which the staff can ensure that these needs are met according to the service user’s preferences. EVIDENCE: The care plans viewed contain photographs and give a comprehensive life history of the service user, which is good practice. There are good details of the service users’ health and personal care needs and risk assessments for falls and for a service users who wishes to smoke. Care plans are regularly reviewed to take account of service users’ changing needs. However, there is a recommendation for one service user to agree and sign a risk assessment to smoke only under supervision, which she was doing at the time of the inspection. She told the proprietor that she was agreeable to this. There is good evidence that other health care professionals visit and offer advice when required. As well as the District Nurse, the Community Psychiatric Nurse, the Physiotherapist and the Chiropodist, a representative of the Blind Association visits when appropriate to one particular service user. The proprietor wishes to update the Care Planning system and to this end has sent a member of staff on a Care Planning Accountability Course, which is to be commended. The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 Page 11 The home operates a key-worker system and the key-workers’ names appear in the newsletter. There is a new medication system in operation, which has been in place for a month. Medication was observed to be administered from a trolley, which when not in use, is locked in the medical room. Medication is contained in blister packs and there is a designated member of staff responsible for the ordering and auditing of medication. The senior members of staff are trained in Medication Administration and the MAR sheets were seen to be in order. There is no one administering their own medication and no controlled drugs in use, although the facilities are available for this. Staff were seen to respect service users’ privacy by knocking on doors before entering and it was evident from speaking to service users that they felt they were treated with dignity. The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 The home has a relaxed atmosphere and its location ensures that the service users remain in touch with the local community and are provided with variation and interest in their day-to-day lives. EVIDENCE: There are many service users from the village of Dersingham and the nearby district, many have known each other for years and also other service users’ visitors, together with members of staff who live locally. This gives the home a very friendly and relaxed atmosphere and keeps the service users in touch with the local community. Service users also attend local associations such as the British Legion and the WI and one service user also confirmed that she enjoyed going out to lunch regularly with friends from the village and also to a Blind Class in Hunstanton. The home operates an open door policy and visitors arrived at the home during the inspection. There was evidence from notices and the newsletter that a Lay Preacher from the Church visits regularly. The report book contains details of activities in which individual service users participate and the staff reported that they had only to suggest ideas for activities and the proprietor provided them with the resources. A member of staff had made an activities box containing craft and painting materials. She confirmed that activities took place at least 3 or 4 times a week, including The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 Page 13 games. The service users participation in activities was recorded in the Report Book and there were photographs of these activities in an album in the hall. A newsletter produced by the home is mentioned elsewhere in this Report. Opportunities were available for service users to have as much autonomy as possible. One service user liked to help to make cakes and pancakes. Another service user confirmed that she liked to go to bed at 10.45pm and it was confirmed by a member of staff that, as far as possible service users were able to choose their bed, as well as their rising times, and when they had a bath. One service user spoken to confirmed that in the Gables it was “home from home” and that “staff know my preferences and are very kind”. The Proprietor said that she is trying to publicise the fact that the home is on the Internet and that relatives living some distance away may like to communicate with service users by email. This is to be commended. One service user, who had been in the home for 6 years said, “The meals are marvellous”. At the time of the inspection, the lunch was seen to be appetising and nutritious and attractively presented. The cook confirmed that there was always an alternative available, if service users wished, and the 3 weekly menu was seen to be well-balanced. The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 The policies, procedures and staff training in the home ensure that the service users are protected from abuse. EVIDENCE: All service users spoken to, were aware to whom to complain, should they have a complaint, and it was evident that they had confidence that any comments they made would be listened to. There was a complaints book in the lounge and there had been no complaints received in the home. The Proprietor reported that service users had used a postal vote if they wished in the recent Election. All the staff spoken to were aware of the home’s Whistle Blowing Policy and had undertaken training in Adult Abuse Awareness and there was evidence of this on the staff files. The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 24, 26 Although there are improvements in facilities taking place in the home, this also needs to be extended to the outside of the building and the surrounding gardens to provide a more attractive approach and outlook for service users. EVIDENCE: At the time of the inspection there was evidence of improvements being undertaken in the home by the provision of en suite facilities in an upstairs room. There are similar plans for other rooms, including an extension to an existing toilet where there is no hand basin. The laundry area appeared to be rather cluttered and in need of refurbishment, particularly in the area of the hatch for dirty linen. Some of the gardens are not particularly attractive, leading to some outlooks from service users’ rooms being of little interest and appearing rather inaccessible to service users. The outside of the building is in need of redecoration and there is a recommendation to this end. The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 Page 16 The communal rooms are furnished in a homely manner and the lounge area has been divided into a TV room leading into a quiet room. All service users had their rooms personalised to their own wishes and the rooms were comfortable and furnished in a homely manner. One service user spoken to, who was bed bound, had a high bed at window level with a good view of the garden and the bird table. She was well-known in the village and had many visitors, including her solicitor who acted as her advocate. All areas of the home were seen to be clean and hygienic. The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 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 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, 28, 29 Staff are enthusiastic about their work and the home has worked hard to increase the level of training, which enables them to meet service users needs in a competent manner. EVIDENCE: It is evident that the Proprietor is enthusiastic in supporting staff training and this was confirmed by the staff, themselves, who are appreciative of the opportunities they are given. There are five members of staff with NVQ2 and one in progress. One staff member commented that her job was “brilliant”, having moved, as she had, from a much larger home. She found that she could spend more time with service users in a one-to-one situation and was therefore much more involved with them. She felt the home was like “one big family” and there was a very relaxed atmosphere. She said that the Proprietor was “100 supportive” and that the meals were “absolutely superb”. This member of staff who had been in post for 6 months was aware of the Whistle Blowing Policy in the home, had completed Courses in Stroke Awareness, Moving and Handling and Abuse Awareness and was starting her NVQ3. Another member of staff confirmed that she too had attended many courses in the year that she had been in post, including an Infection Control Course which was ongoing. She confirmed that the Proprietor provides supervision The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 Page 18 every two months, which was corroborated in the staff files and that although they have informal staff meetings, whenever required, and a comprehensive changeover between shifts, she understood there would be more formal staff meetings, on the appointment of a new manager. Staff files were viewed and these were in order with the necessary documentation. The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 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 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) 31, 33, 35, 38 Good communication within the home, together with good record-keeping ensures that the home is run in the best interests of the service users. EVIDENCE: On the day of the inspection, the Proprietor was in the process of interviewing for the position of a Care Manager. It is the intention on that appointment that the Manager should be responsible for staff training, freeing the Proprietor, who has had many years experience in running a care home, to concentrate on administrative tasks. The results of a quality assurance questionnaire, dated May 2005, were seen. Fourteen questionnaires had been given out and nine had been received back. The questionnaire covered such issues as the control of radiators, activities and bedtimes. The answers were anonymous and published. This occurs every six months, which is good practice. The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 Page 20 The Finances Book for service users’ petty cash was randomly checked and found to be correct. The Accident Book was seen, together with other maintenance records and these were in good order. There is a Fire Drill Evacuation every six months with four members of staff and this is discussed with service users afterwards. The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x 3 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 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 2 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x 3 x x 3 The Gables I55 s27426 the gables v228541 200505(4).doc Version 1.30 Page 22 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 NO 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 19.2/3 Good Practice Recommendations The Proprietor shall ensure that a programme of routine maintenance and renewal of the fabric and decoration of the premises is produced and implemented with records kept. Grounds are kept tidy, safe, attractive and accessible to service users. 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