CARE HOMES FOR OLDER PEOPLE
The Gables 29 Leicester Road Market Harborough Leicestershire LE16 7AX Lead Inspector
Rajshree Mistry Unannounced Inspection 21st December 2005 10:45 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 DS0000001774.V274553.R01.S.doc Version 5.1 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 DS0000001774.V274553.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service The Gables Address 29 Leicester Road Market Harborough Leicestershire LE16 7AX 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) 01858 464612 Niscar Limited Vacant Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places The Gables DS0000001774.V274553.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. To be able to admit the person of category SI(E) identified in correspondence from the previous registration authority dated 9th May 1997. 2nd June 2005 Date of last inspection Brief Description of the Service: The Gables is a care home registered for up to ten people who require care and support due to age related needs. The home is on the outskirts of Market Harborough. There is car parking to the rear of the home and on-the-street parking. The property comprises of a lounge, dining room and quiet room. Bedrooms are situated on the ground and first floors, close to bathrooms and toilets. 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 DS0000001774.V274553.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the service, which took place on the morning of 21st December 2005 and lasted 3½ hours. This is the second regulatory inspection of the service addressing the remaining core standards. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for the resident and their views of the service provided. The primary method of inspection used was ‘case tracking’. Two residents were identified for case tracking and the quality of the care received was examined through reviewing their care records, discussion with the residents, their relative, the staff and observation of care practices. The inspection included a tour of the premises and the examination of health and safety records. What the service does well: What has improved since the last inspection?
Since the last inspection the good practice recommendations have been addressed and the following improvements have taken place: • • • Two new staff have been appointment following pre-employment checks undertaken and have commenced the induction training. Six staff have attended training in Dementia Awareness. Following the inspection from the Environmental Health Officer the home has purchased a new fridge and microwave.
DS0000001774.V274553.R01.S.doc Version 5.1 Page 6 The Gables • Following the inspection from the Health and Safety Executive the Registered Person is in the process of updating the health and safety policy and the risk assessment of the premises. Copies of this documentation would be forwarded to the Commission. 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 DS0000001774.V274553.R01.S.doc Version 5.1 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 DS0000001774.V274553.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6. EVIDENCE: The Gables is not registered to provide intermediate care. The Gables DS0000001774.V274553.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 10. Residents are well cared for whilst respecting their choice of lifestyle and their rights. EVIDENCE: Three residents spoken with described how staff assist them with daily personal care tasks and maintaining their own level of independence. Staff spoken with were familiar to the residents individual needs and how these are met daily. Other comments included “they know how I like things done and they do it to my satisfaction” and “all the staff are very polite and respectful and never hurry me”. The residents’ plans of care examined were comprehensive, detailing the residents’ daily routines, interests including religious practice and last wishes. For example two residents chose to eat their meals in their bedrooms, often with their relative who visits and being addressed by their preferred name. The Acting Manager confirmed reviews of any risks to residents such as moving and handling and care plans are undertaken regularly but was only demonstrated by the date inserted on those documents. The Acting Manager acknowledged the need to ensure reviews of the care needs are documented appropriately and auditable.
The Gables DS0000001774.V274553.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 Residents experience a homely lifestyle and are supported to maintain contact with family and friends. EVIDENCE: Residents spoken with felt this was their home and received visitors at anytime, choosing to meet with them in the privacy of their own bedroom. Some residents spoken with stated they were planning to spend Christmas with relatives and arrangements had been made. Residents are encouraged to continue seeing family and friends, often joining in birthday celebrations, receiving Holy Communion or even going the local church. The homes had the Harborough Youth Theatre singing Christmas Carols that was enjoyed by all the residents and are booked to see ‘Aladdin’ pantomime in the New Year. The Gables DS0000001774.V274553.R01.S.doc Version 5.1 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16. Arrangements for receiving and responding to complaints are satisfactory, resulting in protection of residents’ rights. EVIDENCE: The home’s complaints procedure is displayed at the entrance of the home including the contact details of the Advocacy Service and included in the home’s brochure. Residents and the visiting relative spoken with indicated that they were aware of how to complain and were confident to express concerns if they did arise although felt there was nothing to complain about. Records showed no complaints had been received since the last inspection. The Gables DS0000001774.V274553.R01.S.doc Version 5.1 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 24. Residents live in comfortable and homely surroundings, which is clean and well maintained. EVIDENCE: On the day of the inspection the home was found to be clean, tidy and well maintained. The décor and furniture created a homely feel. Bedrooms viewed were clean, and close to bathrooms and toilet facilities. Equipment such as the bath with a hoist (Parker bath) and other mobility aids are available to the residents to promote their independence. Residents had pictures and family photographs displayed to create familiar surroundings to suit. One resident and visiting relative spoken with said “there was ample space in the room to accommodate the use of a walking aid and to entertain visitors”. Residents generally felt safe in the home, were comfortable moving around the home with or without assistance as required i.e. using the stair lift. The Gables DS0000001774.V274553.R01.S.doc Version 5.1 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29, 30. Residents are protected by the home’s recruitment procedures and cared for by trained staff. EVIDENCE: Two new staff have been recruited in line with the home’s procedures and have commenced employment following the pre-employment checks, consisting of criminal records bureau clearance, protection of vulnerable adults (pova) checks and written references. The new staff member spoken with indicated the recruitment process was robust and appointment was confirmed following the pre-employment checks. The induction training consisted of introduction to home, policies and procedures, health and safety, care skills, shadowing a senior member of staff before completing training in manual handling and hoisting and the administration of medication, prior to commencing the NVQ training. Six staff recently attended training in Dementia Awareness and first aid. Staff training records examined indicated staff had received key training in care. Discussion with the Acting Manager resulted in the acknowledgement of the training records could be more easily accessible and improved to ensure the staff receive timely refresher training. The Gables DS0000001774.V274553.R01.S.doc Version 5.1 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35, 38. Residents’ and staff’s health, safety and welfare are protected through the improving practice, policies and procedures of the home. EVIDENCE: Residents are made aware of the home’s policy regarding management of individual finances at the point of moving into the home. Residents’ finances are managed individually or with the support of family or solicitors. Staff at the home do not manage the residents finances. All the bedrooms have lockable facility to ensure personal property and valuable items can be stored securely. Records relating to the health and safety within the home are kept in good order. The fire and alarm testing is carried out regularly and recorded. During the tour of the premises the fire exits were clearly marked and free from obstructions. All the staff are scheduled to undertake the fire training in January 2006. The water temperatures are regularly tested in addition to the recent inspection for water conformity in relation to Legionella. The
The Gables DS0000001774.V274553.R01.S.doc Version 5.1 Page 15 Environmental Health Officer inspected the home, which resulted in the purchase of a new fridge and microwave. The outcome of the Health and Safety Officer’s visit resulted in the Registered Provider required to update (i) the health and safety policies and procedures and (ii) updating the risk assessment of the premises. The Acting Manager confirmed that copies of these documents would be sent to the Commission. The Gables DS0000001774.V274553.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X 3 X X STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 3 The Gables DS0000001774.V274553.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? NO 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. 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. 2. 3. Refer to Standard OP7 OP29 OP30 Good Practice Recommendations It is recommended as good practice that reviews of care needs and assessments of risks undertaken are recorded appropriately to reflect the changes, if any. It is recommended as good practice to maintain a record of the criminal records bureau clearance reference number and date. It is recommended that a staff-training matrix is developed to record the staff training and skill mix, which can be used to plan refresher training. The Gables DS0000001774.V274553.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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