CARE HOMES FOR OLDER PEOPLE
The Gables 65 Skipton Road Silsden Keighley West Yorkshire BD20 9LN Lead Inspector
Ashley Fawthrop Unannounced Inspection 23rd February 2006 10:00 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 DS0000029159.V279501.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 DS0000029159.V279501.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service The Gables Address 65 Skipton Road Silsden Keighley West Yorkshire BD20 9LN 01535 655846 01535 655846 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) Mrs C M Mallinson Mr R G Smith Mrs C M Mallinson Care Home 44 Category(ies) of Dementia - over 65 years of age (13), Old age, registration, with number not falling within any other category (44), of places Physical disability over 65 years of age (31), Terminally ill over 65 years of age (1) The Gables DS0000029159.V279501.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27th October 2005 Brief Description of the Service: The Gables is an adapted property two extensions to the original building. The home provides accommodation for 44 older people who’s special needs include physical disabilities, dementia related illness or both. The home does provide nursing care. The home provides single and twin bedrooms on two floors, there are two lounges a dining room and a conservatory. The home is situated on a bus route on the outskirts of Silsden village. The Gables DS0000029159.V279501.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was undertaken within one day and included talking to the nurse in charge talking to service users and inspecting some records. Many of the standards were inspected at the last visit in October 2005 and were met. The home continues to provide a god service with appropriately trained staff, the records are kept reasonably up to date investment continues to be made in staff training and the environment. The service users appear to be happy with the level of care that is provided and the service users are protected by the complaints, prevention of abuse and financial policies. What the service does well: What has improved since the last inspection?
The registered person continues to invest in the building a new stair lift has been fitted and internal improvements such as adding en suite toilets and hand basins to bedrooms continues. The Gables DS0000029159.V279501.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Gables DS0000029159.V279501.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 DS0000029159.V279501.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): 2 The contracts on file reflect the care and services offered by the home. EVIDENCE: All the service users have signed terms and conditions and contracts on file. Those service users who’s care is purchased by Social Services have a contract that reflects this. The Gables DS0000029159.V279501.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): 9 and 11 The medication policy is appropriate and is effective. The staff have the skills to care for service users who are dying. EVIDENCE: The medication system is to be updated to a pre packed system at the present time medications are dispensed from bottles the change of the system is due to ordering being more time consuming and tablets were easier to loose. Medications are now dispensed from two medication trolleys one on each floor by two qualified staff this system has reduced the time it takes to administer medications. There is a medication policy available to staff that includes the process to be followed when service users are administering their own medication. Risk assessment are undertaken prior to this being commenced. Staff have undertaken training in palliative care and there are policies available to staff that focus specifically on the needs of the dying and their increasingly changing needs on what can be an hourly basis. The Gables DS0000029159.V279501.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): 14 Service users are helped to exercise choice and control over their lives. EVIDENCE: Service users were seen to enjoy the privacy of their own rooms and service users said that they get up in a morning and go to bed at a time chosen by themselves. Service users are encouraged to maintain contact with their families and friends in the community and on inspecting care plans there is evidence that service users are involved in decision making. The Gables DS0000029159.V279501.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 and 18 Service users are protected by the complaints and protection from abuse policies. EVIDENCE: The standards relating to complaints and protection were inspected at the last inspection and were met, there have been no changes since that time. The Gables DS0000029159.V279501.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, 20, 21, 22, 23, 24, 25, and 26. The home continues to provide a high standard of décor, furnishings and maintenance. EVIDENCE: All the standards relating to the environment were inspected at the last visit and were met. The Gables DS0000029159.V279501.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): 27, 28, 29 and 30 Service users continue to be protected by the recruitment policy and staff training and experience. EVIDENCE: All the standards relating staff recruitment and selection and training were inspected at the last inspection and were met. The Gables DS0000029159.V279501.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): 34, 35, 36 and 37 The service users are protected by the homes financial policies. Staff supervision must be consistent if the benefits to the service users is to be maintained. EVIDENCE: The home has a finance and accounting system that is electronic and specific for the task, this is inspected periodically by a qualified accountant. Invoices are sent to the service users or their representatives via this system this may include services not covered by the fee such as hairdressing or newspapers. The home does not manage any service users personal monies. Staff are supervised on a daily basis and annual appraisals are undertaken the structured supervision of staff continues to be hit and miss and is not always recorded, however, the system has commenced and effort is being made.
The Gables DS0000029159.V279501.R01.S.doc Version 5.1 Page 15 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 2 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 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 X X X 3 3 3 3 X The Gables DS0000029159.V279501.R01.S.doc Version 5.1 Page 16 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. 1. Standard OP7 Regulation 15 (1) Requirement Service users must have the opportunity to be involved in the development of their care plan this should be evident in the plan. Timescale for action 31/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Gables DS0000029159.V279501.R01.S.doc Version 5.1 Page 17 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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