Inspection on 25/10/06 for The Gables

This inspection was carried out on 25th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 21/12/05

The Gables 02/06/05

The Gables 19/01/05

The Gables 02/09/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Gables 29 Leicester Road Market Harborough Leicestershire LE16 7AX Lead Inspector Judith Roan Key Unannounced Inspection 25th October 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 DS0000001774.V317187.R01.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 DS0000001774.V317187.R01.S.doc Version 5.2 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.V317187.R01.S.doc Version 5.2 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. 21st December 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. Fee level range from £450-£500 per week. The Gables DS0000001774.V317187.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. The inspection also included a tour of the home. The Inspector also received questionnaires completed by service users and visitors. The homes acting manager also completed a pre-inspection questionnaire. What the service does well: What has improved since the last inspection? What they could do better: All new residents require an assessment of need that is documented prior to their admission. Care plans need to be drawn up for all new residents. Risk assessments need to be reviewed and up to date within care plans. The Gables DS0000001774.V317187.R01.S.doc Version 5.2 Page 6 Some areas of the home are in need of repair and maintenance. A staff training matrix needs to be available to demonstrate how the manager is ensuring that the service is meeting care sector standards. Health and Safety records need to be available for inspection. Care staff supervision need to be recorded appropriately within the home. A quality assurance systems needs to be in place. Managements arrangements need to be in place to ensure that there is access to records when the acting manager is on leave. 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 DS0000001774.V317187.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Gables DS0000001774.V317187.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is adequate. The home has clear information for prospective residents. New residents do not always have an assessment prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Clear information is available to potential residents about the home so that they can make an informed choice about whether the service will meet their needs. Potential residents can visit the home prior to admission to see whether they would like to move in. During this time care staff can gain more information about the potential residents needs. It is normal practice that information is gained prior to admission. Unfortunately a new residents assessment information was not recorded and on file for use by care staff at the time of the inspection visit. In discussion with residents they confirmed that they were happy with information received about the home, but were not sure that they had been given a service users guide prior to moving to the home. The Gables is not registered for intermediate care. The Gables DS0000001774.V317187.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. Most residents have clear plans of care and are supported by a competent staff team that respect their preferences and privacy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans are normally drawn up after the initial assessment and kept confidential in resident’s files. The file for the newly admitted resident had not been completed and care workers were working from information given by the resident on admission and from a previous visit to the home. Of the files reviewed there is a need to update risk assessments. No risk assessment was found for a newly admitted resident Residents spoken with all said that they were well supported by the staff team and confirmed that carers treated them with respect and ensured their privacy at all times. Carers were knowledgeable about the needs of individual residents and demonstrated that they were confident in carrying out their duties. Residents have access to healthcare services and are supported to access local resources. The Gables DS0000001774.V317187.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. Residents are supported do have a lifestyle of their choosing. Meals are freshly prepared, balanced and served attractively. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents confirmed that they were supported to carry on activities that they had enjoyed prior to moving into the home. One resident liked a daily paper, which was delivered to the home. Residents are fully supported to maintain contact with local churches if they wish. Families and visitors are welcome at anytime and afforded privacy in meeting with residents in their own bedrooms or in the quiet room. All meals are freshly cooked on the premises and undertaken by one of the care staff on duty. The mid day meal served during the inspection was presented well and residents all agreed that it was well cooked and tasty. Residents can choose to have their meals in the dining room or in their bedroom. One resident liked to eat their meal in an evening and the home was able to provide for this need. Residents are encouraged to be as independent as possible and where appropriate facilitated to do some of the preparation themselves. Special diets can be accommodated with care plans identifying particular needs in this area. The Gables DS0000001774.V317187.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. Residents are protected by the homes policies and procedures. Not all residents are confident that their complaints will be dealt with and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No access was available to the complaints records at the time of the inspection. However there have been no direct complaints made to the CSCI since the last inspection. Residents all confirmed that any concerns could be raised with the acting manager or owners. The complaints procedure is included in the service users guide and a copy can be found in the entrance hall to the home. All care workers are aware of abuse procedures and the policies relating to reporting any concerns. Training for this is undertaken within the induction programme. The Gables DS0000001774.V317187.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,26 Quality in this outcome area is adequate. Parts of the home are in need of decoration and maintenance. Resident’s rooms are homely and comfortable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In touring the building and meeting with residents the inspector found that bedrooms were personalised and homely. The lounge and dining room were warm and comfortable. A stair lift is available to enable residents to access the first floor of the home. Bathrooms are equipped with safety aids and hoist for bathing. There is a need for some parts of the home to be internally redecorated, especially the room where fridges and freezers are stored. Outside the home is looking tired and in need of some care and attention. The provider needs to review how the home is maintained and provide reassurance to CSCI that there is regular maintenance undertaken. Care staff at the home keep the home clean, tidy but need to use liquid soap in all communal bathrooms and toilet to prevent cross infections. The Gables DS0000001774.V317187.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28,29,30 Quality in this outcome area is good. A dedicated staff team supports residents. Staff records are not available for inspection at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection staffing levels were sufficient to meet the needs of current residents. Staff conveyed that they were confident within their roles and had a good understanding of the residents needs. Care workers confirmed that there is an induction training programme in place for new staff but showed concerned about the level of turnover with new recruits. The inspector was also informed that staff had good access to training. A request made at the last inspection and again requested after this inspection for a training matrix has not been received by CSCI. Staffing records were not seen at this inspection, as files were locked and not accessible to the senior on duty. Previous visits to the home have not recorded any shortfall in this area except for maintaining a record of Criminal Record Bureau Disclosure Numbers. This was a recommendation at the last inspection. The Gables DS0000001774.V317187.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,37,38 Quality in this outcome area is adequate. There are some shortfalls in meeting the above standards. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Many of the homes records were not available for inspection on the day visited. A request to provide information was in part complied with but the health and safety records have not been made available. A quality assurance system has not been in place with verbal feedback being relied on in the past. The registered provider has however developed a questionnaire that will be implemented in the future. It is recommended that the results of the residents survey be incorporated with feedback from relatives, staff and professional visitors to the home in an annual report. Care workers confirmed that they are supervised but no formal records are kept. A recommendation is made for the acting manager to record these meetings. The Gables DS0000001774.V317187.R01.S.doc Version 5.2 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 3 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 X X X X X x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X 2 2 x The Gables DS0000001774.V317187.R01.S.doc Version 5.2 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. 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. 4. 6. 7. 8. 9. Refer to Standard OP3 OP7 OP7 OP19 OP30 OP33 OP36 OP37 Good Practice Recommendations Assessments of need for all new residents must be recorded prior to admission Care plans for service users must be prepared from the assessment of newly admitted resident’s Care plans need to contain comprehensive risk assessments to ensure residents are fully protected The home needs to have a regular maintenance programme in place to address repairs and decoration 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. A quality assurance system needs to be in place that reflects the views of resident, families and professionals. Supervisions need to be recorded as part of good employment practice. Arrangements for Access to records need to be in place in the absence of the acting manager. The Gables DS0000001774.V317187.R01.S.doc Version 5.2 Page 17 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 DS0000001774.V317187.R01.S.doc Version 5.2 Page 18 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!