Inspection on 28/08/07 for The Gables

This inspection was carried out on 28th August 2007.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Gables 30/08/06

The Gables 03/05/06

The Gables 21/10/05

The Gables 22/11/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 The Gables Willoughby Road Cumberworth Alford Lincs LN13 9LF Lead Inspector Kathryn Emmons Key Unannounced Inspection 28th August 2007 10:30 The Gables DS0000002673.V348904.R01.S.doc Version 5.2 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 DS0000002673.V348904.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 Adults 18-65. 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 DS0000002673.V348904.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Gables Address Willoughby Road Cumberworth Alford Lincs LN13 9LF 01507 490661 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) Email address dominque.pennington@btinternet.com Mrs A D Pennington Mrs A D Pennington Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories:Learning Disabilities (LD) (6) The maximum number of service users to be accommodated is 6. Date of last inspection 30th August 2006 Brief Description of the Service: The Gables is a large home with a separate wing, which has three bedrooms, a lounge and kitchen. Upstairs in the main part of the building there are 5 bedrooms and a bathroom. There is one bedroom with a shower room on the ground floor. The home is owned and managed by Mrs Pennington and there are currently 6 residents living there. The home has large gardens and is in a rural location approximately 5 miles from the small town of Alford. The current fees for the home are £407 per week. The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A visit to the service took place on August 28 2007. This visit was unannounced and took place over 4 hours. Care received by three residents was looked at in detail. This is a method called case tracking. This included looking at their personal records, a range of general home records and staff records. Residents were also spoken to including those whose care was not looked at in detail. Staff and the manager were spoken with and the care they provided was observed. One resident completed a comment card we took with us so they could tell us about living at the service. We also sent a pre inspection questionnaire to the registered manager to provide information before we did a site visit. We didn’t receive this before we did the visit. We spoke with three residents on the day of the inspection to discuss their views of the home. We also looked at how the provider makes information about their service, including CSCI reports available to prospective service users. Residents made comments such as ‘Dominique is a mum to me” “they are all my family” “I like it here its good” Other comments made by residents and staff can be seen in the main body of the report. What the service does well: Residents live in well furnished and decorated accommodation, which they have been able to make decisions about regarding layout and colour schemes. Residents are enabled to make the service their own home and join in with cleaning tasks. Staff receive an in depth induction and ongoing training programme. A competent manager who both staff and residents say many positive comments about manages the home. Residents are satisfied that their opinions are listened to and acted upon. Residents have opportunities to engage in occupation and social activities including work placements and social activities in the surrounding community. Observations on the day evidence that residents can choose how they spend their spare time. Access to the community is encouraged and on the day of the visit residents were being supported to visit the local community. The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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 summary of this inspection report can be made available in other formats on request. The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 3. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Prospective residents can be confident that their assessed needs can be met by the service. Up to date information needs to be available so residents can make an informed decision about living at the service. EVIDENCE: There is a statement of purpose and service user guide in place. These two documents contain information about the service, staff and services offered. Residents and their relatives use this information to help them make decisions about living in the service. The documents need to be updated to show who now works in the home and what kind of service residents can expect to receive. One resident told us that before he came to live at the home the manager met with him and asked questions so that she could be sure the resident’s need could be met in the home. The manager confirmed that she always assessed residents prior to admission and send a letter to the resident and their family confirming the resident’s needs could be met at the service. We saw one of the letters on one of the files we looked at. The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Written records provide residents with confidence that their needs are known and are able to be kept safe. Regular reviews of needs provide staff with detailed information to provide the correct level of support. EVIDENCE: One of the residents spoken with was aware of written records being kept about him. The resident said these records ”tell the staff what help I need and what I can do for myself”. The resident said ”Dominique sat with me and we did the writing together and I signed the writing when I had read it”. There was evidence that reviews had taken place for one of the resident’s case tracked and there were letters inviting relevant people to attend the review. In depth information was in place for reviews. The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 10 The staff member spoken to and the manager were clear on the information that needs to be in the care plan and how daily notes also helped any changes in need to be identified. . The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users have a varied and balanced diet and are able to have their choices catered for. Service users are able tyro participate in community activities. EVIDENCE: One of the residents told us that they were able to attend a local night club run specifically for people with learning difficulties and that even though it finished late and was some distance forms the service he was still able to go and staff would collect him. A couple of service users do attend day time activities such as college and another resident is working with the staff to attend local classes. The service has 2 vehicles so that all service users can go out together even though one service users needs to travel alone due to their needs. The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 12 Residents gave examples of activities such as swimming, going shopping, meals and drinks at a local pub and one resident said they had been working as a gardener for a local neighbour. Service users all have visitors and relatives who they are in contact with. At the time of the visit one resident had gone on holiday with their relative. A new drum kit had been purchased for 2 of the residents to help them with communication. A games room has table tennis and table football. One resident recently went to the Lincolnshire show and bought some chickens, which have had chicks. This has become a hobby for other residents and a chicken house is being built so resident can become more involved in animal care. One resident said.”I like being able to chose what I do and there is always something to do and somewhere to go”. The manager said that a further activities programme is being planned for the autumn with residents being offered more choice and activities to participate in. The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18.19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal and health care needs are met and risk assessments are in place, and identify risks and how these will be minimized. EVIDENCE: We looked at the medication arrangements for the service users. Staff who give out medication have been trained to do this and understood the importance of giving the right medication at the right time. There was policy in place and evidence that training had been given. Medication records we saw had been signed and completed correctly. One of the residents we spoke with said they were happy how they were given their medication and were not able to look after it themselves, but had been given the choice to work towards maybe being able to do this in the future. An assessment was in place to show that service users had been assessed to see if they could manage their own medication. Detailed risk assessments are in place and where a resident was not able to undertake a specific task without support an explanation was recorded. Residents told us that they “can do things by myself it I am safe otherwise I The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 14 have help from Dominique and the staff” Staff discussion and written risk assessments show us that staff understand the need to balance residents right to take risks against residents being placed in potential danger. Residents told us that they were satisfied with the care they received and that they were able to indicate how they wanted their care to be delivered. A staff member gave examples of how they were aware of what a service user was wanting without them being able to use verbal communication. This shows that staff have received training in different communication methods and also have a good understanding of residneits needs, abilities and behaviours. The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident their concerns will be listened to and acted upon. Staff are trained in safeguarding adults procedures and service users are protected from harm. EVIDENCE: One of the residents we spoke with said that they were certain if he had any worries he could speak to any of the staff and they would address his concerns. Staff spoken with said they were confident to challenge the manager if they thought a decision was not in the best interest of the service users. An up to date complaints policy and record book were in place and the manager said that residents were encouraged to raise any concerns or opinions they had. Staff had received training in safe guarding adults and an up to date Lincolnshire safeguarding adult policy was in place. A staff member was given a scenario regarding an allegation of abuse and they were clear on what action they would take and who to refer any allegation to. The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in clean and pleasant surroundings, which are continually updated. EVIDENCE: Since the last visit a new bathroom has been fitted. This enables service users to have comfortable bathing facilities. New patio doors have been fitted in the dining area, which comply with fire safety regulations. Bedrooms have been decorated and two bedrooms seen with service users permission were noted to be clean and decorated in the service users choice of décor. They had enough room for their personal possessions. One resident said “I love my room, it’s big enough for all my stuff and im helped to keep it clean and tidy”. There is a large lounge area and a separate dining room and kitchen there is a snug area and a separate games room across the garden for the main house. The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 17 This enables service users to choose where to spend their time. One resident recently bought some chickens and they are supported by staff to look after these. A new fence has been installed around the garden so that service users who are not able to leave the service without support can go out into the garden without being placed at risk. The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,34,35,36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are cared for by enthusiastic and trained staff. Recruitment procedures need to be more thorough to ensure service users are cared for by the right people. Supervision sessions enable development and training needs for staff to be identified. EVIDENCE: We looked at the recruitment records for one of the staff who was also working on the day of the visit. All recruitment checks had been undertaken including a (CRB) Criminal records Bureau check and written reference had been obtained before the member of staff started work. It is necessary to make sure that 2 written reference are obtained and Mrs Pennington said she would make sure these were in place. A completed application form showed the previous qualifications and experience the member of staff had. A training file was in place for all staff and we saw certificates to show what courses and training staff had received. One of the staff we spoke with told us about recent training for managing challenging behaviour and gave examples of how this had been carried out at the service. An induction programme is in The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 19 place and all staff are enrolled on a nationally recognised induction course called Skills for Care Common Induction Adult services. This enables new staff to be aware of the polices and procedure of the service and how to care appropriately and safely for the service users. We saw certificates for food hygiene moving and handling and fire safety training in one of the files. We saw a record of further training being delivered in September. This means that staff continually receive training to enable them to have the skills and knowledge to give care in safe way. Currently three staff work in the home and two new staff are in the process of completing recruitment checks before they can be considered for employment. Mrs Pennington was also in the process of arranging further interviews for care staff and an administration staff. The staff member we spoke with said they had a contract of employment and a job description. This enables them to be clear of their job role and what is expected of them. There are 3 staff on duty during day time hours during the week and two staff on duty over the weekend. Each night there is one on call sleep in staff member. Agency staff are used for several shifts a week and the agency normally send the same staff to provide continuity for service users. Residents told us they always get the help and support they need and that all staff “Are alright and help you with anything you want” and “They even pick me up late at night and don’t mind” Staff confirmed that staff meetings take place and we saw minutes from a meeting held in June. Staff said they receive supervision sessions and we saw records of these. The sessions are delivered by an external agency so that Mrs Pennington can also receive supervision. The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well run by a competent and trained manager. Service users views are obtained but a more formal way of doing this needs to be implemented so that quality assurance of the service can be monitored. EVIDENCE: The register manager and proprietor of the service is Mrs Dominique Pennington. Mrs Pennington is a trained nurse and has many years experience in the care sector. Mrs Pennington is currently working towards a nationally recognised qualification called the Registered Mangers Award. This provides her with up to date skill and knowledge to manage a service effectively and ensure it is well run. The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 21 A quality assurance programme is in place but this has not yet been implemented. Due to the size of the service Mrs Pennington speaks with all service users each day, however Mrs Pennington intends to start using quality assurance paper work and obtain views of other people involved in the service such as social works and health care professionals. This will enable Mrs Pennington to improve the service. Since the last visit to the service by us a fire risk assessment has been produced and this was on display. Staff also said they had received training in fire safety. Records are available for regular fire equipment checks. The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 3 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 3 32 3 33 x 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 23 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 OP1 Regulation 4 and 5 Requirement The statement of purpose and service user guide needs to be reviewed to provide service users with up to date information. Written references must be obtained before prospective staff start work so that service users can be cared for by appropriate staff. Timescale for action 30/10/07 2. OP29 19)4)(c ) Sch.2. 30/10/07 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 YA39 Good Practice Recommendations It is recommended that the manager implements a formal review of the quality of the service and carries this out regularly The Gables DS0000002673.V348904.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Unity House The Point Weaver Road Lincolnshire LN6 3QN 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 DS0000002673.V348904.R01.S.doc Version 5.2 Page 25 - 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. 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