Inspection on 03/05/06 for The Gables

This inspection was carried out on 3rd May 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 found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Gables 28/08/07

The Gables 30/08/06

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 Kima Sutherland-Dee Unannounced Inspection 3rd May 2006 09:40 The Gables DS0000002673.V292111.R01.S.doc Version 5.1 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.V292111.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 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.V292111.R01.S.doc Version 5.1 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.V292111.R01.S.doc Version 5.1 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 4 until May 31st 2006, from June 1st 2006 up to 6 service users can be accommodated. Date of last inspection 21st October 2005 Brief Description of the Service: The Gables is a large family home with a separate wing. This has three bedrooms, a lounge and kitchen. Upstairs there are 6 bedrooms and a bathroom. The home is owned and managed by Mrs Pennington, there are 2 residents at the home with Mrs Pennington, her family and one member of bank staff support the residents. The home has large gardens and is in a rural location approximately 5 miles from the small town of Alford. The Gables DS0000002673.V292111.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key inspection was undertaken using a review of all the information available to the Inspector regarding The Gables, and through undertaking a visit to the home, with the inspector using a method of inspection called “case tracking”. This involved speaking to one of the residents, looking at information on the care plans and other documents, discussing care with the provider and speaking to a relative. After the visit to the home the inspector also contacted the day service attended by one of the residents, for their views about the care. The inspector also spoke to a member of the contracting team from Social Services and the provider’s solicitor. All of their views add to the information about the care that is provided by the Gables. The Gables currently has 2 residents and the provider is the sole carer, with help from their family, they are currently trying to recruit staff. The residents are very much part of that family and they spend time with the children. One resident attends a day service, but the residents fit in with the provider’s routine. The home charges the standard Lincolnshire Social Services rate of 392.00 per week. It should be noted that during a meeting on the 19th June 2005 the provider informed the commission that they do now have transport, and they have employed a member of staff. What the service does well: The provider is a warm and caring person, who is trying to provide a family atmosphere, where the resident’s can feel secure. The provider enjoys cooking and the residents are offered a wide variety of foods. The home is comfortably furnished and the resident bedrooms are personalised. The home is in a very rural location, which suits resident who are used to that environment. The Gables DS0000002673.V292111.R01.S.doc Version 5.1 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 Gables DS0000002673.V292111.R01.S.doc Version 5.1 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.V292111.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4,5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The provider has not assessed the residents prior to admission. The provider had given the prospective resident opportunities to make an informed choice about the home. EVIDENCE: A new resident moved to the home in March 2006. The provider was able to show that they had obtained a copy of the assessment carried out by the social worker and that they had discussed the residents needs. The provider had invited the resident to the home on several occasions but had not recorded their own assessment. They had not written to the resident offering a place and confirming that their needs could be met. However the social worker had stated to the contracting department how pleased they were with the home and how well the resident had settled in. The provider stated that the contracts and the terms and conditions had not been issued to the residents as they had been given to a solicitor to review. The solicitor confirmed this. The Gables DS0000002673.V292111.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. One of the residents is at risk because of the lack of a care plan or written risk assessments. The provider is meeting the personal care needs of the resident but their individual choices are limited. EVIDENCE: The provider had developed and agreed a detailed care plan with one resident but had not produced any records apart from brief daily notes for the person last admitted. Although the provider could describe their care needs, none of the information was recorded. Therefore the provider is relying on their own knowledge to be available at all times to provide the correct needs. The provider stated that they wished to get to know the resident first, however they moved into the home approximately 5-6 weeks prior to the inspection. The provider talks to the residents daily and the residents are able to make limited choices, however this is not recorded. The Gables DS0000002673.V292111.R01.S.doc Version 5.1 Page 10 Hazards and risks were identified for one resident, however other significant risks had not been identified. The Gables DS0000002673.V292111.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The provider is offering some suitable activities, however the lack of staffing and transport means the residents have limited choices. The residents are offered a suitable and balanced diet. EVIDENCE: The resident had limited daily activities for the reasons listed below: 1. The provider does not have regular transport and relies on a limited bus service or their family. 2. The provider has not clarified who will provide a day service and how this will be funded. The provider is making enquiries. 3. The provider is currently the only member of staff and the resident cannot be left alone, therefore the resident attends appointments and on occasions they have to follow the routine of the provider. The Gables DS0000002673.V292111.R01.S.doc Version 5.1 Page 12 At a meeting following the inspection the provider informed the commission that a member of staff had been employed and they intend to add more staff to the team. The provider has stated in the pre inspection questionnaire that residents have attended places or events that would be of interest to them, and there are records of activities in the home. One of the residents goes out with a relative about twice a week for most of the day, the other person attends a day service. The suitability of this is still being assessed. The provider offers a balanced and varied menu, and they had a good knowledge of each resident’s likes and dislikes. The cupboards and fridge were well stocked. The Gables DS0000002673.V292111.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The provider is meeting the personal care needs of the residents, however there are risks to both of the residents. EVIDENCE: The provider does offer personal support and was able to describe the way this meets the resident’s needs, however the lack of a care plan means that this could not be evidenced. The provider stated that the sister of a resident had commented that they were very pleased with the care at the home. The provider spends time ensuring the environment is hygienic due to the behaviour of a resident. The provider stated their concerns regarding the hygiene of the home, this does pose a risk to the residents. One resident is extremely vulnerable due to their activities and the provider is aware of these issues. A separate letter is being sent to the provider detailing the inspectors concerns and further action required to address these. The previous inspection demonstrated that the provider is able to safely administer medication. There are concerns regarding one resident purchasing The Gables DS0000002673.V292111.R01.S.doc Version 5.1 Page 14 their own medication and the risks that this resident has possibly taken this medication. The risks of this and any actions are recorded in the care plan. The Gables DS0000002673.V292111.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The provider did protect a resident but failed to inform the commission. EVIDENCE: The provider states in the pre inspection questionnaire that they have attended an adult abuse training course, however they have failed to inform the commission of a notifiable event. They did inform social services who have dealt with the matter. The provider talks to the resident’s daily and in detail and the relatives have the opportunity to air their views and raise any complaints, verbally or writing. One relative said that they would be happy to talk to the provider at any time. The Gables DS0000002673.V292111.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a comfortable and clean home. EVIDENCE: The previous inspection and the visit to the home demonstrate that the home is clean and well furnished. The Gables DS0000002673.V292111.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The provider cannot meet all of the residents needs until staff are employed, and trained. EVIDENCE: The provider is the only paid member of staff, and carries out all duties both during the day and at night. After the inspection the provider said that they do employ a bank member of staff but there was no evidence that they had worked any hours. This is affecting the lives of the residents as they cannot be left unattended and therefore they have fit in with the providers routine rather than their own. The provider has attended training courses since the last inspection. The provider has had support from social services contracting department to develop appropriate recruitment documents and these are being used to attempt to recruit new staff. At a meeting following the inspection the provider informed the commission that a member of staff had been employed and they intend to add more staff to the team. The Gables DS0000002673.V292111.R01.S.doc Version 5.1 Page 18 The provider described how the family help in the care of the resident’s. The Gables DS0000002673.V292111.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The provider is not managing the home at an acceptable level. EVIDENCE: The provider is attempting to carry on and manage a service with very limited resources. The residents have a high level of care needs and currently there is no other staff support and this puts the residents at risk. The provider showed a book where comments had been requested from the one visiting relative each month. These were positive. The provider states in the pre inspection questionnaire that they have health and safety policies. The Gables DS0000002673.V292111.R01.S.doc Version 5.1 Page 20 Since the admission of the most recent resident, the provider has fitted locks, to most of the internal doors. This is a risk to the safety of the entire household and must be reviewed by a fire officer. The use of this type of lock must be approved by the fire officer. If they are approved and they continue to be used this must be formally reviewed to show a decision has been made to protect the resident, as part of the strategy to provide care at the home, and as part of the plan of care for that individual. The Gables DS0000002673.V292111.R01.S.doc Version 5.1 Page 21 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 X 2 2 3 2 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 3 12 2 13 3 14 2 15 2 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 2 X 3 X X 2 X The Gables DS0000002673.V292111.R01.S.doc Version 5.1 Page 22 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 YA2 Regulation 14 Requirement Timescale for action 30/06/06 2. YA9 2. YA3 3. YA19 4. YA33 5. YA23 6. YA33 The registered manager must assess each prospective resident. They must assure themselves that the home can meet their needs. 13(4)(a)(b)(c) The registered provider must ensure that risks are identified and that action is taken to minimise these. 14(1)(d) The registered manager must write to each prospective resident confirming that the home can accommodate them and meet their needs. 13(3) The registered provider must (4)(a) ensure that they can meet all of the residents needs. And prevent cross infection. 18 The registered provider must ensure that the home is supported by suitably qualified staff in adequate numbers to meet the needs of the residents. 13(6) The registered person must inform the commission of any suspicions of abuse, and how they have been addressed. 18(1)(a) The registered person must ensure that all the resident’s DS0000002673.V292111.R01.S.doc 30/06/06 30/06/06 30/06/06 30/06/06 30/06/06 30/06/06 The Gables Version 5.1 Page 23 7. YA43 25(1)(2) needs are met by providing suitably qualified staff in sufficient numbers. The registered provider must supply the commission with detailed financial records. A meeting will be sought to discuss theses details. 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA5 Good Practice Recommendations It is recommended that the registered manager supply every resident with a contract, including terms and conditions, as soon as these are received from the solicitor. The registered manager should help the residents make informed choices about their routines and activities These should be recorded. Where this is in conflict with the family the manager should help the resident make decisions in their own best interests. The registered manager should help the residents make informed choices about their routines and activities These should be recorded. Where this is in conflict with the family the manager should help the resident make decisions in their own best interests. The registered manager should make provision for private transport as soon as possible. 2. YA12 3. OP14 4. YA13 The Gables DS0000002673.V292111.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 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.V292111.R01.S.doc Version 5.1 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. 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. 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