Inspection on 30/08/06 for The Gables

This inspection was carried out on 30th August 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 2 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 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 Wendy Taylor Key Unannounced Inspection 30th August 2006 09:15 The Gables DS0000002673.V307829.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.V307829.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.V307829.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) 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.V307829.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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 3rd May 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 2 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 £392:00 per week. The Gables DS0000002673.V307829.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was undertaken on 30 August 2006 over approximately a 4-hour period. The care and support of two residents was looked at in detail. Individual care records and general house records were looked at; residents and staff were spoken to, and an observation of how care and support is provided was made. A resident said that they were pleased with the care and support provided, and they liked living there. Two recommendations have been made and one has been carried over from the previous inspection. What the service does well: What has improved since the last inspection? What they could do better: A requirement has been made to improve the risk assessing processes within the home in regard to fire safety and behavioural needs. The Gables DS0000002673.V307829.R01.S.doc Version 5.2 Page 6 It is recommended that care plans contain more detail about how residents are supported to make choices and decisions. Recommendations are also made to implement a formal quality review process and for the duty rota to show who is on duty at all times. 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.V307829.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.V307829.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,5 Quality in this outcome area is adequate. The judgement has been made using the available evidence including a visit to the service. Residents’ benefit from having clear terms and conditions and the provider has developed a comprehensive pre-admission assessment. EVIDENCE: There have been no new admissions since the last inspection, therefore it is not possible to make a clear judgement regarding the admission procedures, however the provider has updated the initial assessment forms in preparation for any new admissions. The new format incorporates knowledge that the provider has gained from recent training courses regarding, for example sensory needs. Assessments are available for residents and social activity preferences are recorded in those assessments. They also cover mental health and physical needs including oral health triggers. Contracts are in place and signed by the resident’s representatives and there is a service user guide and statement of purpose available. The Gables DS0000002673.V307829.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 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. The judgement has been made using the available evidence including a visit to the service. Residents have individual care plans, which include risk assessments, however plans do not clearly reflect how they are supported to make choices. EVIDENCE: There are provider care plans in place for each resident and also placing authority plans. The plans include emotional support, activities, lifestyle skills and health and safety issues. There is evidence that the care plans are reviewed on a monthly basis. Risk assessments are also in place for issues such as personal safety. Staff were observed to encourage residents to make basic daily choices about food, drinks and activity. There are some references to making choices in care plans, but they do not clearly inform new staff about how to support residents to make choices and/or more complex decisions. The Gables DS0000002673.V307829.R01.S.doc Version 5.2 Page 10 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): 12,13,15,16,17 Quality in this outcome area is good. The judgement has been made using the available evidence including a visit to the service. Residents have increased opportunity to make choices about their lifestyles, and they are offered a balanced and varied diet. EVIDENCE: A resident said that they chose to do activities such as go to a local air show, go out for a drive in the car, help to shop for food and go out to buy new clothes. They said that they liked to help keep their room clean and tidy. There is a record of activities kept in the home and it includes those choices expressed by a resident. There is a good range of foods available and menus are completed on a four weekly plan. A resident said that the food is very good and they can choose what they want to eat. The Gables DS0000002673.V307829.R01.S.doc Version 5.2 Page 11 Family visits are encouraged and there was a relative visiting at the time of inspection. There is now transport available specifically for residents. The Gables DS0000002673.V307829.R01.S.doc Version 5.2 Page 12 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 adequate. The judgement has been made using the available evidence including a visit to the service. Residents’ personal and health care needs are met and some risk assessments are in place, however all identified risks need to be assessed. EVIDENCE: Residents’ care files contain appointment lists for GP’s, chiropody, psychiatry, psychology and daily records show the outcomes of appointments. There are behaviour monitoring forms in place and the provider said that she is in close contact with a care manager from the Local Authority in regard to the behavioural needs for one resident, however there were no risk assessments available in regard to those needs. There is a health action plan available for one resident. Risk assessments are available for medication issues and appropriate actions have been taken to reduce risks. The medication policy was seen during the visit; and administration records and storage were satisfactory. The Gables DS0000002673.V307829.R01.S.doc Version 5.2 Page 13 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. The judgement has been made using the available evidence including a visit to the service. The home provides a safe environment where residents are protected from abuse. EVIDENCE: There were no complaints or adult protection issues recorded and the provider confirmed that none had been reported since the last inspection There are complaints and adult protection policies in place, including local authority guidelines. The complaints policy in contained in the service user guide and in individual terms and conditions. There is also a whistle blowing policy in place A newly recruited staff member said that they had done training in adult protection issues in a previous role and they demonstrated a clear knowledge of how to recognise adult abuse and what to do if they suspected such. A resident said that they would tell the provider or the staff if they have a problem or they’re unhappy about something. The provider said that she talks to the residents on a daily basis and records comments by relatives on a monthly basis, these records were seen. The Gables DS0000002673.V307829.R01.S.doc Version 5.2 Page 14 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. The judgement has been made using the available evidence including a visit to the service. Resident’s live in a comfortable and clean home. EVIDENCE: On the day of the visit the home was very clean, tidy and smelled fresh. The bathroom has been recently decorated and a new floor covering has been laid. One piece of the bathroom suite needs repair and the provider said that she has arranged for this to be done. The ground floor hallway has also recently been decorated. All fire exits were clear of obstructions and cleaning materials were stored in the garage away from the main home. Bedrooms are personalised and a resident said that they liked their room. The provider said that she has ordered office furniture to improve filing and storage of records in the home. The Gables DS0000002673.V307829.R01.S.doc Version 5.2 Page 15 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): 32,33,34,35,36 Quality in this outcome area is adequate. The judgement has been made using the available evidence including a visit to the service. Resident’s are protected by robust recruitment and induction procedures and there are appropriate staffing levels, however duty rotas need to be clearer. EVIDENCE: Two part time staff have now been employed at the home, one of whom was on duty during the visit. The provider continues to work shifts as part of the team. A staff rota is in place but it does not clearly indicate who is on duty at all times. Records demonstrate that staff have received training in infection control, first aid, basic food hygiene, care planning and fire safety. The provider has also completed training in hearing loss and communication, health and safety awareness and attended training in the use of a comprehensive staff induction package. Induction records are available as well as supervision, appraisal and personal development records. There is a policy regarding appraisals and there is evidence of staff meetings taking place. A member of staff said that they had a good induction to the needs of the residents and to all of the paperwork in the home. The provider has obtained a The Gables DS0000002673.V307829.R01.S.doc Version 5.2 Page 16 new, comprehensive induction programme, which is now in place and will start in the near future. Recruitment files were complete and included interview questions and responses. The Gables DS0000002673.V307829.R01.S.doc Version 5.2 Page 17 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 adequate. The judgement has been made using the available evidence including a visit to the service. The provider is currently managing the home at an acceptable level although further improvements to health and safety issues need to be made. EVIDENCE: The provider has obtained a quality review system but there was no evidence of completion. There was evidence in other records that the provider seeks comments from relatives on a monthly basis. A fire risk assessment was not available but the provider said she would liaise with the fire officer in order to establish one. A recent letter from the local fire officer says that door locks used within the home meet with the approval of fire authority, but no risk assessments are in place. Records are available for regular fire equipment checks. The Gables DS0000002673.V307829.R01.S.doc Version 5.2 Page 18 There are policies available for equality and diversity, equal opportunities for staff, health and safety, infection control and quality assurance. Records show that staff have received training in health and safety awareness. Staff were observed to be following procedures for infection control (e.g. hand washing) and the provider said there are no issues arising currently regarding hygiene risks regarding one resident. The Gables DS0000002673.V307829.R01.S.doc Version 5.2 Page 19 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 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 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 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 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 2 3 X 2 X 2 X X 2 X The Gables DS0000002673.V307829.R01.S.doc Version 5.2 Page 20 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 YA19 YA42 Regulation Requirement Timescale for action 30/09/06 13(4)(a)(c) The provider must assess all risks to the health and safety of residents, including behavioural needs and fire safety. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA7 YA33 YA39 Good Practice Recommendations It is recommended that care plans contain more details about how residents are supported to make choices and decisions. It is recommended that the duty rota reflect who is on duty at all times of the day and night. It is recommended that the manager implements a formal review of the quality of the service and carries this out regularly. The Gables DS0000002673.V307829.R01.S.doc Version 5.2 Page 21 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.V307829.R01.S.doc Version 5.2 Page 22 - 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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