Inspection on 07/05/08 for The Gables

This inspection was carried out on 7th May 2008.

CSCI found this care home to be providing an Adequate service.

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 13/06/07

The Gables 01/11/06

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE The Gables Gravesend Road Wrotham Kent TN15 7QD Lead Inspector Justine Williams Unannounced Inspection 7th May 2008 09:00 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 DS0000067669.V363749.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 DS0000067669.V363749.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Gables Address Gravesend Road Wrotham Kent TN15 7QD 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) 02086609953 01732 822758 thegablesnursinghome@hotmail.com Stargate Partnership Ltd Amanda Clampin Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (0) of places The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs to the home are within the following categories: 2. Old age, not falling within any other category - (OP) Nursing The maximum number of service users to be accommodated is 25. Date of last inspection 13th June 2007 Brief Description of the Service: The Gables is a large detached property set in extensive grounds. The home is registered to provide nursing care to 25 older people. There are 6-shared bedrooms and 13 single bedrooms, 10 of which have en-suite toilet facilities. Many of the rooms registered for shared use are being used as singles and the number of double rooms are being reduced, to provide larger single bedrooms for residents. Most of the bedrooms are overlooking the Kent countryside. The home has a small lounge and dining room. The home is situated in a rural location close to the A20 and M20, public transport links are some distance, there is ample off road parking in the grounds of the home. The nearest shops are in Wrotham or Meopham, both are a couple of miles away. The home has recently been taken over by Stargate partnership Ltd, and the responsible individual and the new manager plan to extend, refurbish and redecorate the property in the future. Many of the bedrooms have already been refurbished. The current fees range from £459.56 to £568.02 per week, newspapers hairdressing and chiropody not included in the fees. The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1star. This means the people who use this service experience adequate quality outcomes. An unannounced inspection was carried out on 7th May 2008 between 09.00 am and 2.45pm by Regulatory Inspector Justine Williams. During that time residents, staff and the registered manager agreed to speak with the inspector both in public and privately. This report contains assessments made from observations, conversations and records, case tracking and a tour of the premises. Feedback was given during and at the end of the inspection. As part of the inspection process surveys were sent to service users, GP’s, health care professionals, and care managers. Some specific comments made were: “care staff are very attentive” “the residents and families are treated with a great deal of respect” “The manager goes out of her way to provide a flexible responsive service” What the service does well: The home welcomes residents newly admitted to the home. Care plans are very detailed giving very specific instructions to care staff as to how residents like to be guided and moved, preferred routines, abilities and areas they need help with. The health needs of residents are well documented, and well managed, and the nursing care is good. Residents have access to other healthcare professionals arranged for them through the home. Residents speak highly of the staff and enjoy good relationships with them. Residents feel they are treated with respect. The infection control practices at the home are good, they comply with relevant guidance and good practice. Staff are safely recruited, which protects residents. The home has 50 of staff having achieved NVQ. The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 6 The manager is making the changes needed to ensure better care for the residents in spite of the environment, which provides many challenges. Residents enjoy good relationships with the manager and speak highly of her. What has improved since the last inspection? What they could do better: The initial assessments should include resident’s interests, hobbies and social history. However if this is not possible at time of admission or later due to cognitive impairment, the home is requested to complete this where possible at a later date from information given from relatives or friends / advocates. The privacy of some residents on the ground floor may be compromised as they are overlooked by those using the patio, therefore supplying privacy screening or curtains may solve the problem though a consultation with residents should take place. The activity plan and equipment now needs to be developed further to ensure resident’s interests are included. The refurbishment of the home is now overdue and many areas of the home are in need of urgent improvement, and some areas outside particularly are unsafe. Care staff are expected to help with meal preparation, and some cleaning and laundry on Sundays, which can be to the detriment of residents particularly at busy times. Care staff are helping residents with bathing and showering in the mornings, which means some mornings some residents may not be assisted to wash and dress until 11.00 or 11.30. In addition the lack of a dishwasher is impacting on the cooks time which could be better spent, gaining feedback from residents, baking cakes and more home cooking. Therefore the manager has been asked to review how staff are deployed, and to ensure the wishes of The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 7 residents specifically with regard to times for rising and retiring and bathing should be recorded. Staff trained in first aid are required to be on duty at the home 24 hours per day, currently there are occasional shifts when a there are no first aid trained staff on duty. The quality assurance system needs further development to enable the manager to draw up an annual development plan. Personal information must be held separate for each resident and stored securely, therefore the use and storage of the communication book needs to be reviewed. 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 DS0000067669.V363749.R01.S.doc Version 5.2 Page 8 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 DS0000067669.V363749.R01.S.doc Version 5.2 Page 9 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): 3,6 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Written information about The Gables to help prospective residents and relatives to decide whether the resident wishes to move into the home is available. Clear assessments are carried out prior to admission. However not all assessments included social needs due to difficulties in collecting this information. This however should be collected where possible at the earliest opportunity. EVIDENCE: Residents said they had not visited the home prior to moving in or coming to the home for a period of respite but their families had visited on their behalf. The home leaves a copy of the service users guide in each bedroom. The manager said the guide is regularly updated. Residents have their needs assessed by the manager prior to moving in and again on admission. The home requests copies of assessments undertaken by The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 10 social services where relevant. The assessment undertaken by the home, of the 3 assessments seen, 2 were not fully completed with regard to interests, hobbies and social history. However it is recognised if it is not possible for this to be completed at time of admission or later due to cognitive impairment, the home is requested to complete this where possible at a later date from information given from relatives or friends / advocates. Intermediate care is not undertaken at the home The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 11 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. This judgement has been made using available evidence including a visit to this service. Residents personal care and health needs are well managed. Residents can feel confident that their medication will be handled and administered correctly. Residents privacy and dignity is respected. EVIDENCE: Residents care plans have been vastly improved and now contain very detailed information about how staff are to meet residents needs. They include resident’s preferences about moving and handling etc. Residents had been asked to sign their care plans as agreed or relatives had signed on their behalf, a brief explanation of why a relative may have signed on their behalf would further demonstrate good practice. One resident admitted to the home 9 days previously still did not have a care plan. The manager agreed that this was not acceptable and her expectation was that a care plan would be written within 23 days of moving into the home. The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 12 The resident’s files contained detailed risk assessments with regard to falls, pressure area care, nutrition, and continence. Residents said the home arranged visits by the GP(General Practitioner) when they asked for them and chiropody and opticians appointments had been made at one resident’s request. The resident’s files have specific areas for GP and other healthcare professionals visits, making it easier for staff to access up to date information and advice from professionals involved in the residents care. Nursing staff from the home carry out assessments on pressure area risk etc and the appropriate equipment is either provided from the homes own store or hired. The home enjoys close working relationships with the elderly care nurse specialist and tissue viability nurse employed by the PCT, benefiting resident’s healthcare. The home has a medication policy, which includes homely remedies, these are “over the counter” medicines, which the home can dispense without a prescription from the GP. This has been agreed by the homes GP. The policy however should also include how long each of the medicines will be used before the GP is consulted so as to ensure residents do not have an undiagnosed condition. Medicines are appropriately stored in accordance with legislation and good practice guidance. Residents said the staff dealt with their personal care needs sensitively and were careful not to make them feel embarrassed. The residents rooms which are overlooked by residents using the patio and garden do not have any privacy nets at the windows. The manager agreed to review arrangements for ensuring privacy for residents having their personal care attended to, and to ensure the poorly fitting curtains in one room were replaced. The home does not have a payphone for residents use. Landlines can be installed if residents wish it at the residents cost, and residents can take incoming phone calls to the home, in their rooms or the office as the phone is cordless. The home has several shared rooms though they tend to be used for single occupancy only, in the event the room is shared the home has privacy screens available. The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 13 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. This judgement has been made using available evidence including a visit to this service. Residents have a relaxed comfortable lifestyle with opportunities to occupy themselves with a range of interests. EVIDENCE: The home has now employed an activities coordinator who works at the home from Monday to Friday 11am to 2pm. There is now an activity programme in place on a rolling 4-week basis. Activities include 1 to 1 with residents who prefer to stay in their own rooms, in the morning, then after lunch, group activities such as reminiscence, floor games, dominoes, baking, sing-along etc. In addition clothes parties and outside entertainers visit the home periodically. Access to the community is still somewhat restricted as the home does not have any transport, though the owners have promised a minibus, the activity coordinator and manager are in the process of approaching the owners to pay for additional insurance so the activity coordinator can take 1 or 2 residents out in her own car. The activity programme would now benefit from being developed further by recording resident’s interests and hobbies, and incorporating them into the activity plan. Residents would also benefit from additional funding being made available to purchase arts and crafts materials further board games, and other equipment. Thought should also be given as The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 14 what physical exercises could be safely introduced to promote independence and prolong residents fitness. Record keeping of what activities residents participated in and in particular 1 to 1’s should be recorded separately to comply with data protection. Residents said they enjoyed the activity’s and would like more variety of activities to be offered. Visitors are welcomed at any reasonable time, and links with the local community now should be developed. Residents may bring items of furniture and personal possessions with them when they move into the home and residents right to choose is respected. The home has employed a cook who works at the home from Monday to Saturday from 8.30am- 2.30pm. Residents said the meals were very good. Residents are given menu cards to complete each day, which include drinks snacks and the choices of meals available. The choices of meals is good though on Fridays the choices are different types of fish only, however the manager said residents only need to ask and something different would be cooked for them. A cooked breakfast is available upon request. Special diets are catered for and currently these include diabetic and soft diets. The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 15 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. This judgement has been made using available evidence including a visit to this service. Residents have access to people who listen to any concerns and who will take action to ensure they are protected from abuse. EVIDENCE: Residents said they would complain to the deputy or any staff member if they were unhappy, and they believed that any complaint they made would be listened to an acted upon. The home has received 4 complaints since the last inspection, and details of actions taken are recorded. Not all residents had seen the homes complaints procedure, as this is in the service users guide, and on display in the hall. It is recommended that the service user guide be given to residents and / or time taken to explain it rather than leaving it in bedrooms. All staff have received adult protection training and showed a good awareness of what their responsibilities are. Staff were not confident of what information is in the homes policy. The manager is aware of her responsibilities in reporting and documenting allegations. The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 16 The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 17 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): 19,20,26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents live in a poorly maintained environment. EVIDENCE: The Gables is a detached building with residents’ accommodation arranged over two floors. It was registered under previous legislation and consequently there is not the availability of communal space a new registration would require. The Gables continues to offer a very “homely” environment, from observation, it is remains very difficult for staff to meet all residents’ care needs safely. For example, transporting lifting hoists to different parts of the house and to use them in some of the bedrooms, furniture has to be moved around. An additional hoist has been purchased which has improved this situation slightly. Some building work has started to extend the car park, the position of building equipment has made accessing the garden more difficult at a time when the The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 18 weather has vastly improved and many resident would like to use the patio. However some areas of the patio are unsafe with loose and broken paving slabs, and a low unfixed wall with at one end and a significant drop the other side. The communal areas and several bedrooms are in need of refurbishment and redecoration, although some of the bedrooms are completed, and flooring in some areas has been replaced. The major building and refurbishment work planned for autumn 2007 has not been carried out and this is to the detriment of the residents living at the home, who have an increasingly poorly environment to live in. The wooden handrail on the stairs to the patio is rotten and still in need of repair, however this is not in use or a fire exit. A skandia frame in one of the toilets on the upper floor should be fixed or handrails fitted as this presents a hazard as they can tip. The walls in the corridors are damaged, and marked. Resident’s bedroom doors are not fitted with locks. Several doors still need the closure devices fixing or fitting as they slam and residents said the noise is intrusive. The manager has purchased dining tables and chairs and since the last inspection these have been moved to make 2 lounge diners rather than a separate dining room, when the home is full there is still not enough space for all the resident to use the lounge or the dining areas. Carpets in a few of the bedrooms were stained, though overall the home was generally clean. The home has purchased additional lifting slings for hoists, and needs to ensure that there are adequate numbers for those requiring hoisting. The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement has been made using available evidence including a visit to this service. Residents are cared for by properly recruited staff. Staff are required to carry out work other than “care work” which can mean some resident wait for long periods to be washed and dressed. EVIDENCE: Residents spoken with said they did not have to wait for long periods for assistance from staff. The home is now full and staffing numbers have been increased, the manager is now super-numery. Staff had finished assisting residents with washing and dressing at around 11.40 that morning though this was not usual every morning. Provided evidence can be found to suggest residents preferred times of rising, washing and dressing etc are being adhered to as closely as possible, a staffing review is unnecessary. However, staff said delays in helping residents get up was more to do with sheer workload. Care staff are preparing breakfast and helping with residents bathing in the morning and this could be another reason for residents waiting past their desired times for rising. The manager is considering advertising for additional staff for twilight and early morning hours, and care staff are rostered to cook on Sundays as there is no chef on a Sunday. Cleaning staff hours have recently been changed so a cleaner is on duty on Saturdays, though there are no cleaning staff on Sundays. Care staff are required to cook part of the evening meal though the sandwiches are prepared by the cook. The cooks time is also compromised by the lack of a dishwasher, and can spend up to 2 hours of her The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 20 6 hour shift washing up, rather than preparing food baking, etc. A maintenance person has been employed for 5 mornings a week and has made a positive impact on getting minor repairs completed in a timely way. 50 of the care staff have achieved NVQ at level 2, and the home has demonstrated a commitment to providing support to staff who wish to undertake NVQ training. New staff receive induction which is compliant with skills for care. The home operates a robust recruitment policy and their practices comply with guidance and regulations. Staff are required by the home to provide proof of identity, CRB and POVA checks 2 written references, one from the last employer. Staff training is mapped on a training matrix, which allows the manager to easily identify what training staff have had and when updates are needed. 7 staff have received first aid training and the manager must ensure that the home is covered 24 hours by a staff member who has received first aid training. The matrix does include moving and handling though all staff spoken with said regular updates are arranged. The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 21 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): 31,33,35,37,38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The health, safety and welfare of residents will be improved by refurbishment of the home and by ensuring a staff member trained in first aid is on duty every shift. EVIDENCE: The manager has successfully registered with the Commission as manager since the last inspection, and has been in post around 8 months. The manager has also recently completed the Registered Managers Award and is waiting for her results. The manager undertakes training periodically to update her skills. The manager ahs been developing the homes quality assurance systems and there is now an annual satisfaction survey, circulated to residents and relatives, regular auditing of care plans, medication, accidents, complaints and other documentation. The home does not use a professionally recognised tool, The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 22 and is in the process of making the results of surveys available. The manager must now incorporate residents meeting minutes, health and safety, infection control, and other audits, staff meeting minutes with the quality assurance already done to prepare an annual development plan. The home now manages small amounts of money for residents if they are unable to manage their own money, money is kept separately and securely though the home does not have a safe, separate balance sheets are also kept for residents. Residents may only access their money when the manager or deputy is on duty and this must be reflected in the service users guide. The home is currently using a communication book which was not being stored confidentially and contained “shared” records. There is staff training and policies for reference for staff to help ensure the health and safety of residents. Trained first-aiders must be on duty 24 hours per day. As stated in the environment section of the report there are some health and safety issues in particular to the outside of the building. The home ensures maintenance and servicing of equipment is carried out. Risk assessments are carried out on the environment. The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 N/A 18 3 1 1 X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 2 The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 24 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 OP19 Regulation 23 (2) Requirement The registered person shall ensure that the premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally, in that The major refurbishment planned be commenced. Repeated from the last inspection. Failure to meet with agreed timescale could result in formal enforcement action. Potentially hazardous areas on the patio must be made safe. 2 OP27 18 (1) The registered person shall having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that at al times suitably qualified, competent and experienced persons are working at the care in such numbers as are appropriate, in that A staffing review into the numbers and deployment of staff DS0000067669.V363749.R01.S.doc Timescale for action 30/11/08 30/08/08 The Gables Version 5.2 Page 25 3 OP30 13 (4) 4 OP37 17 (1)(a) be conducted. The registered person shall make 30/08/08 suitable arrangements for the training of staff in first aid. So that at all times staff qualified in first aid is on duty. The registered person shall 30/05/08 maintain records specified in schedule 3 and ensure they are kept securely in that Information in the communication book be kept secure and ensuring each individuals confidentiality in accordance with the Data Protection Act. 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 OP1 OP9 OP12 Good Practice Recommendations The service users guides should be given to or explained to residents, as currently many are unaware of them and their contents. The medication policy regarding homely remedies should include the duration medicines are to be given before the GP is contacted The activity plan should now be developed further and be based on the interests and hobbies of the residents who live at the home, equipment necessary for providing these activities should be made available. The homes quality assurance systems needs to be developed further so that an annual development plan can be produced. 4 OP33 The Gables DS0000067669.V363749.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 DS0000067669.V363749.R01.S.doc Version 5.2 Page 27 - 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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