Inspection on 11/10/05 for The Gables, Burnham-on-Sea

This inspection was carried out on 11th October 2005.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Gables, Burnham-on-Sea 15/10/08

The Gables, Burnham-on-Sea 16/10/07

The Gables, Burnham-on-Sea 13/07/06

The Gables, Burnham-on-Sea 19/05/05

The Gables, Burnham-on-Sea 15/12/04

The Gables, Burnham-on-Sea 09/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 The Gables Grove Road Burnham-on-sea Somerset TA8 2HF Lead Inspector Ms Jane Poole Announced Inspection 11th October 2005 11:30 The Gables DS0000015983.V251386.R01.S.doc Version 5.0 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 DS0000015983.V251386.R01.S.doc Version 5.0 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 DS0000015983.V251386.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Gables Address Grove Road Burnham-on-sea Somerset TA8 2HF 01278 782943 01278 782943 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) R J Homes Ltd Mr Matthew Adrian Tamplin Care Home 10 Category(ies) of Learning disability (10) registration, with number of places The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate one named person over the age of 65, as stated in the letter from Craegmoor, dated 29th September 2004. 19th May 2005 Date of last inspection Brief Description of the Service: The Gables is registered with the Commission for Social Care Inspection to accommodate up to ten people under the age of 65 who have a learning disability. The home is a large detached property within walking distance of the sea front and all the amenities of Burnham on Sea. Service user accommodation is arranged over two floors and all bedrooms are for single occupancy. One room has en suite facilities and communal washing and toilet facilities are shared by other service users. The registered provider is R.J. Homes, which is owned by the Craegmoor Group Ltd. The Registered Manager is Mathew Tamplin. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out over a 6.5 hour period. The inspector was able to meet with staff, service users and management. Many of the service users are unable to fully express their needs and wishes and the inspector was able to observe care practices in the home. All records requested were made available and unrestricted access was granted to all areas of the home. 4 service users completed comment cards prior to the inspection. The manager, staff and service users made the inspector welcome. What the service does well: All service users living permanently at the home have a comprehensive assessment of need and a care plan. Staff spoken to gave evidence that these are working documents used by staff to provide a consistent approach for service users. During the day the inspector observed that there was good interaction between the staff on duty and the service users. People were observed being assisted with household tasks, enjoying leisure activities and going out to use local facilities. There is evidence that service users take part in a wide range of activities, including assisting with household shopping, going to college, visiting family and going out for meals. All service users who were able to express an opinion stated that the quality of the food was good and that they received ample portions. There was evidence that the staff encourage service users to make choices about their day to day lives including the décor of their rooms. People were observed to move freely around the communal areas and were able to spend time alone in their rooms if they wished to. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: The inspector noted that staff morale was low with many staff expressing concerns about poor practice and a lack of guidance and supervision. Issues relating to this were raised with the manager and area manager and will be monitored by CSCI. The home currently has a number of vacancies and is relying on agency staff to ensure that they are fully staffed. An immediate requirement was issued stating that all senior staff must receive formal recorded supervision by the end of this month (31st October.) 3 requirements made at the previous inspection have not been fully actioned. These relate to the environment. An immediate requirement was made to ensure that broken furniture in bedrooms is replaced by the end of this month and the other two have been highlighted again in this report with new dates for compliance set. There is currently one person receiving overnight respite care at the home. The Gables staff have not completed a full assessment with this person and there is no evidence to state that the home is able to meet their needs. Whilst it is acknowledged that this person was admitted in an emergency situation they have now been at the home for some weeks and no timescales or objectives for the placement have been set. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 7 The home also need to improve the ways in which they monitor the quality of care. The management of the home expressed concerns that much of their time was taken up by clerical and administrative duties. These tasks need to be delegated to a more appropriate person to allow the manager and deputy to spend more time with staff and service users. 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 DS0000015983.V251386.R01.S.doc Version 5.0 Page 8 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 DS0000015983.V251386.R01.S.doc Version 5.0 Page 9 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): 1, 2 & 5. The service user guide is now in a format appropriate to the service users and has been explained to each person individually. There is no evidence at The Gables to indicate that the home is able to meet the needs of the person currently receiving respite care. EVIDENCE: The manager stated that since the last inspection the statement of purpose has been updated to reflect all changes in the home. The service user guide has now been made available in symbol form, which staff have explained to each service user individually. The service user guide is tailored to each service user and states the fees payable. At the present time there is one person receiving overnight respite care. An assessment was carried out by a sister home, but no assessment of need has been carried out by staff at The Gables or relevant professionals. There is no evidence within the personal file to suggest that the home is able to meet their needs. Whilst it is acknowledged that this person moved into the home in an emergency situation, this was some weeks ago. The home have still not completed a full assessment or up dated the care plan that came to the home at the time that they were admitted. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 10 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 & 8. The care plans for permanent service users are understood and used by all staff to provide a consistent approach to care. The person receiving respite care had not had their needs fully assessed by the home and staff were unclear about the accuracy of the care plan. Service users are assisted to make choices about their day to day lives in line with their abilities. EVIDENCE: The inspector viewed the personal files of two service users, one for a person living permanently at the home and another for a person receiving overnight respite. Both were comprehensive and gave information on all areas of daily living including likes and dislikes. Restrictions imposed on service users were documented and there was evidence that these had been discussed with service user or their representatives. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 11 The home liaises with relevant professionals such as social workers and psychologists to ensure that the assessments reflect the holistic needs of service users. One person has recently been fully assessed by a multi disciplinary team and staff spoken to were aware of the outcomes of this assessment. One person at the home receives overnight respite at The Gables and spends the day at a sister home nearby. Staff spoken to appeared less clear about the needs or goals of this person. Staff spoken to were unable to confirm whether or not the care plan for this person was accurate. The inspector expressed concerns to the manager about this persons’ care and the appropriateness of the shared placement. The inspector was able to speak with many staff on duty during the day and all gave evidence that the care plans are working documents and used to provide a consistent approach to care. Staff all demonstrated how service users are encouraged to make choices about their daily lives. Some service users living at the home have limited communication skills and signs, symbols and photographs are used to assist people to make choices. Staff stated that service users are involved in choosing the colour schemes and furnishings for their rooms. One person was working with their keyworker to plan the redecoration of their room. Choices were being made using catalogues, colour charts and shopping trips. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 12 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. Service users are assisted to take part in a wide range of activities at the home and in the local community. Service users have unrestricted access to all communal areas or are able to spend time alone if they wish to. EVIDENCE: Service users are encouraged to take an active part in the day to day running of the home. There is a life skills rota that covers household tasks such as hovering, dusting and laundry. Each person living at the home has a weekly or daily activity plan. These are displayed either in personal rooms or communal areas. Signs, symbols and photographs are used to enable people to understand their plans and make choices about activities. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 13 On the day of the inspection the inspector noted that interaction between staff and service users was good and people were given opportunities to take part in a wide range of activities in and out of the home. Staff spoken to considered providing people with stimulating and meaningful activities an important and enjoyable part of their role. All bedrooms are lockable but the majority of service users do not lock their doors. The inspector observed that people moved freely about the communal areas of the home and were able to access their private rooms at anytime. Staff were observed knocking on doors of personal rooms before entering. Some people living at the home attend college on a regular basis. The home has two vehicles and everyone has ample opportunity to access community facilities. All activities and trips out are planed on an individual basis ensuring that they are in line with the service users interests and appropriate to their level of ability. Visitors are welcome at the home at all reasonable times. Staff assist service users to maintain links with their families. To enable people to make choices about the food coming into the home service users accompany staff to the local supermarket on a regular basis. Care staff are responsible for the preparation of meals with the assistance of service users. There is a 4 week menu in the home and personal menus for people requiring a specialist diet. All service users who expressed an opinion stated that they liked the food in the home and that they received ample portions. The main dining room in the home is poorly furnished and decorated. Assurances were given by the manager that this room will be refurbished in the near future. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 14 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. Privacy and dignity for service users could be improved by providing locks on communal bathrooms and taps in individual bedrooms. Service users have access to a range of healthcare professionals. EVIDENCE: Care plans seen gave detailed information about the level of support that each individual requires to maintain personal hygiene. One bedroom has an en suite and, with the exception of one, all others have wash hand basins. The inspector noted that taps had been removed from the sinks in some rooms, when questioned some staff were unclear for the rationale behind this. Staff felt that it would be beneficial to service users to be able to use the sinks in their rooms to promote their privacy and dignity when carrying out personal care. There are adequate communal bathrooms for service users and all have recently been refurbished. Staff felt that some service users would be able to have greater independence if the home had a level access shower. Bathrooms should also be fitted with privacy locks. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 15 Some service users are beginning to experience mobility difficulties and a requirement of the last inspection was for appropriate aids and adaptations to be put in place to promote independence. This has not been fully complied with. Some toiletries and items of clothing are not kept in the rooms of individual service users. Although the reason for this is documented in care plans the inspector requested at the previous inspection that the home should look at ways of making these items more easily available to staff and service users when personal care is being carried out. Staff stated that they are planning to have lockable cupboards in bedrooms but these have not yet been purchased. The inspector was able to observe care practices in the home and noted that staff on duty spoke respectfully to, and about, service users. One issue of concern was raised with the inspector and this was fully discussed with the manager at the time of the inspection. Everyone living at the home is registered with a GP and other healthcare professionals such as dentists, opticians, psychologists and chiropodists in line with their personal needs. Records are kept of all medical appointments. On the day of the inspection a healthcare needs assessment was being carried out with one service user. Currently no one living at the home administers their own medication. Only senior staff, who have received relevant training, administer medication. The inspector viewed the Medication Administration Records and found them to be well maintained and correctly signed. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 16 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. The complaints procedure has now been made available in a format appropriate to service users. The language used by some staff members is inappropriate and must be addressed without delay. EVIDENCE: The home has policies on making a complaint, recognising and reporting abuse and whistle blowing. Many of the staff team have received training in recognising abuse and issues relating to vulnerable adults. The complaints procedure has now been made available in a more appropriate format for service users. 4 service users were able to complete comment cards prior to the inspection, all answered YES to the question “If you are unhappy with your care, do you know who to speak to?” The inspector viewed the recruitment files of two recently recruited members of staff. These gave evidence of a thorough recruitment process. All new staff undergo a Criminal Records Bureau check and are checked against the Protection Of Vulnerable Adults register before commencing work. The inspector was able to speak with a large number of staff during the inspection. It was concerning that many staff spoke of inappropriate language being used by staff at the home. This was discussed with the home’s manager and the area manager and will be followed up by CSCI before the next inspection. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 17 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, 25, 26, 27, 28, 29 & 30. Although the environment does not pose a risk to the health and safety of service users, neither does it provide a homely, comfortable place to live. Requirements of the last inspection relating to the environment have not been fully complied with. EVIDENCE: The Gables is a two storey building located within walking distance of Burnham town centre and the sea front. All areas of the home are fitted with a fire detection system. To the front of the house there is a pleasant garden, which is used by service users for relaxing in and growing flowers and vegetables. At the back of the home is a small courtyard area. The courtyard is presently not very inviting for service users, but on the day of the inspection a contractor had been to the home to look at landscaping the area. On the ground floor there is a communal dining room and a comfortable lounge. There is also a small room next to the office, which appears to be mainly used by staff. On the first floor there is a large resource room, which is The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 18 used by service users to undertake activities such as arts and crafts and games. Since the last inspection the lounge has been decorated by the home’s staff and there is service users art work on the walls. The dining room is poorly furnished and decorated and would benefit from complete refurbishment. There are four communal bathrooms and one bedroom has en suite facilities. All bathrooms have all been upgraded since the last inspection. Privacy locks should be fitted to all bathrooms. The inspector was able to view a selection of personal rooms. All were personal to the individual. In some rooms the taps on wash hand basins had been disabled. When the inspector questioned this staff were unclear for the current rationale for this and there was no mention of the restriction or reason in the care plans. The laundry in the home is appropriate to the needs of the service users. All areas seen by the inspector appeared clean and fresh, the inspector noted that some carpet had been replaced with more suitable flooring. A requirement was made at the last inspection for all broken furniture to be replaced. At this inspection it was noted that some broken furniture had been removed but not replaced and other broken drawers remained in bedrooms. A requirement was made at the inspection for this to be replaced by the 31st October 2005. Another requirement of the last inspection was for aids and adaptations to be put in place to promote the independence of service users with mobility difficulties. There was no evidence that this had been addressed although the manager stated that an engineer had been to assess the lift. The lift is still not in use. Since the last inspection a maintenance person has been employed on a part time basis and staff saw this as a very positive step to improving the environment. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 19 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): 31, 32, 33, 34, 35 & 36. Care staff are in need of higher levels of support and guidance to carry out their roles effectively. The high level of agency staff does not provide consistency for service users. EVIDENCE: The high dependency of service users is reflected in the high staffing levels in the home during the day. Between the hours of 8am and 8pm there is one senior carer and six support workers on duty. Overnight this level drops dramatically to one support worker and one person sleeping in. A recommendation was made at the last inspection that this be increased to two waking night staff. The manager gave assurances that new night staff were being employed and the number of night staff will be increased to two at the beginning of next year. Currently five members of staff have a National Vocational Qualification at level two or above. A further five people are working towards the award. Records viewed by the inspector showed that staff have completed training in health and safety issues, dealing with challenging behaviour, protection of vulnerable adults, total communication and equal opportunities awareness. A previously stated in this report the inspector was able to talk with a number of staff during the inspection. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 20 There are clear lines of accountability laid down in the home, a manager, deputy manager and senior care staff. However discussion with staff suggested that there was a lack of leadership on some shifts with “no clear chain of authority.” No staff spoken to had received recent formal staff supervision. People stated that although there are regular staff meetings in the home these are not always the appropriate forum to air their views. New staff felt that their induction was poor. The home has an induction programme for all staff to follow but it was felt that this needed to be reinforced by regular supervision and appraisals. One member of staff stated that they had not been introduced to service users when they began work at the home. However new staff stated that they were made welcome by colleagues, felt comfortable to ask questions and had been given time to read care plans, policies and procedures. There appeared to be a lack of clarity about the roles and responsibilities of staff. The inspector felt that morale amongst staff at all levels was low. There are currently several care staff vacancies. Staff spoken to stated that existing staff working additional hours, bank staff and the use of agency is covering these hours. Rotas seen confirmed that there is currently a high use of agency staff but the home continues to be staffed by a minimum of 6 staff between the hours of 8am and 8pm. The staff spoken to stated that agency staff are usually familiar with the home and service users. The number of staff who stated that they felt that there was a lack of support and guidance concerned the inspector. Issues of poor practice were also discussed with the inspector. An immediate requirement was issued at the inspection to ensure that all senior staff received formal supervision. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 21 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, 38, 39 & 42. The manager is open and approachable but does not give a clear sense of direction to the home. The systems for monitoring the quality of care are poor. EVIDENCE: Since the last inspection the manager of the home, Mathew Tamplin, has been registered with the Commission for Social Care Inspection. In addition to the manager there is a deputy manager and senior care workers. The manager is currently undertaking the Registered Managers Award. The manager and deputy expressed their concerns to the inspector about the amount of time that they feel is taken up with clerical and administration work. This has a detrimental effect on the service users as they are less present in The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 22 the body of the home and unable to monitor the quality of care being carried out. All staff spoken to stated that the management of the home was open and approachable, but many echoed the feeling that they spent the majority of their time away from staff and service users. Some quality assurance measures are in place. The inspector saw returned questionnaires that had been completed by relatives and advocates. As yet these responses have not been analysed and therefore no action plan put in place to further develop the service. At the last inspection there was evidence of regular service user meetings but unfortunately minutes held show that the last meeting was in April of this year. Appropriate steps have been taken to ensure the health, safety and welfare of service users. A fire system is fitted throughout the home, this is tested weekly by staff and quarterly by outside contractors. Staff receive training in fire safety during their induction and receive regular up dates. All portable appliances were tested in July 2005. Upstairs windows have been restricted and hot surfaces have been guarded. Staff have received training in moving and handling, fire safety, food hygiene and infection control. Staff who administer medication receive training from the dispensing pharmacy and in addition are undertaking a distance learning course. Up to date certificates of registration and insurance are displayed. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 23 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 X X 3 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 1 3 2 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 1 2 2 3 3 1 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Gables Score 2 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 2 1 X X 3 X DS0000015983.V251386.R01.S.doc Version 5.0 Page 24 yes 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 (1) (2) Requirement The manager must carry out an assessment of need with all new service users to ensure the home is able to meet their needs. The home must ensure that they are able to meet the current service users’ needs in ways that promote independence. Aids and adaptations must be put in place where appropriate.(This requirement was made at the last Inspection.) The home must compile an action plan, with time scales, to state how the environment will be up graded. .(This requirement was made at the last Inspection.) Broken furniture in bedrooms must be replaced. (This requirement was made at the last Inspection.) Immediate Requirement made at this inspection. The manager must ensure that all staff are aware of their roles and responsibilities. Timescale for action 01/11/05 2 YA18YA21YA29 23 (2)[n] 01/12/05 3 YA24 23 (2) [b] 15/11/05 4 YA25 16 [c] 31/10/05 5 YA31 18 (1) [a] 01/12/05 The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 25 6 YA36 18 (2) 7 YA36 18(2) 8 YA39 24 (1) All senior staff, including the manager, must receive formal recorded supervision to ensure that the home is conducted in a manner which respects service users. Immediate Requirement made at this inspection. All staff must receive formal supervision and have opportunities to raise issues of poor practice. The manager must ensure that there are suitable systems in place to effectively monitor the quality of care. 31/10/05 15/12/05 15/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard YA18YA27 YA28 YA35 YA37 YA37 Good Practice Recommendations The manager should re connect taps in bedrooms. Privacy locks should be fitted to all communal bathrooms. The manager should refurbish the main dining room and consider the use of the small communal area as an additional lounge/diner. The manager should review the induction programme. The manager should delegate some clerical/administration responsibilities to enable him to spend more time with staff and service users. The manager should complete the Registered Managers Award. The Gables DS0000015983.V251386.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 DS0000015983.V251386.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!