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Inspection on 20/10/05 for The Gables (Cambridge) Limited

Also see our care home review for The Gables (Cambridge) Limited for more information

This inspection was carried out on 20th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The acting manager assesses prospective residents to ensure that the home is suitable. The care plans clearly identify the long term and temporary needs of the residents.

What has improved since the last inspection?

Care plans have greatly improved to ensure that staff are aware of all the residents needs. Each resident now has activities plan for the week. Residents are attending activity sessions outside of the home, which they seem to enjoy. All staff spoken to on the day of the inspection were aware of the Protection Of Vulnerable Adults Procedure.

What the care home could do better:

A greater choice and frequency of leisure activities outside of the home could be offered. The carpet in the small lounge is in need of replacement. This issue was raised in the last report.

CARE HOME ADULTS 18-65 The Gables (Cambridge) Limited 93 Ely Road Littleport Ely Cambridgeshire CB6 1HJ Lead Inspector Joanne Pawson Announced Inspection 20th October 2005 10:00 The Gables (Cambridge) Limited DS0000037198.V250733.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 (Cambridge) Limited DS0000037198.V250733.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 (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Gables (Cambridge) Limited Address 93 Ely Road Littleport Ely Cambridgeshire CB6 1HJ 01353 861935 01353 862887 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) Gables (Cambridge) Limited Care Home 16 Category(ies) of Dementia (2), Learning disability (16), Physical registration, with number disability (16), Physical disability over 65 years of places of age (1) The Gables (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The 2 places in category DE (under 65 years with dementia) are for 2 named individuals, each with a primary vulnerability of learning disability The 1 place in The 1 place in category PD(E) (over 65 years with physical disabilities) is for one named individual whose primary vulnerability is physical disability 8th July 2005 Date of last inspection Brief Description of the Service: The Gables is a residential service providing support and accommodation for up to sixteen adults with a physical and/or learning disability. The home has a respite care facility and has a number of residents using this throughout the year. The home itself is situated on the outskirts of Littleport in Cambridgeshire six miles away from the city of Ely. The Gables (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection for The Gables for 2005/06. This announced inspection took place for six hours and was carried out by one inspector between 10.00 and 17.00hrs. On the day of inspection seven residents were spoken to. Other methods used for the inspection included reading documentation, speaking to staff, speaking to the acting manager and a tour of the home. The majority of the home was clean and hygienic although the lounge would benefit from the carpet being replaced as it is stained. There is not a registered manager. The regional manager is the ‘acting manager’ until a registered manager is appointed. The home must submit an application to register a manager by 1st January 2006. The provider stated that they have made serious attempts to recruit a manager. What the service does well: What has improved since the last inspection? Care plans have greatly improved to ensure that staff are aware of all the residents needs. Each resident now has activities plan for the week. Residents are attending activity sessions outside of the home, which they seem to enjoy. All staff spoken to on the day of the inspection were aware of the Protection Of Vulnerable Adults Procedure. The Gables (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Gables (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 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 (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 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 The acting manager meets with prospective residents to ensure the home can meet their needs. EVIDENCE: The acting manager completes detailed assessments for prospective service users to ensure that the home can meet the needs of the person. The Gables (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 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): 6,7,8,9,10 Care plans have improved and contain the information for care staff to meet the needs of the residents. EVIDENCE: Three care plans were tracked. They contained a photo, admission and assessment form, personal care, information on medication and any other individual needs. Any temporary care plans are printed on Yellow Paper so staff are aware of a temporary change such as a course of antibiotics. Any important issues printed in red on the care plan. This allows staff to be aware of issues such as seizures. Contact with resident’s family is recorded. Care plans tracked showed that residents are being weighed regularly and where needed there food and fluid intake monitored. Care plans encourage the residents to be as independent as possible and remind staff of the importance of offering choices. The Gables (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 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): 11,12,13,14 Residents have benefited from the increased choice of activities. EVIDENCE: There is a printed activities diary for Monday to Friday for each resident. Activities included dominoes, visiting the library, dancing, ride in the van, baking, TV., shopping, gardening, massage and talking newspapers. One resident was going to a gardening session on the day of the inspection. Three residents were playing dominoes. One resident was listening to the radio. The Gables (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 Page 11 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): 18,19,20,21 Residents receive personal and flexible support from the care staff according to their needs. The use of key workers helps to ensure that residents receive a consistent service. The administration of medication policy is being followed by staff. EVIDENCE: Staff spoken to were aware of the residents individual needs. Residents stated that they staff assist them with personal care in the way that they prefer and staff promote their dignity and independence. Residents stated that they could choose when to get up and go to bed. The Gables (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 Page 12 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 home has a satisfactory complaints system. EVIDENCE: Residents stated that if they had any concerns they would discuss it with a member of staff or at the residents meeting. Care staff were aware of what procedure to follow if they suspected abuse of a resident had taken place. The Gables (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 Page 13 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 Resident’s bedrooms are homely and comfortable and can be decorated to suit individual taste. The home was clean and hygienic apart from the small lounge carpet. The lack of individually assessed moving and handling equipment could be placing the residents and staff at risk. EVIDENCE: As stated in the previous report the carpet in the front lounge is stained. Staff stated that they cleaned the carpet on a regular basis but could not remove the stains. The acting manager stated that a replacement carpet is in the process of being ordered. A new fridge has been purchased for the kitchen. The kitchen was clean and hygienic. All staff spoken to on the day of the inspection raised a concern about the lack of moving and handling equipment and commodes in the home including hoist slings and handling belts. One resident stated that she only had one sling that she had been properly assessed for so that when it was used for the bath she had to wait until it was dry to use it again. She declined to use a sling that was identified as suitable but not labelled for her use. The Gables (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 Page 14 The acting manager stated that a moving and handling belt had been ordered and an audit of other equipment would be carried out and necessary equipment provided. The Gables (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 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): 31,32,33,34,35,36 The staff spoken to on the day of the inspection were competent and aware of the needs of the service users. Staff receive basic training and supervision to meet the residents needs. EVIDENCE: Four members of staff were interviewed. They were aware of the role and the individual needs of the residents. Staff were seen talking with residents and seemed approachable and good listeners. None of the care staff hold a NVQ 2 in care. However seven staff members are working towards the NVQ and six more have been identified to commence the training. One member of staff identified that she would like further training on epilepsy as the training video does not address the individual differences that can occur. The acting manager had supplied the member of staff with more information on epilepsy and was booking further training. Staff files tracked showed that they are receiving regular supervision. As staff receive the majority of training by watching videos they have not received any practical training on using fire extinguishers or received any fire training by someone qualified to do so. The acting manager should contact the local fire service to seek advice on what fire training the staff should receive. Staff files are clearly organised. The Gables (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 Page 16 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, 42 The management support is being provided by the regional manager to ensure improvements to the quality of the service continues in the absence of a registered manager. EVIDENCE: In the absence of a registered manager the regional manager continues to work in the role of acting manager. The acting manager stated that the company hopes to be in a position to submit an application for the registered managers post to the commission by 1st January 2006. A deputy manager has been employed who is working closely with the acting manager to ensure consistency within the home. Care staff stated that they felt they could discuss any concerns with the deputy manager. The acting manager completed the pre inspection questionnaire stating that health and safety checks are up to date. The Gables (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 Page 17 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 X 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Gables (Cambridge) Limited Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 1 2 3 3 3 3 3 DS0000037198.V250733.R01.S.doc Version 5.0 Page 18 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 YA29 Regulation 23(n) Requirement Service users must have their moving and handling needs assessed by a suitably qualified person to do so and the equipment must be provided to meet those needs. An application to register a manager must be submitted to the commission by 1st January 2006. This was a requirement from the previous inspection. Failure to take action to meet this requirement may lead to the Commission taking enforcement action. Timescale for action 01/01/06 2 YA37 8 01/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Gables (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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 (Cambridge) Limited DS0000037198.V250733.R01.S.doc Version 5.0 Page 20 - 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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