Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 08/07/05 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 8th July 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 no outstanding requirements from the previous inspection report, but made 6 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 home tries to seek the views of the residents by holding residents meetings and asking residents to complete a satisfaction questionnaire on a regular basis. One resident stated that she had recently had bedroom decorated and that she had been able to choose the colours.

What has improved since the last inspection?

The fire alarms are being tested on regular basis. Staff are not employed before the receipt of a criminal records check unless prior consultation with the inspector has taken place.

What the care home could do better:

The care provided could be improved by more detailed written plans about how residents should be cared for and when they have been completed all staff should be made aware of them and follow the guidance. Activities for the residents could be more meaningful and provide opportunities for personal development.

CARE HOME ADULTS 18-65 The Gables (Cambridge) Ltd 93 Ely Road, Littleport Ely Cambridgeshire CB6 1HJ Lead Inspector Joanne Pawson Unannounced 08 July 2005 @ 10:00 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 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 Stationary 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) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Gables (Cambridge)Limited Address 93 Ely Road Littleport Ely Cambridgshire CB6 1HJ 01353 861935 01353 862887 Telephone number Fax number Email 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) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 29th November 2004 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) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection for The Gables for 2005/06. This unannounced inspection took place for five hours and was carried out by one inspector between 9.00 and 13.00hrs. On the day of inspection five residents were spoken to. Other methods used for the inspection included reading documentation, speaking to staff, speaking to the regulations manager and a tour of the home. The majority of the home was clean and hygienic although the lounge would benefit from the carpets being replaced. There is not a registered manager. The home must submit an application to register a manager by October 2005. 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? The fire alarms are being tested on regular basis. Staff are not employed before the receipt of a criminal records check unless prior consultation with the inspector has taken place. The Gables (Cambridge) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 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) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Gables (Cambridge) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 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 standard(s) These standards were not inspected during this inspection. EVIDENCE: The Gables (Cambridge) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 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 standard(s) 6,7,8 Although changes have been made to care plans they are still inadequate and not being followed by staff and do not provide the information needed to meet the residents needs. EVIDENCE: Although some care plans have been updated and include the relevant information a number of care plans have not been updated. After an internal audit of the home the provider stated that they would update all of the care plans by January 2005. The provider requested that the target date was moved to June 2005 and then again until the 8th July 2005. This target date has not been met. All care plans should be completed by 17th October 2005. Failure to do so could result in the commission taking enforcement action. The Gables (Cambridge) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 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 standard(s) 11,12,14,15,16,17 Since the Activities Co-ordinator left, the organisation of activities has not been well structured and this has resulted in very limited opportunities for residents’ personal development and fulfilment. EVIDENCE: On the day of the inspection three residents were attending a sewing class. At the beginning of the inspection one resident was sitting in the lounge with a drum machine. Other residents were sitting in the lounges or in the conservatory area. One resident was listening to music in the garden. One resident stated that he did not get to go out enough and would like to visit his family more. His care plan stated that his family contact was very important to him. There was a blank for the recording of family contact(the provider stated that the form had only been introduced in June and that was possibly why there were no records of calls). In his care plan file there was an invitation to his twin brother’s birthday party. The resident and staff on shift were not aware that he attended the party. There were no entries made for the day of the party in the resident’s daily notes. The home has been asked to The Gables (Cambridge) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 Page 11 investigate this situation and report it’s findings to the Commission. The Provider stated that the invitation only arrived one day before the party so the rearrangement of staffing could not be achieved to enable the resident to attend the party. There was previously a designated daily activities co-ordinator and records indicate that the activities were on a regular basis and more structured. Since the activities co-ordinator has left one carer each shift is designated to organise activities. The inconsistency of several staff organising activities may be responsible for some residents doing more activities than others. The provider stated that they have been trying to recruit to the post of activities co-ordinator but have not yet been successful. A kitchen for residents to use was fitted last year but residents and staff stated that it had not been used for several weeks since the activities co-ordinator left. The activities log for one resident was inspected and found that over the previous eighteen days he had watched TV three times, listened to the radio twice, played cards once and had gone for a ride in the van to pick up another resident. The activities log for the previous two weeks for another resident showed that they had listened to the radio four times, watched TV four times, had her nails cut, been out for dinner with her brother, had two back rubs and had refused a ride out in the van. The activities log for another resident showed that in the previous week they had watched TV twice, exercised once, had two rides in the van and attended a day centre once. One of the activities recorded is Tesco’s food shopping. In order for the cook to return from shopping in time to cook the lunch she has to go shopping with the residents at 7.30am ( residents who awake early enough are given the choice to go shopping if they wish). The activity may be more beneficial if the residents could go at a later time with other staff and can take time to make choices. The Gables (Cambridge) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Residents’ health and wellbeing may be at risk as result of care staff not following the procedures and care plans set for the individual residents. Staff treat residents with respect when assisting with personal tasks. EVIDENCE: One residents care plan included a detailed action plan that stated that he should only have diazepam administered as a last resort. However, his daily notes indicated that this action plan was not followed on a particular occasion, and diazepam was also being administered as a preventative measure. The member of staff responsible stated that she had administered the medication to prevent further incidents. The home has been asked to investigate this situation and report it’s findings to the Commission. A resident confirmed that service users are treated with dignity and respect by staff. The Gables (Cambridge) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Residents are encouraged to share their views about the home at the bimonthly residents meetings. Not all staff are aware of the procedure for reporting allegations of abuse this could place residents at risk. EVIDENCE: One resident spoken to said that she could discuss any issues at the residents meetings. One member of staff was unable to describe the agreed reporting procedure if an allegation of abuse is made. The provider must ensure that all staff should are aware of the procedure for the protection of vulnerable adults and the reporting procedure. The Gables (Cambridge) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29,30 Resident’s bedrooms are homely and comfortable and can be decorated to suit individual taste. Equipment is provided to promote residents independence. The home was clean and hygienic apart from the lounge carpet which was stained and the fridge which had food spilt in the bottom. EVIDENCE: Specialist equipment is provided for residents to meet their assessed needs. There is a call system in all of the resident’s bedrooms. The majority of home was clean and free from offensive odours. The carpet in the small lounge looked worn and dirty. The large fridge in the kitchen had old food that had been spilt in the bottom and the fridge was leaking water over the floor. Staff on shift stated that the fridge had been leaking for a few weeks. The provider stated that the fridge did not have a drip tray and staff had been instructed to clean the water up. A resident suggested that the purchase of a screen that is available for use in the communal lounge could benefit residents if they need immediate treatment from staff due to illness. The Gables (Cambridge) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 Page 15 To the rear of the building there is an enclosed garden. On the day of the inspection one resident was sitting in the garden listening to music. The Gables (Cambridge) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,34 The staff receive the basic training to allow them to care for the residents needs. Staff vacancies affect the working hours for the permanent staff and have resulted in them being asked to work additional hours. This could affect staff morale in the long term. Recruitment procedures are in place to protect the residents. EVIDENCE: The staff interviewed on the day of inspection had received the majority of their mandatory training by watching a video and answering written questions, which are then marked by the acting manager. The staff spoken to stated that they felt that although they had learnt the basic facts they would benefit more from having a trainer in the room who they could ask questions and do practical sessions with i.e. a qualified moving and handling trainer who they could do a practical session with. Two staff files were tracked and contained all of the necessary recruitment documentation including identification, application forms, PoVA First, criminal records bureau check and interview notes. Some staff spoken to on the day of inspection stated that they felt obliged to work extra shifts to cover staff vacancies. The provider stated that staff agree to the rota and any changes made to it so they could state if they were unhappy with working extra shifts. The Gables (Cambridge) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,40,42 The home tries to seek the resident’s views on a regular basis. The home has procedures in place to ensure the health and safety of the residents. However, the continued lack of a registered manager must be addressed to ensure the service is well run. EVIDENCE: Ten residents completed a quality assurance questionnaire in June. One of the issues raised was that more activities were needed. Fire and accident records were inspected and found to be satisfactory. Cleaning chemicals are stored in locked cupboards. The money held on behalf of three residents were checked and were accurate. The area manager has acted in the capacity of home manager for several months. However due to the provider not being able to recruit to the position of manager there remains no registered manager. An application to register a manager should be submitted to the commission. The Gables (Cambridge) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 Page 18 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 x x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 2 3 3 Standard No 11 12 13 14 15 16 17 2 2 2 2 2 3 3 Standard No 31 32 33 34 35 36 Score x 2 x 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Gables (Cambridge) Ltd Score 2 2 2 x Standard No 37 38 39 40 41 42 43 Score 1 x 3 3 3 x x I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 Page 19 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 YA6 Regulation 15 Requirement Care plans must state how service users needs in repsect of his health and welfare are to be met. All staff must be aware of the care plans and follow the procedures stated in individual plans.(This was a requirement from the previous two reports. Failure to meet the requriement may lead the commission to take enforcement action.) Provide suitable activities taken into consideration the needs, likes and interests of the service users. Ensure that service users are enabled to visit or maintain communication with their families and friends according to their wishes. Ensure that medication is administered inaccordance with written guidance and procedure. Ensure that all staff are aware of and follow the procdure for the protection of vulnerable adults. An application to register a manager must be submitted to the commision by 1st October 2005. Timescale for action 17th October 2005 2. YA12 16(2)(m)( n) 16(2)(m) 1st September 2005 1st Spetember 2005 Immeidate i.e.8th July 2005 Immediate i.e.8th July 2005 1st October 2005 3. YA15 4. 5. 6. YA20 YA23 YA37 13(2) 13(6) 8 The Gables (Cambridge) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations The Gables (Cambridge) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 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) Ltd I53 I03 s37198 GABLES LITTLEPORT v237328 080705 STAGE 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!