Inspection on 20/07/05 for The Gables Care Home

This inspection was carried out on 20th 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Gables Care Home 15/10/08

The Gables Care Home 30/10/07

The Gables Care Home 02/05/07

The Gables Care Home 02/05/06

The Gables Care Home 05/12/05

The Gables Care Home 02/11/04

The Gables Care Home 08/04/04

The Gables Care Home 17/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE The Gables 37 Manchester Road Buxton Derbyshire SK17 6TD Lead Inspector Marie Bonynge Unannounced 20th 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 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 C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Gables Address 37 Manchester Road Buxton Derbyshire SK17 6TD 01298 70567 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) Mrs Teresa Alice Rzepa Vacancy CRH PC Care home only 23 Category(ies) of 23 places for Older people registration, with number of places The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 2nd November 2004 Brief Description of the Service: The Gables is a care home registered to provide personal care and accommodation for up to 23 older people. The home is located on the outskirts of Buxton in the Peak District. Local amenities include an opera house, leisure complex and park. Shops are located in the town centre.Accommodation is provided on 2 floors with a passenger lift and stair lift accessing the upper floor. There is a large communal lounge and separate dining room. 15 of the bedrooms are single accommodation and 4 are double.A spacious garden is provided to the rear of the building. Car parking space is available at the bottom of the steep drive. The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day in July 2005. It found that progress had been made regarding compliance with most of the requirements and recommendations made at the last inspection of the service. Inspection methods used included a tour of the building, sampling of records such as care plans, training records, staffing rotas and accident records. Discussions were held with residents, relatives, staff and the management of the home. The Inspector was made to feel welcome and staff were helpful throughout this visit. What the service does well: What has improved since the last inspection? What they could do better: Improvements in staffing levels are expected in accordance with increased occupancy and the dependency levels of residents. Recruitment has taken place in response to this. The appointment of a manager is also expected. The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 6 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 C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 and 4 Residents can be assured that comprehensive assessment information is generally obtained that contributes to meeting the assessed needs of individuals. EVIDENCE: The home has updated the statement of purpose to provide information for prospective residents and their representatives in order to help them make a decision about whether to live in the home. This requirement from the last inspection report has therefore been met. New residents have been admitted in accordance with the homes registration of older people (OP) and a requirement made at the last inspection in respect of this has been met. A number of residents have been admitted for respite care and some of these residents have made a decision to live permanently in the home. Comprehensive assessment information had been obtained for the three residents care plans that were examined on this visit. This included the homes own assessment. Training has also been completed regarding dementia care to enable staff to gain the skills needed to deliver the services and care that the home offers to provide. A requirement has been met in respect of this. The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 Systems were in place that contributed to ensuring that the personal and health care needs of residents were generally met. EVIDENCE: Three residents care plans were examined. These indicated that the records had been expanded to include more detailed information that covered the action needed to be taken by care staff to ensure that all aspects of the persons care were met. Entries in the daily records were more comprehensive to enable monitoring of the residents care. Reviews of the care plan had been carried out, although this was not consistent with the recommended guidelines. Good relationships were reported with GP’s and the community health team with District Nurses offering support and advice where needed regarding health related issues. Nutritional screening was undertaken and a record of residents weight was in place. Discussions with relatives indicated that they felt the care needs of the person they had come to visit were met. Residents said that they felt their privacy was respected and direct observations of care staff supported this. A statement regarding the homes philosophy on privacy and dignity was available. The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 The programme of activities and daily routines of the home generally met with the expectations and preferences of residents. EVIDENCE: Discussions with residents indicated that they spent the day in accordance with their preferences. One resident said that they liked listening to music and playing dominoes. Photographs were displayed of some of the events that had taken place and residents talked to the Inspector about the recent carnival and wells dressings in Buxton. Residents said that they had enjoyed this. Some of the entertainment provided included quizzes, arts and crafts and bingo. There were no dedicated hours for activities although this did not appear to directly impact on the availability of these. It was reported that staff worked hard to ensure that residents did not miss out. (See standard 27 for further comments regarding staffing). Visitors to the home reported that they were made welcome and could visit at any reasonable time. Information regarding the availability of independent advocacy was displayed on the notice board. Residents were able to bring personal possessions into the home with them. A sample of menus was provided, these indicated that a varied menu was provided. Residents reported that a choice of meal was available and said that the food provided The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 11 was ‘good’. Meals were taken in the communal dining room and were said to be relaxed. The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The complaints procedure contributes to enabling residents to voice their concerns and to be generally confident that they will be listened to. EVIDENCE: A complaints procedure was in place that gave a timescale for responding to complaints. The Proprietors have maintained a strong visual presence in the home in view of the Registered Manager vacancy and evidence was seen of relatives being able to discuss queries with the Proprietors. Staff had attended training regarding Derbyshire’s multi agency protection of vulnerable adult procedures and it is expected that newly appointed staff will also complete this training. A requirement has been met in respect of this from the last inspection report. The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 23, 24, 25 and 26 The home provides residents with generally comfortable and well maintained accommodation that appears clean and pleasant. EVIDENCE: The Gables is set in a pleasant garden with mature trees surrounding the lawned area. The Proprietor advised that the requirements from the Fire Officer’s last visit had now been implemented although the Fire Officer had not visited since these had been completed. General redecoration and maintenance was ongoing. Fixtures, fittings and furniture were domestic in style and in keeping with the homely setting. Residents expressed satisfaction with their individual bedrooms and these were personalised with photographs and pictures. Residents had been consulted regarding their preferences as to the furniture in their rooms and locks had been fitted to bedroom doors in accordance with residents’ wishes. The area of unguarded pipe work in the downstairs corridor was still exposed although it was not hot to the touch on this visit. Draught proofing had been The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 14 completed for the two identified bedroom windows. Toiletries were being used for named individuals and a new washing machine had been purchased in accordance with a requirement that had been outstanding since the inspection report of 16.08.02. It is expected that this will be installed in the next few weeks. The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 30 The level of staff during busy times of the day does not always ensure that the needs of residents are fully and consistently met. EVIDENCE: There were 19 residents accommodated on this visit with varying levels of dependency ranging from low to high. Three residents were assessed as having high dependency needs and one resident was being nursed in bed due a deterioration in their health. A number of residents were known to have some level of dementia and all residents needed some level of assistance with their personal care. A sample of staffing rotas was examined. These indicated that the usual complement of staff was 2 care assistants in the morning and 2 care assistants in the afternoon with 1 waking member of staff and 1 sleep in member of staff at night. This was not sufficient to meet the assessed needs of residents during the day, particularly at busy times of the day such as during personal care giving and at meal times. It was reported that staff were always busy and seemed ‘stretched’ although it was not reported that this had had a noticeable impact on the care of residents. The issue of staffing was discussed with the Proprietors who stated that recruitment had taken place and a new member of staff was expected to commence employment this week. A programme of NVQ training was in place and a commitment to training was evident in the home. The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 37 and 38 The presence of the proprietors contribute to a home that is generally well run, however the continued absence of a manager does not assist in ensuring that the home meets with its stated purpose, aims and objectives. EVIDENCE: The Registered Manager has resigned from her post since the last inspection and there has been a vacancy for a number of months. Recruitment has taken place for this post although an appointment has not yet been made. The Proprietors have maintained a strong visual and hands on presence in the home and have kept the CSCI informed of the interim arrangements for the management of the home. Records were generally well kept and maintained with the exception of those records identified in the main body of the report and Regulation 26 Provider reports. The Proprietor advised that a suitable lock would be provided for the laundry room door as an urgent matter. Some toiletries, bars of soap and The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 17 creams had been left in the bathrooms, these presented as a potential source of cross infection. The Gables C52-CO2 S19989 The Gables V237684 180705 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 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 3 2 2 STAFFING Standard No Score 27 2 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 x 3 2 x x x x x 2 1 The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 19 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 OP4 Regulation 14 (1) (d) Requirement The registered person must confirm in writing to service users that having regard to the assessment the care home is suitable for the purpose of meeting the service users needs in respect of their health and welfare. From inspection report 2nd November 2004. The registered person must ensure that the care plan is reviewed in accordance with recommended guidelines. The registered person must ensure that exposed pipe work is guarded. From inspection report November 2004. The registered person must ensure that the new washing machine is fitted and working. The registered person must ensure that staffing numbers are appropriate to the assessed needs and number of residents accommodated. The registered person must ensure that records required by regulation for the protection of service users are maintained, up Timescale for action Previous timescale 01.01.05. New timescale 01.10.05 2. OP7 15 (2) (b) 01.10.05 3. OP25 13 (4) (a) (c) 4. 5. OP26 OP27 13 (3) 18 Previous timescale 01.01.05. New timescale 01.09.05 01.11.05 01.08.05 6. OP37 17 (1) (a) Previous timescale 01.02.05. New Page 20 The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 7. OP38 13 (1) (a) (c) 8. OP37 26 to date and accurate. From inspection report November 2004. A suitable lock must be provided for the laundry room door in consultation with the Fire Officer and a risk assessment completed. From inspection report November 2004. Regulation 26 provider visits must be recorded. From inspection report November 2004. A manager must be appointed to the current manager vacancy. timescale 01.11.05 Previous timescale 01.12.04. timescale 01.09.05 Previous timescale 01.02.05. New timescale 01.09.05 01.11.05 9. OP31 9 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. Refer to Standard OP10 Good Practice Recommendations The panes of frosted glass in the upper floor bedroom windows should be screened to ensure complete privacy. The Gables C52-CO2 S19989 The Gables V237684 180705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection South Point, Cardinal Square Nottingham Road Derby DE1 3QT 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. 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