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Please note that the information on this website is now out of date.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 04/05/05 for The Gables Nursing and Residential Home

Also see our care home review for The Gables Nursing and Residential Home for more information

This inspection was carried out on 4th May 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.

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

Service users and the relative spoken to liked the staff and the relative said she had no qualms about leaving her husband in the care of the home and that she cannot find fault with the home. The home takes its responsibility for the care of service users with dementia and mental health needs seriously and works hard to make sure service users are not over medicated. Staff members are involved in making sure service users are able to access proper health care and the home reviews recommendations made. All staff members are given the training they need to properly care for this service user group.

What has improved since the last inspection?

The home has looked at its employment procedures for all new staff members and staff members are not employed without the required information. Assessments and care documents telling staff how to look after people have improved. This means staff members have the information needed to care for service users.

CARE HOMES FOR OLDER PEOPLE The Gables Nursing & Residential Home Eastrea Whittlesey Cambridgeshire PE7 2BD Lead Inspector Lesley Richardson Unannounced 04 May 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 Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Gables Nursing and Residential Home Address Coates Road Eastrea Whittlesey Cambs PE7 2BD 01733 351252 01733 204610 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) BUPA Care Homes (CFC Homes) Ltd Care Home with nursing 55 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (MD(E)), 55 of places Dementia, over the age of 65 DE(E), 55 The Gables Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 42 places to provide nursing care. Date of last inspection 5th October 2004 Brief Description of the Service: The Gables is a purpose built building providing accommodation, support and care, including nursing, for up to 55 people over the age of 65 years with mental health needs or dementia. The home is situated on the outskirts of the village of Eastrea, which lies east of Peterborough and two miles from the neighbouring market town of Whittlesey. Accommodation in the home consists of 55 single rooms, all of which have en-suite facilities, and the home has other bathing and toilet facilities, which are provided with aids to enable the needs of the residents to be met. The gardens, which surround the home, include a sensory garden and there are views over surrounding arable land. The Gables Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 3¾ hours and was carried out as an unannounced inspection on 4th May 2005. 1¾ hours was spent talking to the manager and examining records and documents. The inspector looked around the building and spent time with service users and staff. Three people who live at the home, two of the staff on duty and one visitor were spoken to during the inspection. What the service does well: What has improved since the last inspection? What they could do better: All care records must be looked at every month and rewritten if there are any changes. Although the home organises different activities for service users, not many of these are tailored to individual interests. The home needs to look at what service users interests were before they entered the home to do this. The radiators in one part of the home are not covered and can reach very high temperatures. This places vulnerable people at very high risk and the home needs to cover the radiators or make sure the temperature is controlled. The Gables Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 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 Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 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 Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 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) 3 and 4 Pre-admission assessments of prospective service users, and specialist and regular staff training ensure the home is able to meet service users needs. EVIDENCE: The manager stated she completes pre-admission assessments to ensure new service users needs are properly assessed and planned for. One of the two service user files seen during the inspection also contained a copy of the social services assessment completed prior to that service users admission. The home provides staff members with training sessions each month on different subjects and all staff are given a self-learning package on understanding dementia when they start working at the home. The Gables Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 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 for referring service users to health care professionals to ensure personal, health and social care needs are met. Personal care is offered in such a way as to promote and protect service users’ privacy and dignity. EVIDENCE: Individual care plans were available to ensure all aspects of personal and health care needs were identified and planned for. Care plans were being reviewed on a monthly basis and were re-written when care needs changed; ensuring changes were recorded. However, one service user’s care plans had not been reviewed in the month preceding the inspection Service users care records showed the access each service user had to health care professionals. Records seen showed service users had been seen by CPN’s and clinical psychologists as well as medical practitioners. One service user’s plan identified a range of strategies staff could use to ensure this persons mental health needs were met. The Gables Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 Page 10 Service users and relatives stated that staff were always polite and treated them with dignity and respect. Staff members showed a good understanding of ways to ensure privacy and dignity were maintained. The Gables Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 Page 11 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 and 14 Social activities provide stimulation and interest for people living in the home. Visits from relatives and friends, ensured continued social contact. EVIDENCE: Staff stated activities are organised by the home on a one to one basis due to the changing environment and needs of service users. Service users were also able to watch television and play board games and one of the lounge areas also included a sensory area. Theme days are organised to coincide with public holidays or days of interest and included a ‘VE day’ and cookery sessions. One service user’s file had a well-completed social history and included photographs of activities that person had enjoyed during his life. However, in another service user’s file there was little to indicate a social history had been documented or discussed with the service user or his relatives, and neither file indicated how individual social needs might be met. Information was available for service users and their relatives about help lines and national organisations. Relatives stated they were able to visit throughout the day. The Gables Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 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 The home has a satisfactory complaints system with evidence that service users are able to confidently raise concerns. EVIDENCE: The home has a detailed complaints procedure that would assist and guide service users, visitors to the home and staff members in making and dealing with a complaint. A relative stated they would be confident in making a complaint and that it would be taken seriously. The Gables Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 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, 25 and 26 The standard of the environment within this home is good, providing service users with an attractive and homely place to live. There was one area of concern which put service users at risk of serious harm and did not provide safe surroundings in which to live. EVIDENCE: The home was well decorated and maintained, areas were accessible with large open communal spaces. All radiators in the new extension were covered to ensure safety and radiators in the existing home were not covered but were reported to have guaranteed low temperatures. However, 3 radiators within the original home could be turned to temperatures that were too hot. Checks were made on two of the radiators by the inspector who identified temperatures of 48oc and 55oc. There was good natural and domestic style lighting throughout the home. The home was clean, tidy and all areas were free from offensive odours, including the sluice areas. Dirty laundry and sluice areas were placed well The Gables Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 Page 14 away from the kitchen and dining areas, these areas all had separate hand washing facilities to ensure infection control. The Gables Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 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, 29 and 30 The procedures for the recruitment of staff had improved and offered greater protection to people living at the home. Staffing numbers and staff training opportunities were sufficient to meet the needs of service users. EVIDENCE: Information given by the manager showed a good ratio of staff members to service users at all times of the day and night, staffing numbers on the day of inspection were good. The staff files of one recently employed member of staff and another member of staff showed that the home had undertaken all the necessary recruitment checks to ensure the protection of service users. Enhanced Criminal Record Bureau checks had been applied for and Protection of Vulnerable Adults checks had been returned prior to staff starting work. Staff members stated they underwent induction and foundation training over a period of time and also shadow worked with other staff members when they first started at the home. The manager stated training sessions are given each month on different subjects and all staff are given a self-learning package on understanding dementia when they start working at the home. The Gables Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 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 The manager is qualified to run the home, thereby ensuring service users safety and care is given in their best interests. EVIDENCE: The manager has been in post since October 2004 and has a registered mental nurse qualification. An application has been submitted to the Commission to register a manager. The Gables Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 Page 17 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 x x 3 3 x x 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 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 x x x x x 2 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x x x x x x x The Gables Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 Page 18 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 7 Regulation 15(2) Requirement Service users care records demonstrate review at least monthly or more often if care needs change. (31st December 2004 timescale not met.) Service users must be consulted about their social interests and arrangements made to engage them in local, social and community activities. All parts of the home to which service users have access must be free from hazards to their safety. Timescale for action 30th June 2005 2. 12 16(2)(m) 30th June 2005 3. 25 13(4)(a) 15th June 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 7 7 Good Practice Recommendations Care records should be dated with a full date format and signed by each author for each entry. Assessments should include service users social histories. The Gables Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 Page 19 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 Nursing & Residential Home I53 I03 S24303 GABLES EASTREA V224415 040505 STAGE 2.doc Version 1.30 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. 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!