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Inspection on 28/07/05 for The Gables Nursing Home

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

This inspection was carried out on 28th July 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

Pre-admission assessments are thorough to ensure the suitability of Service Users before admissions take place. A competent and efficient staff team, who ensure the needs of Service Users are fully met with the Service Users privacy and dignity maintained, implement care. Service Users conveyed their support for Staff and felt they were able to express their views and concerns openly. Careplans are maintained to a high standard and are reflective of review to ensure all identified care needs are implemented. Routines are flexible with Service Users able to express their personal choice and preferences for how care is implemented. Meals are nutritious and planned taking into consideration the likes and dislikes of Service Users. Complaints or issues of concern raised are acted upon within recognised timescales to ensure a satisfactory resolution can be reached which will support the Service User in the environment. The Manager and Proprietors are supportive of the staff team and Service Users and work hard to ensure change benefits those residing at the Home.

What has improved since the last inspection?

The Proprietors have been working hard to improve the general appearance of the Hoe and facilities offered, since the last inspection a number of improvements have been made. New Windows have been fitted to the first floor. New Carpets have been fitted to seven bedrooms. The exterior of the Home has been painted with additional work on the front garden having taken place to further improve the exterior of the Home. As rooms have become vacant a programme of redecoration has been implemented. A new stairlift to support Service Users to access the first floor has been fitted. Additional profiling and raising beds have been purchased. Additional risk assessments have been added to the generic risk assessments to address the use of portable heaters. Medication administration records are now maintained to an acceptable standard with no gaps found on the day of inspection. C.O.S.H.H. items are safely stored. Moving and Handling Risk assessments are now up-to-date and reflective of review. Staff hours continue to be monitored by management to ensure any member of staff does not work excessive hours.

What the care home could do better:

As previously mentioned in the summary of this report two requirements were made, these were both in relation to general maintenance and can be easily resolved by the Home. In addition, two recommendations were made, one was to aid the home to further improve a recording system in the Careplan and one was to further improve the facilities in one bathroom. The requirements and recommendations are as follows: REQUIREMENTS. 1. The Doors to room 10, 15 and the main hallway door at the top of the stairs are repaired to ensure they are operating efficiently. 2. The lock on the downstairs sluice facility is fixed to ensure the safety of Service Users. RECOMMENDATIONS. 1. Waterlow risk assessments are re-written when scores have changed. 2. The purchasing and fitting of new flooring for the upstairs bathroom is added to the future maintenance plan/budget of the Home.

CARE HOMES FOR OLDER PEOPLE The Gables The Gables Nursing Home 123 Wendover Road Aylesbury Bucks, HP21 9LW Lead Inspector Sue Smith Unannounced 28 July 2005 10:00 a.m. 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 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Gables Address The Gables Nursing Home, 123 Wendover Road, Aylesbury, Buckinghamshire, HP21 9LW 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) 01296423077 Mr A.S. DhotMrs S.K. Dhot Mrs Minerva Patti Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 General Nursing Care Date of last inspection 8th December 2004 Brief Description of the Service: The Gables Nursing Home is an older building with character, retaining some of its original features. The Home is situated on a main road close to local amenities. The Home provides Nursing care for 22 Service users. The staff team consists of a skill mix of qualified Nurses and Carers with a Manager who is a suitably qualified Nurse.The Home has access to a large well-kept garden, which is situated approximately five minutes away at Mandeville Grange, also owned by the proprietors. Due to the Close proximity of these two Homes the Manger is registered to manage both Homes. The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the Home carried out over 3 hours. The Deputy Manager was present throughout the Inspection with the Manager and Proprietor present for the last hour of inspection. The Inspection was carried out by one inspector who undertook a full environmental tour of the building, assessed a selection of Careplans and supporting systems and documentation, assessed general health and safety documentation, and complaints, discussed care implementation with both the Manager and Deputy Manager and spoke with a selection of Service Users to gain their views of the Home. This Inspection resulted in the Home receiving a requirement to fix a lock on one of the sluicing facility doors, and a further requirement for maintenance to two bedroom doors and one communal hallway door. Two recommendations were made as a result of this inspection, one for Waterlow risk assessments to be re-written when a change in status has been assessed and a further recommendation for the bathroom flooring to one bathroom to be included for replacement in the next maintenance plan/budget. Service Users were complimentary throughout the inspection of the staff team and the support they receive. Commendable practice was observed or for care implemented to one Service User who is presently subject to a health crisis, the use of outside medical advice was well planned and implemented in a commendable manner. This was a positive inspection carried out with the support of the Manager, Deputy Manager and Proprietor, the Inspector would like to thank the Service Users and staff for the warm welcome received and support offered throughout the Inspection. What the service does well: Pre-admission assessments are thorough to ensure the suitability of Service Users before admissions take place. A competent and efficient staff team, who ensure the needs of Service Users are fully met with the Service Users privacy and dignity maintained, implement care. The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 6 Service Users conveyed their support for Staff and felt they were able to express their views and concerns openly. Careplans are maintained to a high standard and are reflective of review to ensure all identified care needs are implemented. Routines are flexible with Service Users able to express their personal choice and preferences for how care is implemented. Meals are nutritious and planned taking into consideration the likes and dislikes of Service Users. Complaints or issues of concern raised are acted upon within recognised timescales to ensure a satisfactory resolution can be reached which will support the Service User in the environment. The Manager and Proprietors are supportive of the staff team and Service Users and work hard to ensure change benefits those residing at the Home. What has improved since the last inspection? The Proprietors have been working hard to improve the general appearance of the Hoe and facilities offered, since the last inspection a number of improvements have been made. New Windows have been fitted to the first floor. New Carpets have been fitted to seven bedrooms. The exterior of the Home has been painted with additional work on the front garden having taken place to further improve the exterior of the Home. As rooms have become vacant a programme of redecoration has been implemented. A new stairlift to support Service Users to access the first floor has been fitted. Additional profiling and raising beds have been purchased. Additional risk assessments have been added to the generic risk assessments to address the use of portable heaters. Medication administration records are now maintained to an acceptable standard with no gaps found on the day of inspection. C.O.S.H.H. items are safely stored. Moving and Handling Risk assessments are now up-to-date and reflective of review. Staff hours continue to be monitored by management to ensure any member of staff does not work excessive hours. The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 7 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 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 8 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 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 9 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. All Service Users are subject to a pre-admission assessment prior to admission to the Home to ensure all their needs can be met. EVIDENCE: Within the Careplan is evidence of pre-admission assessments taking place prior to admission to the Home. A suitably qualified Nurse undertakes these. The format considers physical, medical and social needs. In addition families and potential Service Users are invited to visit the Home prior to admission to ensure they are happy with the arrangements. The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 10 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, 9, 10. Careplans assessed were found to be up-to-date and were reflective of review dates, which enable staff to provide the required care. Staff demonstrated a sound knowledge of the individual needs of Service Users and their interactions and relationships with them were positive, which enabled Service Users to express their thoughts, feelings and needs. Medication administration records were found to be appropriately signed with all medication stored, administered and disposed of in a satisfactory manner; ensuring Service Users are protected by the systems in place. Staff practice in giving and assisting with such elements as personal care and arrangements for medical examinations ensure the privacy and dignity of Service Users. EVIDENCE: All Careplans sampled were found to be up-to-date and maintained to a high standard. Careplans contained an admission assessment, which is used to The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 11 formulate individual plans of care, these are added to when there has been a change in health to reflect current care needs. Separate night and daytime Careplans are in place with relevant daily recording sheets found to be informative and up-to-date. Waterlow assessments are in place; these are reviewed monthly or as required. It is recommended that these be re-written when needs are identified as changed, presently scorings are crossed out with new numbers added, this makes it hard to distinguish what date the changes occurred. Previous assessments can be stored behind the current assessment for easy access should they be required for comparison. All Service Users have a manual handling assessment in place; which identifies adaptations or equipment necessary to support the Service User in the environment, these were reflective of review. In addition to the individual Careplans all Service Users have a progress report, these were found to contain clear notations of care given. Risk assessments are in place to support the use of Cot sides with consent for their use in place. Medication is generally administered by Nursing Staff; those Service Users who administer their own medication are supported to do so in a safe manner. Up-to-date medication alerts are available to staff which include any recommended changes to storage and disposal guidance. The Home is finalising its new disposal arrangements with their contractors, at this time the pharmacy are continuing to receive disposed of medication to ensure the Home is able to operate in a safe and professional manner. New disposal containers will be provided once the contract has been finalised. MAR (medication administration records) sheets were found to be appropriately signed and dated, these records have improved immensely with previous issues addressed and resolved. There was no out-of-date medication held in the Home with all medication administered, stored and disposed of appropriately. Staff observed throughout the inspection were seen to have positive relationships with Service Users. Personal care is implemented in a way that ensures the privacy and dignity of individuals is maintained. Care regimes are flexible and in line with the Service Users wishes and needs. Service Users spoken with at the time of inspection were complimentary of the staff team and the way in which care is implemented, Service Users felt their individual needs were understood and that Staff supported them to remain as independent as possible. The additional attention that was given to one Service User who was subject to a health crisis was observed; Staff were supportive and compassionate towards this Service User with thorough records of changes that were taking place made. The care, attention to detail and understanding of this Service User’s specific needs was reflective of commendable practice of both the Nursing and Care team. The use of outside medical assistance was effectively planned and implemented by the Nursing Staff to ensure the Service User received the best possible support. The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 12 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) 13, 14, 15. Visitors are welcomed to the Home during all reasonable hours with no restrictions in place. This enables Service Users to maintain their friendships and relationships whilst residing in the Home. Service Users are supported to make decisions in the routines of care within the Home ensuring their views and personal choices are taken into consideration. The Home provides cooked meals and snacks throughout the day ensuring the dietary needs of individuals are met. EVIDENCE: Service Users spoken with at the time of inspection were happy with the way staff implement care, they felt they were listened to when things needed changing and that their personal choices were implemented as far as staff were able. During the inspection the employed cook was on annual leave, which necessitated the use of a relief cook. The implementation of a relief cook had no reported affect on the standard of meals offered with Service Users complimentary of the menus and additional snacks. One Service User noted that they did not always like what was on the menu and were able to ask for The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 13 an alternative meal should they need to. The kitchen was clean and tidy on the day of inspection with all recommendations from the environmental health inspector implemented. Daily recordings of food temperatures are taking place with records open to inspection. These were not assessed during this inspection due to the inspection-taking place during the lunchtime period, they were however offered to the Inspector by the relief cook. The Service Users reported no restrictions in place for visiting times, there were no visitors at the Home during this inspection, therefore their views have not been gained during this inspection. Previous inspections have not raised issues with visiting times and support has always been offered to family members to maintain their relationships with Service Users. The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 14 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 comprehensive complaints procedure, with records of complaints and investigations open to inspection. The Complaints procedure is made available to Service Users and significant others, which ensures all relevant persons are able to make a formal complaint appropriately. EVIDENCE: The Home has a thorough and comprehensive complaints procedure, which is followed by staff; this procedure includes timescales for action. A record of complaints was open to inspection, this contained details of complaints, how they were addressed and the outcomes. Each complaint and its supporting documentation are recorded individually. The complaints log also has records of minor concerns that have been raised and how these have been addressed. There have been no serious complaints received at the Home or directly to the Commission since the last inspection. Service Users spoken with conveyed that they felt able to express their concerns without fear of reprisal, they believed that staff worked hard to make things easier for them, all Service Users spoken with were complimentary of the open and inclusive relationships they have with staff. The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 15 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, 21, 22, 23, 24, 25, 26. The Home is well maintained with an evident programme of redecoration in place. Fixtures, fitting and furnishings are supplied in communal areas making the environment homely for Service Users. Several fire doors require repair to ensure they are in line with current fire authority regulations; currently they leave Service Users at risk. Suitable single and double accommodation is provided with evidence of personal possessions to make these more homely for Service Users. The Home has designated cleaners and laundry staff, which ensure the home, is clean, hygienic and free from offensive odours. Sufficient numbers of toilet and bathrooms are available to ensure the needs of Service Users are met. EVIDENCE: The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 16 The Home is an older building, which is maintained to a high standard to ensure it is homely and safe for the use of Service Users. A programme of redecoration and maintenance is in place, the proprietors have recently fitted new windows to the first floor of the building; this has created greater ventilation in the hallways and improved the facilities in bedrooms. The work was carried out in a way that ensured minimal disruption to Service Users. New carpets have been fitted in seven of the bedrooms and some bedrooms have been redecorated. New profiling and raising beds have been purchased. A new stairlift has now been fitted which ensures Service Users are able to access both the downstairs and upstairs areas of the Home. This caused some disruption for Service Users, which resulted in a complaint from a relative; unfortunately the issue was out of the control of the proprietors. Equipment was purchased, however the Home had to rely on outside contractors to fit this equipment, which resulted in a longer than anticipated timescale before the work was completed. The proprietors had, previous to this complaint, acknowledged the difficulties and tried to minimise the disruption by providing an additional lounge space for Service Users on the first floor. The exterior of the Home has recently been painted with additional work carried out to the front garden to further improve the Home. As part of the day-to-day maintenance the Home will need to ensure that repairs are made to the following doors: Room 15 (door does not close appropriately) Room 10 (the door is sticking when closed from inside the room) Main hallway door at the top of the stairs (this does not close appropriately). Until these doors are repaired the Home are unable to meet standard 19.5. A requirement is made to this effect. The Home provides adequate numbers of communal toilet and bathroom facilities, the upstairs bathroom will in the future require new flooring to be fitted as the present floor is bubbling, is sticky when walked on and has several paint splatters on it, a recommendation is made for this work to be included in the future maintenance plan/budget of the Home. All toilets and bathrooms were found to be clean, tidy and free from offensive odours. A designated laundry assistant is employed by the Home to ensure laundry is maintained to a high standard. In addition designated cleaners ensure the Home is clean and tidy, free from offensive odours and infection control measures are implemented. All C.O.S.H.H. items used by the laundry and cleaning staff are stored appropriately in lockable facilities. The Home does need to ensure the lock on the downstairs sluice facility has the lock fixed to further improve the safety measures in place; a requirement is made to this effect. The Home provides both single and double accommodation, which is adapted to meet the needs of the Service Users. Call bells are within easy access to The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 17 Service Users in all bedrooms with equal amounts of facilities for both Service Users residing in double occupancy bedrooms. Several bedrooms have been decorated to further improve the facilities offered. All Service Users are able to bring personal possessions to the Home to ensure they feel at home and are able to personalise their rooms. Bedrooms are reflective of these personal items with family pictures hung on walls and personal items placed throughout. Service Users spoken with during the inspection liked their rooms and felt the staff provided a homely and inclusive atmosphere. The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 18 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. The Home provides sufficient numbers of qualified Nurses and Carers at all times to ensure the needs of Service Users are met. EVIDENCE: The Home provides a skill mix of both registered nurses and carers to meet the needs of Service Users. Presently the Home provides 1 RGN and 5 Carers each morning shift, 1 RGN and 3 carers each evening shift and 1 RGN and 3 Carers each night shift. In addition the Home has a full time Deputy Manager who competently oversees the running of the Home in the Manager’s absence. An Activities co-ordinator is shared between The Gables and Mandeville Grange to ensure a number of planned activities takes place, these are posted around the Home to ensure Service Users are aware of what is offered any given week. The Manager and Deputy Manager are continuing to monitor staff working hours to ensure excessive hours are not worked which could be detrimental to care delivery. The Home is presently fully staffed. The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 19 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, 32, 37, 38. The Manager has the necessary training for her role to ensure the Home is run in the best interest of the Service Users. However further management training will be required to enable the Home to fully meet standard 31.2. The Leadership qualities and professionalism of both the Manager and the Deputy Manager ensures all procedures in the Home are in the best interest of the Service Users. Individual records were up-to-date and stored appropriately, ensuring the Home are safeguarding Service User information and working within guidance of the Data Protection Act 1998. The Health and Safety procedures and record keeping of the Home ensures Service Users, Staff and visitors to the Home are protected as far as is reasonably practicable. EVIDENCE: The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 20 The Home’s Manager is competent and efficient; she also manages Mandeville Grange (also owned by the proprietors), which is situated within walking distance of The Gables. An efficient and competent Deputy Manager who will oversee the day-to-day operation of the Home in the Manager’s absence supports the Manager. This arrangement works well due to the expertise of the Deputy Manager and the support that is given to her by the Manager and Proprietors, being a small family business, support is always only a phone call away with the proprietors visiting the Home regularly. The Manager splits her day between the two homes to ensure continuity is maintained and the Home runs in the best interest of the Service Users. The Manager is considering retirement in the coming years; the Inspector has advised that she will need to make some definite decisions as to her future. To continue managing the Home she will need to undertake a management course such as the Registered Managers Award, this was discussed at length with the Manager who will make plans with the Proprietors and inform the Inspector when a final decision is made. All documentation is stored appropriately and in line with the Data Protection Act 1998. All records necessary for inspection were made available. Fire systems are in place to ensure the protection of the Service Users, Staff and any visitors to the Home. Weekly fire alarm tests are taking place with a current service record of all fire equipment dated 8/4/05 open to inspection. All recommended actions from the last fire authority report have been actioned. Generic risk assessments are in place for the protection of Service Users, Staff and Visitors to the Home; these now include an assessment carried out for the use of portable heaters. All items of C.O.S.H.H. are stored appropriately with data sheets available to staff. A variety of health and safety information is available to staff to ensure they are working within current guidance. In addition the Home has supporting policies and procedures, which staff receive on induction to the Home. The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 21 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 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 3 x x x x 3 3 The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 22 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 19.5 Regulation 13 (4) c Requirement The doors to rooms 10, 15 and the main hallway door at the top of the stairs are repaired to ensure they are operating efficiently. The lock to the downstairs sluice facility is fixed to ensure the safety of Service Users. Timescale for action 15/9/05 2. 25 13 (4) c 15/9/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 7 21 Good Practice Recommendations Waterlow risk assessments are re-written when scores have changed. The purchasing and fitting of new flooring for the upstairs bathroom is added to the future maintenance plan/budget of the Home. The Gables 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 23 Commission for Social Care Inspection Cmabridge House, 8 Bell Business Park, Smeaton Close Aylesbury Bucks, HP19 8JR 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 20052807 Gables Nursing Home X00015 UI Stage 5 S19226 V242016 H53.doc Version 1.40 Page 24 - 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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