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Inspection on 05/07/05 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 5th 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

Residents and staff are positively supported by Ms Wellspring, and staff work hard to meet the needs of the residents in a caring and friendly manner. Residents, relatives and visitors were positive about the home and the way the staff care for residents. The chef provides well-balanced and nutritious meals which residents were complimentary about. The Registered Providers are committed to improving services and staff support, training and development. The home recently underwent an audit for Investors in People and has only one minor amendment to make to achieve this. The home was clean well decorated and homely.

What has improved since the last inspection?

The meals served at the home are much improved and training for the staff that work in the kitchen has been provided. Resident`s contracts are being changed to meet legislation and the record keeping in relation to staff records has improved. Activities within the home are more regular and the member of staff undertaking activities was bright and encouraging with residents. Training in adult protection has been carried out and is ongoing.

What the care home could do better:

A nurse does not always visit residents from the home before being admitted. This practice should be reviewed and where practical new residents should be pre assessed before being admitted. This will ensure that residents and their relatives will know that the home will be able to meet their needs. Social care plans could be expanded to identify social and cultural needs and how the home will meet them. The timetable for staff training in fire safety procedures should be better organised to ensure staff attend when they are due.

CARE HOMES FOR OLDER PEOPLE The Gables Nursing Home 56 Ifield Green Crawley West Sussex RH11 0NU Lead Inspector Ann Peace Announced Tuesday 5 July 2005, 9:00am th 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 Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Gables Nursing Home Address 56 Ifield Green, Crawley, West Sussex, RH11 0NU 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) 01293 552022 Excel Care Homes Limited Ms Sara-Jane Wellspring Care Home 56 Category(ies) of Care Home with Nursing 56 registration, with number of places The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13/10/04 Brief Description of the Service: The Gables Care Home is registered to provide personal and nursing care for fifty six residents in the category of older people. Excel Care Homes Limited privately owns the service and the Responsible Individual on behalf of the company is Mr K Indra. The Registered Manager is Ms Sara Jane Wellspring. The home is located in Ifield Green which is on the outskirts of Crawley. There is a car park to the front of the home. A local shop, post office and pub are close by. Bus services are available close to the home and Crawley town centre and other amenities are approximatley 10 minutes drive away. The home consists of a two-storey building, the majority of the residents rooms are situated on the ground floor, those on the first floor are accessible by a passenger lift. Fifty two of the residents rooms are single, twenty five have en-suite facilities. Two double rooms are available, one of which has an en-suite facility. An enclosed garden is in the centre of the premises, this is surrounded by residents rooms. A pleasant garden with a lawn, shrubs and flowers is to the front of the premises. The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Mrs Ann Peace Regulatory Inspector carried out this announced inspection on Tuesday July 5th 2005. Prior to the inspection all records held on file since the last inspection were reviewed. Mr Indra the Responsible Individual for the home had submitted a pre inspection questionnaire and other related records in good time for the inspection. During the inspection a tour of the home was carried out and the majority of the rooms visited. Records relating to the care of residents and the administration of the home, including a number of staff records were examined. A case tracking exercise for a number of residents was carried out. Information was taken from their records since pre-admission and tracked to care being given, the continuity of that care and any equipment used. 4 satisfaction surveys were returned to The Commission. 2 were from relatives and 2 were from visitors to the home one being a member of the clergy. All were positive about the home, the way it is managed and the way the staff carry out the care. Two relatives were spoken to during the inspection and both were complimentary about the home and the staff. Staff were spoken to during the inspection and all said they enjoyed their work and felt well supported at the home. The conclusion of the Inspector was that a good standard of care is provided at The Gables from a caring and committed team. No immediate requirements were made so a feedback form was not left at the home following the inspection. Any matters arising from the inspection were discussed with Ms Wellspring at the conclusion of the inspection. What the service does well: The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 6 Residents and staff are positively supported by Ms Wellspring, and staff work hard to meet the needs of the residents in a caring and friendly manner. Residents, relatives and visitors were positive about the home and the way the staff care for residents. The chef provides well-balanced and nutritious meals which residents were complimentary about. The Registered Providers are committed to improving services and staff support, training and development. The home recently underwent an audit for Investors in People and has only one minor amendment to make to achieve this. The home was clean well decorated and homely. What has improved since the last inspection? What they could do better: A nurse does not always visit residents from the home before being admitted. This practice should be reviewed and where practical new residents should be pre assessed before being admitted. This will ensure that residents and their relatives will know that the home will be able to meet their needs. Social care plans could be expanded to identify social and cultural needs and how the home will meet them. The timetable for staff training in fire safety procedures should be better organised to ensure staff attend when they are due. The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 7 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 Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 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 Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 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) 1,2,3,4,5. The home does not have a thorough pre assessment procedure for residents admitted from hospital. However once admitted the homes assessment procedure is good and residents are told they can visit on a trial basis to ensure the home will meet their needs. EVIDENCE: Ms Wellspring told the Inspector that The Statement of Purpose and Service User Guide for the home is still relevant and no changes have been needed. These documents do give potential residents and their relatives a clear picture of what the home offers. Residents admitted from hospital are not always assessed before admission to the home. However Ms Wellspring does ask for all relevant information before deciding if the home would be able to meet the resident’s needs and was confident that this arrangement was satisfactory. The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 10 The Inspector was concerned that if the home was not able to meet the residents needs it may mean another move to a more suitable home for that resident. This was discussed with Ms Wellspring. Evidence from the case tracking exercise indicated that a full assessment is undertaken when residents are admitted and any risk assessments carried out. A number of residents did not have a contract in their file and Ms Wellspring told the Inspector that new ones were presently being sent out. The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 11 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. Residents are cared for at The Gables to a good standard and are respected and treated kindly by the staff. Policies and procedures are available as guidance for staff and safe procedures are being followed for the administration of medicines. EVIDENCE: Ms Wellspring has the overall responsibility for the care of residents. Since being employed at the home she has built up a good team who support her and she is now able to delegate certain responsibilities to other qualified nurses. Care plans and risk assessments were clear and contain information staff need to care for the residents. Daily records of care are kept to ensure all needs are met on a daily basis and plans were regularly updated and showed the changing needs of residents. Social care plans could be expanded to identify social and leisure needs and how the staff will meet those needs. Staff were noted to speak to residents in a caring and sensitive manner. The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 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) 12,13,14,15 The home provides a lifestyle that respects the privacy and dignity of residents. The home operates an open door policy for family and friends if residents choose. Meals served are varied, nutritious and well balanced. EVIDENCE: A number of residents do choose to stay in their rooms for the majority of the time. Others use the large open plan lounge or a smaller conservatory. One of the staff undertakes activities with residents on a regular basis and on the day of the inspection Bingo was being played by about 18 of the residents who were enjoying it. Locks are not routinely provided on bedroom doors but residents have been told they can have one fitted if they wish and Mrs Wellspring had a list of residents to show they had all been asked. A copy of the menus was given to the Inspector and these indicated that meals served at the home were well balanced and nutritious. The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 13 Residents who could offer an opinion were complimentary about the food served. Staff were noted to help residents who needed feeding in a sensitive and appropriate manner. The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 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) 16,18. The clear complaint procedure enables those using the service or their representatives to have confidence that their complaint will be responded to within 28 days. The home operates the West Sussex Adult Protection Guidelines and staff have been trained to recognise abuse. EVIDENCE: There is a clear complaint procedure available. The Commission has received no complaints since the last inspection. One adult protection alert was instigated recently in the home. Ms Wellspring responded by taking appropriate action in line with West Sussex Guidelines. The Commission and Social Services Department were satisfied with the way the incident was dealt with by the home. The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 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. Residents live in a safe, clean, well-maintained and comfortable environment with aids and equipment to meet identified needs. EVIDENCE: The home was clean and fresh with no unpleasant odours detected during the inspection. All areas are decorated and furnished in a homely fashion. Resident’s rooms are comfortable and meet the needs of the residents. Residents and their relatives have been encouraged to personalise their rooms to make them more homely. Call bells were available for residents to summon staff if needed. Safety checks on equipment and for health and safety purposes are recorded at regular intervals and risk assessments are carried out. The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 16 There is a pleasant garden to the front of the home and an enclosed garden laid to lawn in the central area of the home. The rooms on the upper floor can be accessed by a passenger lift. The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 17 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) 27,28,29,30 There is sufficient staff to meet the needs of the residents and the majority of staff have received training related to residents needs and health and safety requirements. EVIDENCE: Duty rotas were available and these indicated that staff are employed with the appropriate skill mix to meet the needs of residents over the 24-hour period. Trained nurses and care staff work in two teams one at each end of the home to ensure all areas of the home are covered by staff at all times. Residents were complimentary about all of the staff especially the ancillary staff who clean their rooms they said they were cheerful and helpful. Staff meetings are held and minutes available. The Gables is committed to training and development and numerous training sessions were recorded in the nursing office. The Gables has recently been audited and recognised as a suitable training establishment for overseas nurses undertaking adaptation courses through Buckingham and Chilterns University College. The home will meet the practical aspect of the course and oversee the theoretical learning. The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 18 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) 31,32,33,36,37,38 The home is well managed and run in the best interests of the residents. Residents are protected by the environmental, health and safety practices of the home. EVIDENCE: Ms Wellspring has almost completed The Registered Managers Award. A Deputy Manager assists Ms Wellspring in the running of the home. Over the last two years since Ms Wellspring became the Manager for the home she has worked hard sometimes under very difficult circumstances to raise standards and implement good practice throughout the home. Staff appraisals have been carried out and staff supervision is in operation. The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 19 The timetable for fire safety training for staff could be more organised however the Inspector concluded that generally the home is being run by a good management and staff team in the best interest of the residents. The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 20 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 2 2 2 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 2 3 3 STAFFING Standard No Score 27 3 28 3 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 3 3 3 3 x 3 x 3 2 The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 21 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 Regulation Requirement Timescale for action 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 3 38 32 Good Practice Recommendations New residents are admitted on the basis of a full assessment undertaken by people trained to do so. The fire safety training timetable should be adhered to by all staff. The registered providers should ensure Regulation 26 reports are sent to CSCI on a regular basis. The Gables Nursing Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 Home H60-H11 S24225 The Gables Nursing Home V227867 050705 Stage 4.doc Version 1.30 Page 23 - 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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