Inspection on 08/12/08 for The Gables Residential Care Home

This inspection was carried out on 8th December 2008.

CSCI found this care home to be providing an Adequate service.

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 Residential Care Home 23/04/08

The Gables Residential Care Home 06/11/07

The Gables Residential Care Home 01/05/07

The Gables Residential Care Home 19/12/06

The Gables Residential Care Home 01/06/06

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOMES FOR OLDER PEOPLE The Gables Residential Care Home Thrush Drive, Huntley Mount Road Bury Lancs BL9 6JO Lead Inspector Lucy Burgess Unannounced Inspection 8th December 2008 10:00a X10015.doc Version 1.40 Page 1 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 The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 2 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 Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Gables Residential Care Home Address Thrush Drive, Huntley Mount Road Bury Lancs BL9 6JO Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161 764 6593 0161 764 6593 Mr Ghennessen Pumbien Mrs Radha Rajcoomaree Pumbien Mr Ghennessen Pumbien Care Home 14 Category(ies) of Dementia (1), Mental disorder, excluding registration, with number learning disability or dementia (14), Old age, of places not falling within any other category (14) The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories Old age, not falling within any other category - Code OP Mental Disorder, excluding learning disability or dementia - Code MD Dementia - Code DE (maximum 1) The maximum number of service users who can be accommodated is: 14 Date of last inspection 23rd April 2008 Brief Description of the Service: The Gables is a privately owned care home providing care and accommodation for up to 14 older people. The current fees for the home are £349.00 per week. The home is situated in a residential area of Bury approximately 1 mile from the town centre. There are bus routes, shops, and other community facilities close by. The home is on two floors and it has 6 single and 4-shared bedrooms. None of the bedrooms have en-suite facilities. There is one large comfortable lounge, a separate dining room and a conservatory, which is the designated smoking lounge. There is a garden and limited car parking at the front of the home. A Service User Guide and a Statement of Purpose describing the home’s services is available A copy of the latest inspection report is also available on request. The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was the second key inspection carried out by 2 inspectors, which included a site visit and took place over one day, for a period of 5 ½ hours. A pharmacist inspector also visited the home to look at how medication is managed. The providers did not know that the inspectors were going to visit. During the inspection care and medication records were looked at as well as information about the staff and health and safety including how the home and the equipment were kept safe. The inspectors also looked around the building to check if it was clean and well decorated. Two random inspections have been undertaken since the first key inspection to look at progress made. Improvements were noted during these visits. As part of the inspection process the provider’s are asked to complete a selfassessment survey information document (Annual Quality Assurance Assessment). This was sent to the home before the inspection and had been completed and returned to us prior to the site visit. Other information was gathered from the feedback surveys we sent out. We received completed surveys from 10 people living at the home. Comments have been added to the report. Discussion and feedback was held with Mr Pumbien, one of the owners of the home who has recently been approved as the registered manager. A further application to vary the current registration has also been approved. This now enables the home to admit people in the category of mental disorder. What the service does well: People living at the home are settled and are cared for by a number of staff that have worked there for sometime and therefore are aware of their support needs. People appeared settled and relaxed and enjoyed spending time in all areas of the home. The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 6 Comments were received from people in the surveys. Generally people felt that they received the support they needed, that staff listened to them, that activities were available to them, they liked the meals and that they knew how to make a complaint if they needed to. What has improved since the last inspection? What they could do better: The home needs a period of stability within the management team to make the necessary improvements so that people receive a good quality service. Care plans must be reviewed and updated on a monthly basis and made available to all care staff so that they are aware of the current and changing needs of people ensuring their health and well being is maintained. A plan of care should be provided for staff with regards to the administration of when required medication so that they know when and why it should be given. Having written care plans and detailed records for ‘when required’ medicine helps to make sure they are given to people correctly. All staff must complete training in safeguarding adults ensuring they are aware of the procedure to follow should an allegation be made and people are kept safe. Further improvements are needed to the physical environment including refurbishment and redecoration so that people live in a good standard of accommodation, which meets their needs. Information provided by new staff must be checked to verify its authenticity ensuring people employed to work at the home are suitable and people are not placed at risk. The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 7 The manager needs to develop a programme of training for the forthcoming year ensuring all staff have the knowledge and skills needed to support those people living at the home. All staff must be offered formal supervision so that they receive the support and direction needed to carry out their role. The manager is to forward confirmation that money belonging to people at the home has been transferred to the residents bank account. The manager must also forward confirmation that servicing has been completed to the oil boiler, call bell system and small appliances ensuring the home is safe and well maintained. 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 summary of this inspection report can be made available in other formats on request. The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Placements have not recently been made at the home due to concerns about the care provided. This will be reviewed again to ensure that people are being cared for safely. EVIDENCE: Concerns were found during our inspection visits in 2007 that people were being admitted to the home with care needs, that the home was not registered to provide for. Enforcement action was taken against the providers as well as discussions about how this matter could be resolved. The providers submitted an application to us to vary their current registration and add the category of mental disorder (MD). This has now been approved. The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 10 Due to this and as the home had been rated as a poor service, no placements have been made at the home since April 2008. Therefore standard 3 could not been assessed. We spent sometime talking with the owner/manager about the changes to the registration and their long term plans for the home. Consideration will need to be given to ensuring staff are provided with adequate training ensuring they have the knowledge and skills to met the specific needs of people with mental health needs. The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements have been made ensuring the health and well-being of people is maintained however care plans need to reflect the current and changing needs of people so that staff are aware of the support required and people are not placed at risk. EVIDENCE: Due to changes within the staff team care files are now reviewed and updated by the manager and a senior carer. We looked at several files for those people where there had been changes in need. There had been changes in the health care needs of one person. Whilst previously they had been able to weight bear they were now completely dependent on staff and were being hoisted for all personal care tasks. However the care plan on file was dated September 2008 and therefore did not reflect the recent changes. Risk assessments for this person were however up to date and had been reviewed. The district nurse was also making weekly visits. The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 12 Changes had taken place for another person who had been prescribed PRN medication due to their sleep pattern and behaviours. Whilst information was recorded on the professional visits and risk assessment that this had been introduced there had been no up date on the care plan outlining for staff when PRN should be considered as outlined further below. Clear guidance is needed for staff to ensure that medication is administered safely and appropriately. It was also evident that the health care needs of people continue to be addressed with additional support from relevant health and social care professionals such as the GPs, consultants, social workers, dietician, district nurse and optician. Further records are maintained. These include daily diaries, food intake charts, daily routines, professional visits and weight charts. Information provides a good overview of the persons health and social needs. These are completed more frequently if concerns have been identified. As part of the visit a pharmacist inspector looked at the handling of medicines. We checked the medicines records, medicines stocks and a sample of care plans. We found continued improvements in the way medicines were being recorded and given to people. Our checks showed medicines were being given to people correctly and an accurate record of this was usually made. We found one recording mistake when staff had wrongly signed a person’s record for the whole of the previous month but had not given the medicine. This showed that staff did not always check the records carefully when giving and signing for medicines, which could lead to serious mistakes. We looked at the times medicines were given and found some improvements. However, the records did not always state the exact and correct time a medicine was given, so it was not always possible to show that they had been given to people properly. We looked at a sample of care plans and daily notes to make sure medicines were correctly reflected in them. One person’s care plan did not have enough information about how their ‘when required’ medicine for anxiety was to be used. There was no clear information about when and why it should be given and when it had been used there was no explanation why in the daily care notes. Having written care plans and detailed records for ‘when required’ medicine helps to make sure they are given to people correctly. We looked at how controlled drugs (medicines that can be misused) were handled. The controlled drugs cupboard had now been properly attached to the wall to help prevent any mishandling or misuse. We looked at how medicines were stored and found the room and trolley to be clean, tidy and secure. A suitable fridge was used for storing medicines that The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 13 required cold storage and the temperature of this was checked daily to make sure it was working properly. Storing medicines at the right temperature prevents them being spoilt. The manager said that all staff that had been observed whilst giving and recording medicines to make sure they were competent, and we saw some records about this. He also said he regularly checks stock and records to make sure they are being completed correctly. However, we saw no evidence of these checks so we gave some further advice on how to improve this so that any audits find and prevent mistakes happening again. The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Routines are flexible enabling people to make decisions about how the wish to live their lives. Consideration is given to the nutritional needs of people ensuring their dietary needs are met. EVIDENCE: Routines within the home vary depending on the needs and wishes of people. This may include activities both in and away from the home. People continue to access the community independently, visiting local shops, the community centre and pubs. One person still attends the local community centre to learn computer skills. Other people visit the centre for social gatherings. Arrangements had been made for the week following our visit for people to visit the centre for a Christmas party. People have also visited on a Thursday for the bingo. Information about the activities on offer is displayed on a notice board in the hall. Information showed that someone visiting the home provides exercise classes on a fortnightly basis. Staff also offer baking, indoor bowls, manicures, The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 15 sing-a-long and film afternoons. There were also photographs displayed from the recent Halloween party. Information about what people do on a day-to-day basis is recorded in their diary sheets. This showed that people had also received communion, had visits from family members and had their hair done by the visiting hairdresser. Due to the health needs of some people routines are very relaxed with people spending time relaxing and watching television. One person appeared more settled than at our previous visit and was seen to be very relaxed and happy. Two other people were enjoying a game of dominoes in the dining room whilst others relaxed in the communal areas or the privacy of their own rooms. People were seen to move freely around the home. Arrangements in relation to meals and food stocks were looked at to see if the improvements previously noted had been sustained. Meals continue to be prepared by the cook who works between 10am and 12.30pm each day. Care staff prepare the breakfast and evening meal. The main meal is served at lunchtime. The cook was aware of people who had specific dietary needs or requests and ensured that this was considered when preparing their meal. Where additional support and advice has been required contact has been made with the persons GP and dietician to ensure that their health needs are met. Food stocks are held in the basement. Sufficient items were available along with items bought for the Christmas period. No issues were identified. The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Suitable arrangements are in place with regards to complaints and protection however staff training is required to ensure they are aware of the procedure to follow should an allegation be made so that people are safe. EVIDENCE: The providers have recently reviewed and updated the homes statement of purpose and service user guide. Information is provided in these documents about how to complain. A copy of the procedure is also displayed within the hall and is easily accessible to visitors. Information provided on the AQAA stated that there had been no complaints raised within the home. No issues have been raised with us. Ten surveys were received back from people who live at the home. Two were incomplete. However 8 people answered Yes confirming that they knew how to make a complaint if they needed to. As previously identified the home has a copy of the Local Authority Safeguarding Procedure. The owner/manager is aware that staff have further training needs in this area and has accessed information from the local authority training partnership group. Arrangements are to be made with staff to ensure that they are fully aware of their responsibilities in this area. The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 17 The owner/manager is currently completing management training with regards to reporting and investigating safeguarding issues. The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst improvements have been made further work is required to enhance the appearance as well as improve the overall standards within the home so that people live in a pleasant, comfortable and well maintained home. EVIDENCE: The owners have spent the last year updating and improving the home and standard of accommodation provided. When we visited in July 2008 we found that work had been carried to improve both the exterior and interior of the home. The front of the home had been painted and the grounds tided. Inside the home the cellar had been cleared and some areas had been painted including woodwork near to the conservatory. Water temperatures were checked, as these had previously been very high. This had been addressed and temperatures taken were found to be between 42°C and 44°C. The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 19 We also received a copy of the fire officers letter dated 21 May 2008, following their follow-up visit to the home on the 15 May 2008. This stated that all work previously identified had now been addressed and was satisfactory. The providers were advised to keep the fire risk assessment under review ensuring people were kept safe. One area requiring attention was a broken window in a first floor bedroom. This needed to be replaced to make sure that the person occupying the room did not come to any harm. Further work had then been completed when we visited again in September 2008. The decoration had been improved in the dining room, hall, stairs and landing, upstairs bathroom, toilet and several bedrooms. The garden was tidy and the pathways had been levelled. The broken window identified during our last visit had also been replaced. The home was found to be clean and tidy. Since this visit a new carpet had been fitted throughout the lounge, hallway and stairs. Discussion was held with the owner/manager about further plans for the home. Two double rooms are now unoccupied and would benefit from further decoration and refurbishment offering prospective new residents a good standard of accommodation. In two other rooms we noted a malodour with one of the carpets being heavily soiled. We were told that rooms had been identified for new carpeting. The owner/manager was asked to develop a plan of work for the forthcoming year and forward it to us so that we can monitor work within the home. The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 20 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst some improvements have been made in relation to recruitment and training of staff further improvements still need to be made ensuring people working in the home are suitable and have the knowledge and skills needed to support people safely. EVIDENCE: Since our last visit further changes have taken place within the staff team. Information provided on the AQAA stated that several staff have left over the last 12 months. One member of staff is also on long term sick. Existing staff and the owners are currently working additional hours to cover the shifts. Staffing rotas were looked for the week of the visit. We found that 2 care staff are available each day between the hours of 8am and 9pm with a wake in staff member at night. In addition to this the owner/manager works each weekday between 9am and 5pm and there is a cook between 10am and 12.30 each day. The owners also have accommodation on the premises and are therefore available should additional support be required or an issues arises. The owner/manager told us that since our last visit in August 2008, two new staff have recently been appointed. Recruitment information was looked at for these people. Information seen included; an application form, written references and criminal record checks (CRBs). One of the staff members is The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 21 from overseas. The manager was asked to confirm that all relevant documents needed to work in the UK were available and copies held on file. A training matrix is also now displayed within the office. This shows what training each staff member has undertaken and clearly identifies their training needs. The owner/provider advised us that each member of the team has recently completed a training analysis, which is to be submitted to the training partnership group. This identifies what their training needs are and will help to plan a programme of training for the forthcoming year. Information seen showed that there are a number of areas where staff now required further training updates including all mandatory courses. Whilst recent training has been provided for most staff in relation to mental health awareness, the manager must ensure that all staff undertake this. Further relevant training should also be considered as part of their training and developed particularly as the home has varied its registration to include the category mental disorder, ensuring staff have the knowledge and skills needed to support people safely. NVQ training has also been offered however due to staff changes information provided on the AQAA and seen on the staff training matrix were different. The manager is asked to clarify this when responding to the report. The owner/manager has recently qualified as a registered mental health nurse. He has now commenced the leadership and management courses required for his role. The induction programme was also seen. This included staff being informed of health and safety, policies, terms and conditions, support and development, training, emergencies, information specific to those working and living at the home and other information in relation to the workplace. Whilst this had been undertaken by one of the new staff members this had not been done with the other. The owner/manager must ensure that all staff employed at the home have completed a comprehensive induction so they are ware of the homes policies and procedures and their responsibilities whilst working at the home. The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 22 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A period of stability within the management team is needed to ensure that staff are supported and directed in carrying out their duties and that people living at the home receive a quality service, which meets their needs. EVIDENCE: Since our last key inspection in April 2008, the providers have submitted two applications to us. One was in relation to Mr Pumbien becoming the registered manager and the second was to add the category of mental disorder to the homes current registration. These applications have now been approved and the providers have received an updated certificate. During this inspection visit we found that a number of improvements had been made to address requirements made during our previous visits. The home The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 23 now needs a period of stability to ensure that the improvements made are sustained and further improvements ensuring the people living at the home receive a good quality service. The staff/managers office has now been moved to the second floor. Whilst this provides a better working environment for the manager this does take care staff away from the floor when updating plans. Due to the number of areas identified at the first inspection we have not explored systems in relation to quality assurance. This will be explored during our next visit once requirements have been addressed ensuring the owners have systems in place to make sure that the improvements made continue and that the home continues to develop the service based on the changing needs of those living at the home. Suitable arrangements have now been made with regards to money held on behalf of people living at the home. Two people were previously identified as having money being held in the business account. The owner/manager advised us that a residents bank account has now been opened and arrangements are to be made to transfer all monies over to this account. Confirmation that this has been done must be provided. Further records are held for those people whose personal allowance is held by staff. A number of people are supported by relatives or manage their own affairs. During our previous visits we identified that staff supervision was not being held. The owner/manager was aware of this, however had been prioritising other areas of improvement required. During this visit we found that supervision sessions had commenced for some members of the team. The owner/manager must ensure that all staff receive regular supervision ensuring they receive adequate support and direction to carry out their roles. We also looked at the servicing certificates and checks carried out in the home. Up to date certificates were available for fire alarm and equipment, electrics, hoist and passenger lift. In house checks were also being carried with regards to fire safety, water temperatures and emergency lighting. A fire drill was also carried out on the 5 October 2008. We carried out a random check of water temperatures, readings were at 44°C. The owner/manager advised us that checks had recently been carried out on the small appliances and that they were waiting for the certificate and the oil boiler was due for servicing. No certificate was seen for the call bell system. The owner/manager must provide evidence that these have been completed. The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 2 X 2 The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15 Timescale for action Care plans must be reviewed and 30/01/09 updated on a monthly basis and made available to all care staff so that they are aware of the current and changing needs of people ensuring their health and well being is maintained. 30/01/09 A plan of care should be provided for staff with regards to the administration of when required medication so that they know when and why it should be given. Having written care plans and detailed records for ‘when required’ medicine helps to make sure they are given to people correctly. Further improvements are required to the physical environment including refurbishment and redecoration so that people live in a good standard of accommodation, which meets their needs. 30/05/09 Requirement 2. OP9 13(2) 3 OP19 23 The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 26 4. OP29 19(1)(b) Schedule 2 Information provided by new staff must be checked to verify its authenticity ensuring people employed to work at the home are suitable and people are not placed at risk. 30/01/09 5. OP30 18(1) A programme of training must be 30/01/09 developed for the forthcoming year ensuring all staff have the knowledge and skills needed to support those living at the home. All staff must be offered formal supervision and support in line with the standard and records made of such meetings. (Previous timescale of 30/08/08 not met) 30/12/08 6. OP36 18(1)(2) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP18 Good Practice Recommendations All staff must completed training in safeguarding adults ensuring they are aware of the procedure to follow should an allegation be made. The manager needs to forward confirmation that money belonging to people at the home has been transferred to the residents bank account. Confirmation needs to be provided with regards to the completion of servicing to the oil boiler, call bell system and small appliances. 2. OP35 3. OP38 The Gables Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Residential Care Home DS0000065390.V373480.R01.S.doc Version 5.2 Page 28 - 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!