Inspection on 11/10/05 for The Gables Retirement Home

This inspection was carried out on 11th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Gables Retirement Home 22/08/06

The Gables Retirement Home 11/05/05

The Gables Retirement Home 30/11/04

The Gables Retirement Home 10/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Gables Retirement Home (The) Heath Road Holmewood Chesterfield Derbyshire S42 5SJ Lead Inspector Steve Smith Unannounced Inspection 11th October 2005 11:30 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 Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 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. Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gables Retirement Home (The) Address Heath Road Holmewood Chesterfield Derbyshire S42 5SJ (01246) 855152 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) Mr David William O`Brien Mr David William O`Brien Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Plus Three (3) Day Care Places 1 (DE) place for person as named in the Notice of Proposal to Register, for as long as they are accommodated at the home. 11th May 2005 Date of last inspection Brief Description of the Service: The Gables Retirement Home is registered to provide personal care and accommodation for up to 35 older people. The Home is situated in the village of Holmewood, which has a number of shops and a public house nearby. Services within the Home include hairdressing and activities such as dominoes, bingo and cards, and trips out are also organised. There are two lounges, both of which have dining areas. The large garden has undergone futher development and there is a patio area with seating. Car parking space is provided and the home is near a main bus route. Access is provided to community services such as GPs, District Nurses, Dentists and the Opticians. Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place in just over 4.5 hours. Discussion was held with the Home’s Registered Provider/Manager, a senior care worker and two Residents. Some of the Home’s records were examined, some of the bedrooms were seen, and the public areas of the Home were looked at. What the service does well: What has improved since the last inspection? The Registered Provider/Manager has improved the recording of the terms and conditions of residency, the fees payable for the stay, and who is responsible for each portion of the charge. The terms and conditions also specify which bedroom is to be occupied. Care plans are now reviewed once a month and are updated to reflect the changing needs of each Resident. Residents’ weights are now monitored in line with the nutritional risk assessments. The temperature of the medicines fridge is now appropriately recorded, as is the administration of all Controlled Drugs. Medication Administration Record sheets are now appropriately maintained. Staff are booked to attend Derbyshire’s multi-agency training on the protection of vulnerable adults. The windows have been repainted as required by the last inspection report. Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 6 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. Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These Standards were not reviewed during this inspection of the Home. EVIDENCE: Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 9 and 10. Residents’ health and personal care needs were being met, as demonstrated within care plans. Medication was also appropriately distributed to meet Residents needs, although some improvements were needed. EVIDENCE: To help assess Standard 7, the Resident’s Care Plan, the records of four Residents were examined, for the purpose of case tracking. Almost all of the basic information concerning each Resident was found to be in the files examined. However, all of the files lacked details of the Residents preferred name. All of the files contained the initial assessment completed by the Care Manager placing each Resident at the Home. The Registered Provider/Manager had also completed his own initial assessment of needs for the four Residents. There were also copies of the ongoing care plan and good quality risk assessments available in each file examined. Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 10 The Registered Provider/Manager had not provided details of each Residents limitations of choice, freedom and decision making ability. The Registered Provider/Manager carried out 6 monthly reviews of care on each Resident, sharing this with local Social Services Dept. The Residents Guide, which was available in the Home’s office, had not been made available to each Resident. The files showed that regular recording of events affecting each Resident were kept up to date. However, these were rather bland and repetitive. All of the files examined were extremely well organised. The files showed that the Registered Provider/Manager had read each file at regular intervals, although the files did not contain a confidential section. Lastly, none of the files contained a copy of a letter given to the Resident, before admission, to say that the Home was suitable to meet the Resident’s needs in respect of their health and welfare. All medication and the method of distributing it to Residents were examined, and a good record was found. However, a number of medications required ‘1 or 2’ to be given to the Resident, but staff responsible for the distribution of medication were not recording whether 1 or 2 medications were given. It was also noticed that a number of medications had been altered or stopped midway through the month, but these were not marked to say who had authorised the stop of medication, and nor were they supported by two staff signatures. Two Resident were spoken to about life in the Home. They said that staff were very good at listening to their views on how their wished to be cared for and staff would carry out their wishes. They said that care needs were always met with dignity and respect. As a result, they said they felt very safe in the Home, and appeared to have a strong sense and appearance of well being. In part this may well have been due to the fact that each Resident held a key to their bedroom door, which they chose to used at all times. Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 & 15. Residents preferred lifestyles were respected by the Home. They were able to receive visitors and to exercise choice and control over their lives. Residents were given a wholesome and appealing diet in pleasant surroundings. EVIDENCE: The Residents spoken to during the inspection said that they felt very safe in the Home. Staff respected their confidences and all their needs were met with dignity, respect and choice. The Inspector also observed this during a mealtime. The Residents said that they could go to bed and get up at times of their own choosing. They could also choose or change their bath times. They said that staff did not attempt to influence them on how they spent their money, as their extended family provided this support. Residents said that they could go shopping in the local town, although they required assistance from relatives or staff to achieve this. One Resident explained that at times of local or general elections the management team assisted them to vote. They also said that entertainers visited the Home at least monthly. Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 12 Relatives and friends of the Residents were able to visit at any time, and could always be seen in private. One Resident said that some staff always knocked and wait to be invited in to their bedroom, while others simply knocked, paused and entered. The Registered Provider/Manager was concerned by this, and agreed to follow this up with staff. Both Residents said that their mail was always delivered unopened, and were able to describe the system in place should they wish to smoke. Both Residents said that there was always a choices provided at all mealtimes. Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 13 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 the following standard(s): These Standards were not reviewed during this inspection of the Home. EVIDENCE: Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 14 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 the following standard(s): Standards 19 & 26. The Home was well maintained throughout, providing all Residents with a safe, comfortable environment in which to live. EVIDENCE: A tour of the public areas of the Home was made, and the Home was found to be maintained to a good standard, and was well decorated throughout. Certain areas of the Home were likely to need redecorating in the near future. The Registered Provider/Manager was aware of this and had planned the future redecorating programme to address it. During this inspection the only bedrooms examined were those of the two Residents interviewed. These bedrooms were well furnished and provided ample space for each Resident. However, neither bedroom was provided with two armchairs, or a table at which to sit. Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 15 During the inspection the Registered Provider/Manager showed the Inspector empty bedrooms that were being upgraded with private bathrooms and showers. Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These Standards were not reviewed during this inspection of the Home. EVIDENCE: Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These Standards were not reviewed during this inspection of the Home. EVIDENCE: Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X 2 X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Each file must contain details of the limitations placed on Residents, as agreed by each Resident or their representative, on the Resident’s choice, freedom and decision-making capability. Each Resident must be given a copy of the Residents Guide to the Home. Each Resident’s file must contain a copy of a letter sent to the Resident, before admission, from the Registered Provider, to say that the services provided in the Home are suitable to meet the Resident’s needs in respect of their health and welfare. When the Medication Administration Record (MAR) sheet indicates that ‘1 or 2’ medications are to be given to a Resident, staff must record whether 1 or 2 medications were given. Details recorded on a MAR sheet cannot be altered without a Doctors authorisation. When this is provided, details of the DS0000019990.V257960.R01.S.doc Timescale for action 1 OP7 17, Sch 3 06/12/05 2 OP7 5 06/12/05 3 OP7 14 06/12/05 4 OP9 13 06/12/05 5 OP9 13 06/12/05 Gables Retirement Home (The) Version 5.0 Page 20 6 OP24 16 7 OP24 16 change must be recorded on the MAR sheet, together with the name of the Doctor and the date on which the change is to take place. This must then be signed by two members of staff. All bedrooms should be provided with comfortable seating for two people (per Resident). However, this could be discussed with each Resident, or their Representative, and comfortable seating for one person could be provided if they agreed, and if this was recorded within each Resident’s Care Plan. Bedrooms must be provided with a table to sit at and a bedside table. However, this can be discussed with the Resident or their representative as necessary, giving them the choice of being provided with or without tables as appropriate. The results of the discussion must be recorded within each Resident’s care plan. 06/12/05 06/12/05 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 Refer to Standard OP7 Good Practice Recommendations The Registered Provider/Manager should include each Resident’s preferred name in the front of each of their files. The Registered Provider/Manager should review the process of daily recording of events that affect each Resident and encourage staff to provide more detail. Currently they are very bland and repetitive. The Registered Provider/Manager should provide a confidential section within each file, to be used when DS0000019990.V257960.R01.S.doc Version 5.0 Page 21 2 3 OP7 OP7 Gables Retirement Home (The) 4 OP19 appropriate. The Registered Provider/Manager is encouraged to carry out his planned redecorating programme to improve the appearance of the Home. Gables Retirement Home (The) DS0000019990.V257960.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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