Inspection on 22/08/06 for The Gables Retirement Home

This inspection was carried out on 22nd August 2006.

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.

Other inspections for this house

The Gables Retirement Home 11/10/05

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 Rose Veale Unannounced Inspection 22nd August 2006 10:00 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.V309079.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. Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gables Retirement Home (The) Address Heath Road Holmewood Chesterfield Derbyshire S42 5SJ (01246) 855152 01246 857761 David@thegablesretirementhome.co.uk 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.V309079.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To accommodate the older person with Mental Disorder MD(E) named in variation application number V32959 at The Gables Retirement Home The maximum number of persons to be accommodated at The Gables Retirement Home is 35 11th October 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, churches and a public house nearby. The home comprises an older converted property with a newer extension. Accommodation is provided on 2 floors accessed by a shaft lift or a stair lift. There is a choice of lounges and dining areas. There is a large, accessible garden. Car parking space is provided and the home is near a main bus route. Fees at the home range from £289.70 to £319.70 per week. The fees do not include hairdressing, chiropody or newspapers. This information was provided by the owner/manager in the pre-inspection questionnaire dated 21/07/2006. Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and took place over 5½ hours. The inspection visit focused on assessing compliance to requirements made at the previous inspection and on assessing all the key standards. There were 17 residents accommodated in the home on the day of the inspection, including 1 resident assessed as needing dementia care. Residents, visitors and staff were spoken with during the visit. Some residents were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. Records were examined, including care records, staff records, maintenance, and health and safety records. A tour of the building was carried out. A questionnaire and surveys had been completed and returned prior to the inspection and information from this has been included in the body of this report. The owner/manager was available during the inspection and was very helpful. What the service does well: What has improved since the last inspection? The home had complied with the requirements made at the last inspection, resulting in improvements to the medication systems and to the information provided for residents. A shared room had been refurbished to provide a single room with en-suite toilet and shower. An additional member of staff had been provided from 11am to 1pm to help with the busy lunchtime period. Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 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.V309079.R01.S.doc Version 5.2 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.V309079.R01.S.doc Version 5.2 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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The assessment process was good so that residents were confident the home could meet their needs. EVIDENCE: The care records of 3 residents were examined, including 1 resident recently admitted. The records had a range of assessment information, including hospital and social services assessments received prior to admission. Assessment following admission included assessments of the risk of developing pressure sores, nutritional needs, moving and handling needs and the risk of falls. Each resident had a letter from the home confirming that his or her needs could be met. One record included details of visits made to the home by a resident before permanent admission. Care plans had been produced from the assessment information. Residents and visitors spoken with said the home was able to meet the residents’ needs. Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 Page 9 Standard 6 did not apply to this service. Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 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 the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents’ health and personal care needs were well met and their dignity and privacy respected. EVIDENCE: Individual care plans were seen in the 3 care records examined. The plans were detailed and covered all the assessed needs of the residents. The plans were signed by the resident or their representative to indicate their involvement and agreement. The care plans had been reviewed and updated at least monthly. Residents spoken with were aware of their care plans. Residents and relatives spoken with said they had been involved in care reviews with the resident’s care manager. There were records of the visits and input of health care professionals such as GP, District Nurse, chiropodist, dentist and optician. There were records of hospital outpatient appointments and of admissions to hospital. Residents spoken with said the GP was called promptly when needed. There was evidence in the daily records that residents were promptly and appropriately Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 Page 11 referred to health care services. For example, one resident with continence problems was seen by the district nurse for assessment; another resident was seen by the chiropodist soon after admission to treat a foot problem. Residents spoken with said that staff were “very caring”, “kind” and “friendly”. Visitors spoken with were pleased with the standards of care and commented that residents were “well cared for”. Staff spoken with were knowledgeable about the care needs of residents and were able to discuss the care requirements of individual residents. Staff were familiar with residents individual preferences, such as food likes and dislikes, and preferred daily routines. The care plans seen referred to maintaining the privacy and dignity of residents. Residents were able to give examples of how their privacy and dignity were maintained, such as being able to have keys for their bedroom doors, and staff knocking on doors before entering. It was observed during the visit that staff spoke to residents in an appropriate and respectful way. Staff spoken with were aware of the need to promote residents privacy and dignity and gave examples such as ensuring clothes were changed when food had been spilt, and making sure that all staff were aware of and respected residents’ individual preferences. Staff induction records showed that promotion of residents’ rights to privacy and dignity was included. Medication in the home was securely stored and was administered by senior care assistants who had received appropriate training. The medication administration records seen were correctly completed and had a photograph of the resident attached. Two requirements made at the last inspection regarding the recording of the administration of medication had been met. Records were seen of the receipt and disposal of medication. The pharmacist visited the home every 3 months to carry out a check audit. The lunchtime medication round was observed and the procedure appeared safe. Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 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 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 the service. Residents were encouraged to exercise choice and control over their lives and were offered a range of activities so that their social, cultural and religious needs were met. EVIDENCE: Records were seen of the activities provided at the home. Activities included a regular bingo session, dominoes, music, exercises, entertainers and trips out. Two residents spoken with liked some of the activities and said there should be a wider range with some more stimulating activities. A resident and a visitor spoken with commented on a recent trip to Chatsworth with a picnic and said how much residents had enjoyed this. One resident had enjoyed taking part in a book reading scheme with a local school. Residents spoken with enjoyed using the garden, particularly as it had been made more accessible recently. A religious service was held once a month at the home. The staff rota showed that an additional member of staff was provided on week day afternoons specifically for activities. The owner/manager said that he was planning to recruit an activities organiser and to expand the range of activities offered. Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 Page 13 Residents spoken with said they could choose what time they could get up or go to bed. Details of residents’ preferred daily routines were included in the care records. Visitors spoken with said they were always made welcome when they visited and were always offered refreshments. Residents and visitors said they could meet in private if they wanted to. The menus seen appeared varied and well balanced. Residents were offered a choice at lunch and tea time. Residents spoken with were generally pleased with the meals, although one commented that teatime choices were a bit limited. Residents were encouraged to comment on the menu and offer ideas through talking to the cooks and the residents’ meetings. The meal served at lunchtime during the inspection visit was home made and looked appetising. Staff spoken with were knowledgeable about residents’ food preferences. The care records included a nutritional assessment. There were two dining areas in the home, both providing a pleasant place for residents to eat. It was observed that there was a calm and unhurried atmosphere during lunch. Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 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 the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home had a robust complaints procedure in place and there were good staff awareness and attitudes regarding safeguarding adults to ensure residents felt safe and were well protected. EVIDENCE: Each of the care records seen included a copy of the complaints procedure that had been signed by the resident or their representative. Residents and visitors spoken with were aware of the complaints procedure. They said they would be happy to go to the owner/manager with any concerns and were confident that appropriate action would be taken. None of the residents or visitors spoken with had ever made a formal complaint to the home. One commented that “it would never get that far” because they were able to discuss anything with the owner/manager and it would be “sorted out”. No complaints about the home had been received by CSCI. The staff training records showed that all the staff had received recent training in safeguarding vulnerable adults. Staff spoken with were aware of the procedures to follow if abuse was suspected. The home had safeguarding adults and whistle blowing policies in place. Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 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 the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The standard of the environment within the home was good, providing residents with a safe, pleasant and comfortable place to live. EVIDENCE: A tour of the building was carried out including the communal areas, the laundry, kitchen, bathrooms and most of the bedrooms. The home appeared well maintained with decorating work being carried out on the day of the inspection visit. A first floor shared bedroom had been refurbished since the last inspection to provide a single room with en-suite toilet and shower. The garden had been made more accessible to residents by the provision of wide, level paths. The bedrooms seen were personalised with residents’ own possessions. The bedrooms, lounges and dining areas were comfortably furnished. It was Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 Page 16 commented that the lounge area near the office could be dull as there was little natural light. The laundry and kitchen were suitably equipped. The home was clean and free from offensive odours throughout. Residents and visitors spoken with said the home was always clean. Staff training records showed that staff had received training in the control of infection. It was observed that staff used disposable aprons and gloves when assisting with personal care. Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 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 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): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There was a well-motivated, competent staff team to ensure residents’ needs were well met. EVIDENCE: The staff rotas for the home were seen and showed that there were 2 care staff on duty from 7am until 10pm, plus an extra person to help between 11am and 1pm. On Monday to Friday each week an extra care assistant was provided for 2 hours each afternoon to help with activities for residents. There was 1 care assistant on duty during the night from 10pm to 7am with the support of the owner/manager sleeping-in. In addition, there was a cook and domestic assistant working every day. The staffing levels shown on the rota were in line with the guidance from the Residential Forum for staffing in care homes. The owner/manager said that the home never used agency staff. Residents and visitors spoken with said there were enough staff on duty to meet residents’ needs. One visitor commented that there was always a member of staff around in the lounges. Two residents said that staff were always available when needed. Staff spoken with said that staffing levels were satisfactory to meet residents’ needs. Staff said that the provision of an extra member of staff to cover the busy lunchtime period was an improvement. Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 Page 18 The staff training records seen showed that 4 of the 8 care assistants currently employed had already achieved a National Vocational Qualification, (NVQ), in care, and 1 care assistant was working towards the qualification. The cooks had achieved NVQs in catering. The owner/manager had achieved the NVQ Level 4 Registered Manager’s Award. Each member of staff had an individual training record. All staff had received training in fire safety, first aid, moving and handling, safeguarding adults, basic food hygiene, and infection control. The senior care assistants responsible for administering medication had received appropriate training. Some staff had received other training related to the needs of residents, such as dementia awareness and oral health care. There was an induction programme in place for new staff. Staff spoken with were pleased with the training programme at the home. The personal records of 2 members of staff were seen. The records included all the required information, such as a photograph, recent form of identification, and 2 written references. The records were stored securely. Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 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 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): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home was well-managed and was run in the best interests of residents. EVIDENCE: The owner/manager was suitably qualified and experienced to run the home. Residents and visitors spoken with said the manager was “approachable”, “always ready to listen”, “well organised”, “very involved in the home”. One resident said they were pleased that the owner/manager chatted to residents every day to make sure they were alright. Questionnaires were seen that had been completed by residents or their representatives about their satisfaction with the service provided by the home. Residents spoken with confirmed that they had completed questionnaires. Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 Page 20 There was a policy for quality assurance in the home and annual surveys were completed. Some residents chose to have personal money held at the home for hairdressing, toiletries and so on. The money was kept securely in a safe. The records seen were well kept with details of all transactions and receipts kept. All transactions were signed, although few had a second signature of the resident/ their representative or a second member of staff. This would be good practice to ensure the safety of residents’ money. The home had a comprehensive health and safety policy in place. Health and safety records were seen, including the fire log book, accident records, maintenance and servicing records. All the records seen were up to date. Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A 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 Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 3 X 3 X 3 X X 3 Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 Page 22 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 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. Refer to Standard OP12 OP35 Good Practice Recommendations The activities programme should be expanded to cater for the needs and interests of all the residents. The records of residents’ personal money should have 2 signatures per transaction. Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 Page 23 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. Extracts may not be used or reproduced without the express permission of CSCI Gables Retirement Home (The) DS0000019990.V309079.R01.S.doc Version 5.2 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. 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. 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