Inspection on 25/11/05 for The Gables, Stroud

This inspection was carried out on 25th November 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Gables, Stroud 10/07/07

The Gables, Stroud 06/06/06

The Gables, Stroud 09/06/05

The Gables, Stroud 18/02/05

The Gables, Stroud 23/08/04

The Gables, Stroud 05/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 The Gables Lovedays Mead Folly Lane Stroud Glos GL5 1SB Lead Inspector Mr Simon Massey Unannounced Inspection 25th November 2005 13:30 The Gables DS0000016379.V269429.R01.S.doc Version 5.0 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 DS0000016379.V269429.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 Adults 18-65. 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 DS0000016379.V269429.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Gables Address Lovedays Mead Folly Lane Stroud Glos GL5 1SB 01453 758318 01453 797399 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) Stroud & District Mencap Homes Foundation Limited Louisa Merrick Care Home 5 Category(ies) of Learning disability (5) registration, with number of places The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th June 2005 Brief Description of the Service: The Gables is a semi-detached house that provides care and accommodation for five adults with learning disabilities. The home is situated close to the local town of Stroud enabling easy access for community facilities. The home provides twenty-four hour care and is a spacious property with large gardens. The home is staffed and run by Stroud Mencap, which is affiliated to the national Royal Mencap Society but is essentially an independent organisation. The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 3.5 hours. The inspector met and spoke with three care staff, four service users, one parent and also the organisation’s business manager. The environment was inspected, as well as records relating to Care Planning, Health and Safety and medication administration. What the service does well: What has improved since the last inspection? What they could do better: Further improvements are needed in the administration and recording of the care planning systems. The organisation must re-commence Regulation 26 inspections. The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 6 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 DS0000016379.V269429.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 & 4 Prospective service users needs are assessed prior to admission and they are provided with an opportunity to have a trial stay at the home. The home needs to update and revise both its Statement of Purpose and Its Service User Guide to ensure the information is accurate and up to date EVIDENCE: At the time of the inspection a prospective service user was staying for a trial visit. They had also visited on other occasions and had had two weekend stays. Family and relatives had supplied basic information and the manager of the home was in the process of completing a assessment. The person appeared comfortable in the home and was observed interacting with staff in a relaxed manner. The home is well equipped to meet the personal care needs of the prospective service user. Staff have been recorded some information in the daily notes file but it would have been preferable for a designated file to have been set up. This could have collated information that would have contributed to the assessment process. The manager was absent at the time of this inspection and staff on duty were unsure whether the required changes to the Statement of Purpose and Service User Guide had been completed. However, as these documents have not yet been supplied to the Commission, this requirement has been repeated. The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Improvements are required to the administration and organising of the care planning to ensure that service users are supported by a robust system. The documentation needs to provide clear evidence of the procedures followed and the outcomes desired and achieved. EVIDENCE: A sample of care plans were examined and these showed that plans were in place with a certain amount of reviewing being undertaken. There is clear recording of personal care and activities being undertaken. There remains a need for the files to be more clearly organised to make accessing of information easier. The files examined all contained material that could be archived. Also different files were organised in different sequences, which can be confusing. The connection between the care plans and Individual Personal Plans is also not entirely clear. Some IPPs contain goals and objectives whilst others appeared not to. The system for preparing, holding and recording IPPs appears unclear. The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 10 Some care plans state they have been reviewed, by a staff member signing on the back of the plan. There appears to be no record of any meeting that may have occurred, or of any changes that may be required to the care plan. Some of the entries in the daily notes appear a little brief, containing phrase such as “fine tonight” or “care given”. It would be preferable if some information was recorded against criteria connected to assessments, planning for future needs or goals, and objectives identified in care plans and IPP’s. One IPP gives its date as “2005”, but contains no definite date, notes or details of how the plan was organised or reviewed. In summary, there is a need for the manager and staff team to ensure greater clarity about the process involved in reviewing and developing care plans and IPPs, the paperwork that needs to be completed and filed, and finally, that material is accurately dated and signed. A requirement has been made that the manager produces an action plan to address these various issues. One parent was spoken to, who was collecting their daughter for a weekend at home. They commented that they were very happy with the care provided and the communication they have with the staff at the home. The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 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 standard were not examined in detail during this visit. EVIDENCE: There appears to be a more relaxed atmosphere in the home following the departure of one service user whose needs could no longer be met. Records show a variety of trips out and activities being supported including college, samba dancing, horse riding and massage therapy. The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 The home provides a good standard of personal care and support but action is required in relation to medication. The home and staff must ensure that all medication is correctly administered and any errors reported. EVIDENCE: The home has met the previous requirement for service users to have dental checks. Records show that health needs are being monitored and appointments being supported. The weight loss of one person was being monitored by staff, and records show this has now stabilised. The home have recorded the intake of food and any circumstances that may have been influencing the persons diet. The care plans give guidance to staff on how personal care is to be delivered and the home has the specialist equipment required to meet people’s needs. The medication administration and storage were examined and seen to be in order. However minutes from a staff meeting inform staff that if they make three errors in medication they could face disciplinary action. The inspector The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 13 believes this is misleading advice, as any error should potentially result in action being taken by the management. Also, all medication errors are required to be reported to the Commission under Regulation 37. The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 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 inspected during this visit. EVIDENCE: The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,29 &30 The home provides a homely and comfortable environment for service users that is well equipped to meet their personal care needs. EVIDENCE: The home has recently had an inspection from the environmental health department. They have received the report, which made no requirements or recommendations. One bedroom was being decorated at the time of the inspection and this was being done in a manner to ensure the least disruption to the service user. The rest of the building appeared well maintained and decorated to a good standard. The bin storing clinical waste in the bathroom contained materials there were not properly bagged ready for disposal and a requirement is made in respect of this. The rest of the home appeared clean and hygienic. The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, &33 The service users are supported by staff that work well as a team and have a good understanding of the needs of the service users EVIDENCE: The home has been holding regular staff meetings and the minutes show discussions on a range of issues concerning the care of the service users. There are also records of guidance and reminders being given to staff, and of planning for future events and activities. Staff on duty at the time of the inspection were well informed about the needs of the service users,and demonstrated a good understanding of their roles and responsibilities. The rotas show that sufficient staff are provided and that cover in the evenings and weekends is appropriate to meet the needs of the service users. The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 With the exception of Standard 42 none of these standards were examined during this inspection. EVIDENCE: Fire safety records and tests were examined and shortfalls were identified in the recording of weekly tests for the month of October 2005 and also for the monthly recording of emergency lighting tests for September. All equipment had been tested and serviced. The water from the bedroom taps is still extremely hot, something that was also noted at the previous inspection. The senior staff member on duty explained that some work had been carried out but this had been unsuccessful. A maintenance firm were due to arrive the following Monday to carry out further adjustments. The home are required to provided the details of the outcome of this work. The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 18 At the previous inspection the inspector was informed that the organisation had now appointed someone to undertake and complete the required Regulation 26 visits but this has still not yet started. This requirement is carried over from the previous inspection. All required health and safety checks have been completed and correctly recorded The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 x Standard No 22 23 Score X x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X X X 3 2 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 3 X X x CONDUCT AND MANAGEMENT OF THE HOME X x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Gables Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x X X X X 2 X DS0000016379.V269429.R01.S.doc Version 5.0 Page 20 yes 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 YA1 Regulation 4&5 Requirement The home must update its Statement of Purpose and Service User Guide and supply copies to the Commission (previous timescale 31/08/05) The home must ensure that regulation 26 visits and reports are completed and copies sullpied to the Commission(previous timescale 31/07/05) The manager must produce an action plan to address the issues in the text relating to the care planning within the home Clarification must be given to staff over their responsibility for correctly adminsistering medication The home must ensure that all errors in medication are reported to the Commission The home must ensure that all clinical waste is correctly disposed of The home must ensure that all fire safety checks and tests are completed and recorded The home must lower the water temperatures in the en-suite DS0000016379.V269429.R01.S.doc Timescale for action 31/01/06 2 YA39 26 31/01/06 3 YA6 15 & 12(b) 13(2) 28/02/06 4 YA20 31/01/06 5 6 7 8 YA20 YA30 YA42 YA42 13(2) 16(2)(j) 23(4)(a) 13(4)(a) 31/01/06 31/01/06 31/01/06 31/01/06 The Gables Version 5.0 Page 21 sinks RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Gables DS0000016379.V269429.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 DS0000016379.V269429.R01.S.doc Version 5.0 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. 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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