Inspection on 28/06/07 for The Gables, Truro

This inspection was carried out on 28th June 2007.

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, Truro 04/06/09

The Gables, Truro 05/06/08

The Gables, Truro 08/06/06

The Gables, Truro 19/01/06

The Gables, Truro 07/06/05

The Gables, Truro 05/01/05

The Gables, Truro 19/07/04

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 Newquay Road Goonhavern Truro Cornwall TR4 9QD Lead Inspector Diana Penrose Unannounced Inspection 28th June 2007 09:10 The Gables DS0000008970.V343581.R01.S.doc Version 5.2 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 DS0000008970.V343581.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 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 DS0000008970.V343581.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Gables Address Newquay Road Goonhavern Truro Cornwall TR4 9QD 01872 571030 0871 661 8115 choicecareservices@yahoo.com 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 John Aubrey Nicholls Mrs Rebecca Jane Warren Mr John Aubrey Nicholls Care Home 10 Category(ies) of Learning disability (10), Dementia (1) registration, with number of places The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Learning disability, excluding dementia or mental disorder (Code LD) - maximum 10 places Dementia (Code DE) - maximum one (1) place Total number of service users not to exceed a maximum of 10 2 Date of last inspection 08/06/06 Brief Description of the Service: The Gables is registered to provide care for ten service users with learning disabilities and one with a dementia. This home offers day care; respite care and holidays for service users with a learning disability. The registered providers Mr Nicholls and Ms Warren live on the premises. The Gables is a detached house situated in the village of Goonhavern, which is between Perranporth and Truro. It provides single accommodation for service users and there is a self contained flat to accommodates one service user. There is a suitable dining room and two lounges on the ground floor. There are two workshops situated at the rear of the home that predominantly provide activities for day care service users but are also utilised by all service users accommodated in the home. The home is clean, warm and comfortable. The service users currently living in the home attend weekday activities assessed for and provided by the Cornwall department of adult social care. Service users are given ample opportunities for socialising and visitors are openly encouraged. Information about the home is available in the form of a statement of purpose / service users’ guide, which can be supplied to enquirers on request. A copy of the most recent inspection report is available in the home. Fees range from £300.00 to £550.00 per week; this information was supplied to the Commission in the pre-inspection questionnaire received on 15/05/07. Additional charges are made in respect of private healthcare provision, hairdressing and personal items such as confectionary and toiletries The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An Inspector visited The Gables Care Home on the 28 June 2007 and spent eight hours at the home. This was a key inspection and an unannounced visit. The purpose of the inspection was to ensure that resident’s needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus was on ensuring that resident’s placements in the home result in good outcomes for them. It was also to gain an update on the progress of compliance to the requirements identified in the last inspection report dated 08 June 2006. All of the key standards were inspected. On the day of inspection eight residents were living in the home, two were on holiday and one was receiving respite care. There was one day care service user; the home can cater for up to fifteen service users for day care but have eight most days. The methods used to undertake the inspection were to meet with residents, the registered provider and manager to gain their views on the services offered by the home. Records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. The registered provider has complied with most of the requirements set at the last inspection two are re-notified. Residents expressed satisfaction with the care and services provided at the home and were treated with kindness. Overall the home is providing a adequate quality of care to the residents placed there. What the service does well: The home provides a comfortable relaxed environment for permanent and holiday residents and those spoken with are very happy living in the home. The grounds are tidy and residents can access them easily. Residents said the registered providers and staff are kind and caring and their health needs are met. Residents are able to make decisions on how they live and maintain their independence. They said the daily routines are flexible to meet their individual needs and wishes. Contact with family and friends is encouraged and visiting is open. Residents have access to a variety of activities at the home and via day centres and work placements. The home has its own transport, which enables residents to go out on a wide range of day trips and outings. There is a suitable complaints policy that up to date and available to residents and staff. All documentation and records are stored confidentially and in line with data protection requirements. The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 6 Health and safety precautions are good and appropriate maintenance; equipment and service checks are undertaken. What has improved since the last inspection? What they could do better: The registered providers must ensure they consult with residents and / or their representatives when compiling and reviewing the care plans. The plans must also be fully completed and in sufficient detail to direct staff in the care provision. Some parts of the home still require extra cleaning or decoration and some furniture and fittings need to be replaced. The manager has agreed to undertake an environmental audit to identify the needs and to compile an action plan to address them. The duty rota does not accurately show the number of staff on duty or the hours worked by staff and management. The manager has agreed to devise a new rota to provide this information. The home must implement a robust recruitment system that complies with legal requirements. No person must commence work in the home without a satisfactory POVA check and all employees awaiting a CRB disclosure must be supervised at all times and not work unattended. Training specific to the client group must be provided and there must be evidence in the home that staff keep up to date on current issues relevant to the type of residents they care for. The home has no quality assurance systems in place and these are required to monitor and improve the service. The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 7 One of the registered providers’ must obtain an NVQ 4 in both management and care or a registered manager must be employed who either has these qualifications or is working towards them within a specified period. 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 DS0000008970.V343581.R01.S.doc Version 5.2 Page 8 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 DS0000008970.V343581.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents are given information about the home enabling them to make an informed decision; the home must ensure that this information is up to date. The home receives appropriate information from external agencies prior to residents being admitted to the home, they should ensure that they also undertake a thorough written assessment prior to admitting a new resident and that this is kept in the resident’s file. EVIDENCE: Evidence was provided in the form of records and talking with the manager. The home has a suitable statement of purpose. The service user guide shown to the inspector was dated March 2006 and is in need of reviewing and updating. The manager agreed to do this. The manager stated that prospective residents are assessed by the home prior to admission and there is a suitable form used for this assessment. There were no completed forms within the resident’s files inspected, one permanent admission the other a respite admission. This was discussed with the manager who said that an assessment was done for the new resident but the other has received respite care for years and may not have been done when he was first The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 10 admitted, he should be assessed prior to each visit. There were assessments from the department of adult social care, the CPT and the hospital ward. There has only been one permanent admission since the last inspection. The home requests that the person referring a resident for a holiday stay completes one of The Gables profile forms. This gives information about the resident and their care needs, completed profiles are on file. The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individual care plans are generated for each permanent resident that inform and direct staff in the care provision when completed appropriately. The registered providers must ensure full completion of documentation and produce care plans for the holiday residents. Residents and other relevant people should be involved in the compilation and review of the care plans. Residents make decisions about their lives but they need to be more involved in decisions about the running of the home. Risks are assessed and staff are make efforts to enable residents to lead a more independent lifestyle. EVIDENCE: Evidence was provided in the form of three resident’s care records, discussion with residents and the manager. Residents who live permanently or receive respite care at The Gables have an individual care plan that informs staff on the care to be provided. The format is detailed and covers all relevant areas. All of the documents in the file should The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 12 be completed; inserting ‘not applicable’ is more appropriate than leaving sections blank. A new resident’s care plan was inspected and was not fully completed; the manager stated that this is because the admission was only a few weeks ago. Another care plan inspected was in need of a review; the resident or their representative should be involved in this and other people as appropriate. Daily records are informative and held individually; one resident also keeps a diary of his daily events. Residents on holiday have a profile completed for each visit that is used to inform staff on the care provision. Many of the holiday residents have visited the home several times. The profile should be seen as an assessment and full care plans should be produced and reviewed on each visit. These would contain more detail to direct care staff. There is some evidence that residents are involved in making decisions about their lives from the records maintained. Residents spoken with said they decide what they want to do each day and how they wish to spend their time. Staff were observed asking residents what they would like to do. Some days the permanent residents go to day centres so there is more free choice at weekends. One member of staff spoke about how she has been helping a resident make decisions on how he lives his life and what is important to him. She said she has been talking to his family as well. The manager said that discussion regarding life in the home tends to be carried out informally, but there are meetings when required; no minutes are kept. Staff manage most residents’ monies, each has a post office account and some have a bank account as well. Benefits are paid in monthly and residents receive regular money to spend as they wish. Records are maintained and receipts are kept for all expenditure on behalf of residents. Two staff act as appointees for two residents’ benefits. There is evidence that residents are encouraged to take reasonable risks and risk assessments are included with the care plans. One resident said he goes out to the shop and to the pub on his own. As in previous reports it is recommended that the registered providers explore further possibilities for providing residents with more choices and opportunities for consultation on the running of the home. This could include involvement in the choice of colours and so on when the home is decorated, for example. Opportunities for further participation in community life, within a risk assessment framework are being explored. All records are stored confidentially in the owners’ accommodation or in a locked cupboard in the home. The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents attend day centres and some opportunities are available for education; the home aims to offer a lifestyle that meets individual residents needs. Links with the local community are limited but residents said they could go out as they wish. Visiting and contact arrangements are open and residents know they can see their visitors in private. Daily routines are flexible but residents are expected to fulfil household tasks and participate together in the home. Dietary needs of residents are catered for with a varied selection of food available that aims to meet their taste and preference. EVIDENCE: Evidence was provided in the form of documentation, records, interviews with residents and discussion with the manager. The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 14 Residents participate in a variety of activities. Two residents talked about the home’s workshops and the pottery they had done. The manager showed the inspector some of the work undertaken by residents. One resident said he enjoys using the computer. Other activities include art and crafts and a home cinema. A greenhouse and small garden are now available for residents and day care service users; they are growing flowers and vegetables. Residents have unrestricted access to the grounds supervised as necessary. The manager said that residents attend day centres and sheltered work placements. One has undertaken a horticultural NVQ. Residents can go out in the local community according to their assessed ability. They go to the local pub for lunch on Sundays. One resident said he goes shopping or to the pub, he also spoke about travelling by bus. The manager said that one resident attends the local church. The home has its own transport, which enables residents to go out on a range of day trips; some went to Flambards at Helston on the day of the inspection. Another went out to Perranporth. Residents said routines are flexible, and tailored to their individual needs. The manager said that residents have contact with their families as they wish, by visits to the home, days out and by telephone. One resident said his family and friends visit him and he goes out with them. The visitors book shows that residents receive visitors. The manager said that residents also have friends at the day centres. One permanent resident said he enjoys meeting new people when they come on holiday and has made a lot of friends. The manager said that residents undertake household tasks in the home, for example all residents are responsible for cleaning their rooms, they also help to lay and clear the dining tables. They sometimes help to water the garden or wash the cars. Bedroom doors are fitted with locks and residents can have a key to their room in accordance with their individual risk assessment. A varied menu is on offer that includes fresh fruit and vegetables. Some residents have meals at the day centres or in cafes when the go out. Residents said they enjoy the food provided and can have an alternative to the menu if they wish. Drinks and snacks are on offer at any time. Records are kept of the food provided. The manager said there are no special diets required at the moment but they did have a resident on a gluten free diet once and this was managed well. The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support is given to residents according to their needs ensuring their individual preference is respected. Residents have access to health care services as necessary to ensure their physical and emotional needs are met. There are suitable systems and policies in place for dealing with resident’s medicines some minor adjustments to the policy and completion of staff training will further and assure residents safety. EVIDENCE: Evidence was provided in the form of observation, documentation, records, interviews with residents and discussion with the manager. Daily care records show that personal care support is provided although limited, as residents are quite independent. One needs assistance in the shower and said the staff are very good. The manager said that sometimes residents need reminding to shave and so on. Daily routines are flexible unless residents are going to the day centres when they have to get up in time. Residents said they go to bed when they like and they choose the clothes they are going to wear each day. The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 16 Residents are all registered with a GP and their health is monitored. Visits to the dentist and optician take place when needed. One resident talked about the help he has had from a physiotherapist and recent tests he had in hospital. Medicines are supplied by a local pharmacy. Storage, administration and disposal records are maintained appropriately. The manager writes the medication administration record charts by hand at present but is looking to type these in future. Two signatures must be recorded for handwritten instructions on these charts, as stated in the home’s policy. The manager said he would ensure this is done. Patient information leaflets for medicines administered are held in the home. All staff administering medicines have received appropriate training. The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure that should ensure complaints are listened to and acted upon; there have been no complaints. Arrangements are in place to protect residents from possible risk of harm or abuse staff training must take place to ensure systems are robust. EVIDENCE: Evidence was provided in the form of documentation and discussion with the manager and staff. There is a suitable complaints procedure in place that has been updated to include the latest CSCI contact details. A summary of the policy is included in the resident guide but the CSCI details have not yet been updated there. There have been no complaints since the last inspection. Thank you letters and cards are kept in a file. The home has an adult protection policy that includes the referral of incidents to Social Services. Seven staff, including one of the registered providers, have attended the Social Services ‘No Secrets’ training. New staff are required to read the adult protection policy as part of their induction to the home and the manager hopes to implement in house training now that he has attended the assessors course to facilitate abuse training. The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The building and grounds are well maintained providing a safe environment for residents, staff and visitors. Rooms need to be audited and action taken to ensure that acceptable furniture and fittings are provided. The lounge that was used by smokers is in need of re-decoration. The home is generally clean and free from odours but would benefit from some more in depth cleaning. EVIDENCE: Evidence was provided in the form of a tour of the building, observation and discussion with the manager. The home provides a reasonable environment for the present residents but is not suitable for wheelchair users; the registered providers acknowledge this. Parts of the home have been re-decorated recently including the downstairs corridor, room 10 and one bathroom. The lounge that was for smokers is to be done next. This will be an improvement as there is a strong smell of cigarette The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 19 smoke in the home and the lounge has discolouration on the walls, ceiling and pictures from the smoke. The home is now a non-smoking facility. Some new furniture has been purchased but there is furniture and fittings in the home in need of replacement. One resident mentioned that the drawers in her room were off of the runners so she has not used them and lack of towel rail in her bedroom. Some furniture and furnishings in the home are very shabby; the registered providers must undertake an environmental audit of every room and produce an action plan for the work that needs doing. A copy must be sent to the Commission. Maintenance of the home is ongoing; there is no written plan. Bedrooms are personalised with resident’s belongings and fitted with Yale locks, keys are provided according to individual risk assessments. Bath, shower and toilet facilities are suitable. Communal rooms include two lounges and a dining room that has a home cinema facility with a screen and speakers. The kitchen has been fully refurbished; some high cleaning is required to remove cobwebs. Laundry facilities are suitable. The home is generally clean, residents are responsible for cleaning their rooms, and this needs to be checked to ensure that high places and areas such as washbasin overflows are kept clean. Hand washing facilities and protective clothing such as gloves and aprons are provided for staff. The grounds are tidy with lawns and beds of flowers. There are workshops and a greenhouse at the back of the home for the provision of day-care and activities. The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff have been working towards qualifications to improve their knowledge and skills; some are awaiting verification of their course work. Staffing levels appear to be suitable to meet the present resident’s needs; the rota must reflect this and the hours worked. Recruitment procedures have not been robust enough to offer protection to residents, the registered providers must comply with legislation. Staff now receive statutory training relevant to their roles, the registered providers must now ensure that they are up to date with current issues, and able to meet resident’s specific needs appropriately. This includes training in subjects relevant to the client group. EVIDENCE: Evidence was provided in the form of documentation, records, interviews with residents, staff and manager. The registered providers work as part of the care team with the manager and seven care workers. Staff spoken with said there are a suitable number of people on duty at all times; extra are brought in when required. The duty rota does not include the hours worked in the home by the management team and The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 21 there are gaps on the current sheet that make it look as though there are no staff in the home during those times. The on-call section has not been completed. The duty rota must show the hours actually worked in the home by the management team and staff and specify if this is care work or administration. There must be an up to date on-call rota so that staff know whom to contact. Three carers have completed NVQ level 2 courses in care and are awaiting external verification. At present no staff have this qualification. There is a training policy in place. Statutory training is provided for staff and records are kept; copies of training certificates are also held on file. Some staff have worked at the home for several years but there has been minimal training in specialist subjects linked to the client group; epilepsy training took place in 2005. The Manager said that LDAF training would be looked into as well as dementia training although he said some dementia training has been provided by a social worker. Evidence that staff read relevant care magazines, would also show they are updating their knowledge. Some external courses would be beneficial as most of the training is in house, based on training packs supplied by a company and facilitated by the manager. Residents said that staff are kind and look after them very well. One said he was very happy in the home and would not want to be anywhere else. Three staff files were inspected all had application forms and health questionnaires. There were interview records but one was incomplete. All had two references but for two employees they were not received prior to employment. None had signed terms and conditions of employment but they had a starting letter. None of the POVA first or CRB checks were received prior to the employees starting work in the home. No person must commence work in the home without a satisfactory POVA check. All employees awaiting a CRB disclosure must be supervised at all times and not work unattended. Induction training records were seen on one staff file but not on the files for the most recent recruits, there were copies of letters to the members of staff requesting that they return their paperwork to the manager. The manager said the Red Crier induction pack is used; he must ensure that the system used complies with the Skills for Care induction standards and said he would check this. The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 22 The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered providers are experienced and they are working towards the requirements made at the last inspection to ensure that residents benefit from a well managed home. The management team run the home in the best interest of the residents but they would benefit greatly from a Quality Assurance system being in place as there is no monitoring at present or systems for improvement. Appropriate training and safety checks are undertaken. EVIDENCE: Evidence was provided in the form of documentation, records, observation, talking with residents and the manager. The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 24 The registered providers are responsible for the day to day running of the home along with the manager, Mr Farnan, who has now completed the Registered Managers Award. One of the registered providers must complete the RMA and an NVQ level 4 in care or appoint a registered manager with, or working towards, these qualifications; this requirement is notified for the third time and must urgently be complied with. Mr Farnan said he keeps up to date by using the internet, reading magazines, reading the monthly Croners information and attending statutory training sessions. Records show that he and Mr Nichols have not attended moving and handling training although it is understood that they both work in the home and provide care to residents. All staff must attend this training by the end of September 2007. Residents said the registered providers are kind and caring and they can talk freely to them at any time. One resident said the manager is a friend. Staff spoken with said the management team are approachable and have a very relaxed and open management style. Documentation and policies have been produced to a good standard and there is a page in the file that shows when reviews occur. Residents said the registered providers are kind and caring and they can talk freely to them at any time. The registered providers interacted well with residents and staff during the inspection. Documentation and policies have been produced to a good standard. The policies were updated in February 2006. Residents spoken with were very happy with the home and the care they receive. Quality assurance questionnaires have been given to residents or their representative to complete following respite care or a holiday stay in the past but the manager said these have lapsed. Letters of thanks are kept. To date the registered providers have not surveyed the permanent residents, their representatives, staff or stakeholders. The deputy manager said that feedback is obtained informally from the residents and their families. The manager said he has discussed the last CSCI inspection report with staff but this could not be evidenced. He also stated that staff and resident meetings take place but there are no minutes taken. There are no audits undertaken by the management team. Quality assurance systems must be in place and the results published and made available to the residents, their representatives and other interested parties including the Commission for Social Care Inspection. There is a fire risk assessment in place. All relevant fire checks are carried out appropriately. All service and equipment checks are up to date. Accidents are recorded and reported appropriately, the home has minimal accidents. No accidents have been recorded since September 2006. The manager said that The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 25 some window restrictors need to be fitted to upstairs windows and the downstairs risk assessed for security reasons. He said he is attending to this. The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 26 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 Standard No Score 1 2 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 1 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 1 X X 3 X The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 27 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 YA6 Regulation 15 Timescale for action Unless it is impracticable to carry 05/11/07 out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan (“the service user’s plan”) as to how the service user’s needs in respect of his health and welfare are to be met. (2) The registered person shall— (a) make the service user’s plan available to the service user; (b) keep the service user’s plan under review; (c) where appropriate and, unless it is impracticable to carry out such consultation, after consultation with the service user or a representative of his, revise the service user’s plan; and (d) notify the service user of any such revision. For example: • All of the care plan documentation must be completed • Care plans must be compiled DS0000008970.V343581.R01.S.doc Version 5.2 Page 28 Requirement The Gables for holiday residents 2 YA26 16 The registered person shall 05/11/07 having regard to the size of the care home and the number and needs of service users— (a) provide, so far as is necessary for the purpose of managing the care home— (c) provide in rooms occupied by service users adequate furniture, bedding and other furnishings, including curtains and floor coverings, and equipment suitable to the needs of service users and screens where necessary; For example: • An environmental audit must be undertaken with an action plan compiled to address the issues • A copy of the action plan must be sent to the Commission Subject to regulation 4(3), the 31/08/07 registered person shall not use premises for the purposes of a care home unless— (2) The registered person shall having regard to the number and needs of the service users ensure that— (d) all parts of the care home are kept clean and reasonably decorated; The registered person shall 31/08/07 maintain in the care home the records specified in Schedule 4. (3) The registered person shall ensure that the records referred to in paragraphs (1) and (2)— (a) are kept up to date; For example: • The duty rota must show the hours actually worked in the home by the management DS0000008970.V343581.R01.S.doc Version 5.2 Page 29 3 YA30 23 4 YA41 17 The Gables • team and staff and specify if this is care work or administration. There must be an up to date on-call rota so that staff know who to contact. 5 YA34 19 6 YA35 18 The registered person shall not 28/06/07 employ a person to work at the care home unless the person is fit to do so. Satisfactory checks must be completed on the person to ascertain this as outlined in Schedule 2 of the Care Homes Regulations 2001 For example: • No person must commence work in the home without a satisfactory POVA check. • All employees awaiting a CRB disclosure must be supervised at all times and not work unattended. The registered person shall, 30/09/07 having regard to the size of the care home, the statement of purpose and the number and needs of service users— (a) ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users; (ii) suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. For example: • There must be evidence that management and staff keep up to date with issues relevant to the client group • Training specific to the client group must be provided 2nd notification • All staff must attend suitable DS0000008970.V343581.R01.S.doc Version 5.2 Page 30 The Gables 7 YA39 24 8 YA37 9, 10 moving and handling training including the manager and registered provider The registered person shall establish and maintain a system for evaluating the quality of the services provided at the care home 9 A person shall not manage a care home unless he is fit to do so. (2) A person is not fit to manage a care home unless— (i) he has the qualifications, skills and experience necessary for managing the care home; 10 If the registered provider is— (c) a partnership, it shall ensure that one of the partners undertakes, from time to time such training as is appropriate to ensure that he has the experience and skills necessary for carrying on the care home. For example: • One of the registered providers’ must obtain an NVQ 4 in both management and care • or a registered manager must be employed who either has these qualifications or is working towards them within a specified period. 2nd notification 31/12/07 01/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. The Gables Refer to Good Practice Recommendations DS0000008970.V343581.R01.S.doc Version 5.2 Page 31 Standard 1 YA11 2 YA36 The registered provider should explore possibilities for providing residents with further choices and opportunities for consultation within the home. Staff should receive regular formal, documented supervision in line with the home’s policy The Gables DS0000008970.V343581.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 DS0000008970.V343581.R01.S.doc Version 5.2 Page 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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