Inspection on 13/09/05 for The Gateway Rest Home

This inspection was carried out on 13th September 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 but made no statutory requirements on the home.

Other inspections for this house

The Gateway Rest Home 24/08/07

The Gateway Rest Home 24/08/06

The Gateway Rest Home 18/04/05

The Gateway Rest Home 26/11/04

The Gateway Rest Home 03/06/04

The Gateway Rest Home 12/05/04

The Gateway Rest Home 17/11/03

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE The Gateway Rest Home 409 Folkestone Road Dover Kent CT17 9JT Lead Inspector Chris Randall Unannounced Inspection 13 September 2005 : 09.00 th 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Gateway Rest Home Address 409 Folkestone Road, Dover, Kent, CT17 9JT Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01304 203650 Mrs Ann Leonard Mrs Patricia Ann Thompson Care Home 20 Category(ies) of OP Old Age registration, with number of places The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 18.04.05 Brief Description of the Service: The Gateway Rest Home is registered for 20 older people, the current occupancy is 17. The home is a large two-storied property situated on the outskirts of the town of Dover. Public amenities are within easy reach, such as public transport, a church, shops and a public house. Accommodation in the home comprises of 12 single bedrooms and 4 double bedrooms, although currently 2 of the double rooms are being used for single occupancy. There is a passenger lift which provides access to the first floor for those who wish to use it. In addition to bedrooms there is a large, bright, spacious communal lounge which includes a dining area, and a smaller, artificially lit, sitting area joined to the main area by a ramp or steps. Smoking is permitted in this upper lounge area. The home has a small front garden and at the rear there is a hard surfaced area where service users can sit in the summer months. The home has some dedicated parking facilities at the rear of the property and on street parking at the front. The home is owned by Mrs. Ann Leonard and is managed on a day-to-day basis by Mrs. Patricia Thompson. In addition there is a dedicated care team, a cook who works Monday to Friday, and a designated domestic. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took 11 hours (6 hours in the home plus preparation time). The inspection consisted of a tour of the home; speaking to most service users, 10 in some depth, 3 staff, 1 visitor and the manager; observation of medication storage and administration, a meal being prepared and served, and interaction between service users and staff; and examination of records. With the exception of one bedroom, which had an odour problem, the home appeared clean and fresh smelling. The atmosphere in the home was friendly and welcoming. Staff comments included, “it’s a friendly home”, and “the best thing about the home is the nice atmosphere”, a visitor commented “On the whole its good”, and a service user commented, “the general efficiency is excellent What the service does well: What has improved since the last inspection? The registered manager has now completed her NVQ4/RMA. Recruitment procedures have been improved. The registered provider has started to undertake the required Regulation 26 visits. A hot drink has been introduced for service users mid afternoon. Medication administration has improved. In the interests of fire safety the home have had automatic release door guards fitted on all doors. A hand-wash basin has been fitted in the laundry. Foul laundry is now being washed at appropriate temperatures and red alginate sacks are being used for soiled linen. The statement of purpose has been updated, although this still needs to be typed up before being issued. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 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. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 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 standard(s) 1, 2, 3, 4, & 5 The home operates a good assessment process and trial visits, but lack of evidence of contracts compromise the ‘choice of home’ EVIDENCE: The statement of purpose and service user guide for the home have both been updated to reflect the current situation and to include all of the information required. However, these are in draft, handwritten form and now need to be typed before they can be distributed to existing and potential service users and a recommendation has been made regarding this. Although the home produces a contract or statement of terms and conditions for service users, there is no evidence of signed copies of these being kept on service users files, and a visitor who was asked about her mothers contract said that she had not received one. A requirement is added to cover these issues. The manager visits all prospective service users, either in their own home or in hospital, and carries out a comprehensive assessment of their needs including a nutritional assessment. For service users funded under the care The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 Page 9 management scheme a joint assessment is also received from Social Services. These two assessments are used to form the basis of a care plan for the service user. The home will not accept any service user whose needs they are not confident of meeting. All prospective service users are offered the opportunity to visit the home and look around prior to admission. The first 4 weeks of occupation are deemed to be a ‘trial visit’ to give the service user time to get used to the home and decide if it is the right place for them and to give the home the opportunity to be sure that they are meeting the service users needs. Permanent occupancy does not start until this trial visit has been completed. A service user commented, “I came for 2 weeks respite, liked it and stayed” and a visitor commented, “it was mums choice to come here”. The home does not offer intermediate care. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, 10, & 11 The staff team meets the health and personal care needs of the service users and their privacy and dignity are respected. EVIDENCE: The home operates a comprehensive care planning system which includes a photograph of the service user, admission details, long term needs, doctors notes, a social activity plan, a short term care plan, details of mobility, personal care, feeding and drinking, pressure sore risk assessment, handling assessment, nutritional assessment, risk assessments, dependency profile, details of personal clothing, and a daily report. These care plans are reviewed and updated on a monthly basis. This home is currently registered to accommodate elderly people and does not have a registration to accommodate service users with dementia. Currently there are residents in the home who suffer from dementia and the manager is awaiting completion of care manager’s assessments before applying for the appropriate variation to registration. The requirement made previously regarding this is therefore repeated. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 Page 11 There was evidence of personal and oral hygiene of service users being supported by staff. Any potential or actual pressure areas are referred to the district nurses who give treatment, advice, and who supply any necessary aids equipment. The continence nurse visits the home monthly. When service users mental health deteriorates the G.P. is approached to arrange an appropriate assessment and a CPN will visit. Nutritional screening is carried out on assessment and is regularly reviewed with all service users weights being recorded monthly and any concerns being monitored and reported to the G.P. Service users have access to the specialist medical, nursing, dental, and chiropody services that they need. There appeared to be a lack of opportunity for appropriate exercise and physical activity and a recommendation has been made that this is addressed. Service users comments included, “they are looking after me well”, “they are taking care of me” and “the care is all I require”, a visitor commented, “99 of the time I am happy with the care”, and a staff member commented, “I think we give good quality care”. Receipt, disposal and administration of medication in the home are properly recorded. The storage of medication is appropriate for the drugs currently used, however a recommendation is made that a dedicated drugs fridge is provided and that the temperature is recorded on a daily basis. The home does not currently have any controlled drugs but do have a system for storage of these on the rare occasion they might be necessary. It was witnessed that service users were being treated with respect. Staff call service users by the name they prefer, and service users and their clothes are clean and well presented. One staff member commented, “I always knock on the residents doors before entering”. In the double rooms service users privacy and dignity is upheld by the use of screens when personal tasks are being carried out. The homes procedures for caring for service users at the time of their impending death mean that, unless the G.P. feels that hospital care is necessary, service users are able to die at home, cared for by staff they know, and surrounded by familiar objects. The G.P. and the district nursing team give support to the home at this time. Visitors are made welcome at any time of day or night according to the wishes of the service user, they are made comfortable and given hot drinks, sandwiches, and support from the staff team. At least one member of staff, often more, attends funerals of service users. 6 members of the care staff have undertaken training in loss and bereavement. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 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 standard(s) 12, 13, 14, & 15 The daily life of service users would benefit from a more structured activities programme. Service users are able to maintain contact with family and friends, and they receive a balanced and nutritious diet. EVIDENCE: The home does have an activities programme which includes large scale ludo and snakes & ladders, reminiscence, hand exercises and ‘bean bags’ and the manager stated that these are undertaken Monday to Friday for 1 – 1½ per session by the staffs who are on duty, however it was not witnessed that this was happening on the day of the inspection. The importance of having an activities programme to stimulate the physical and mental needs of service users, particularly those who suffer from dementia and therefore need a higher level of stimulation and 1:1 care is stressed and a requirement for a more structured activities programme taking these points into consideration has been made. The home are also reminded that the use of the care staff on duty to carry out these programmes should not prevent them from meeting the other assessed needs of the service users. In addition to the daily activities a ‘music man’ visits alternate months, and there are occasional other entertainers brought in, including a local play school who visit to sing Christmas carols. The home held a strawberry tea on a recent weekend, but the attendance from service users families was disappointing. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 Page 13 One service user commented, I am knitting squares to make a blanket”. A local vicar used to call on a regular basis but stopped visiting the home without explanation, although it is assumed that this was due to so few service users making use of his visits. Contact would be made with appropriate religious leaders if and when any service user requested this service. Visitors are made welcome in the home and are able to call at all reasonable times. The service users can see their visitors in one of the lounges or in their own bedrooms. Service users commented, “my friend visits me”, “my daughter brought me in this knitting”, and “I go out sometimes with my son” Choices are given to service users regarding all aspects of their lives, e.g. when to get up and go to bed, what to wear, how much help they need, what, where and when to eat. The home retains information on advocacy to inform service users or their families when needed. Service users are able to bring a selection of personal belongings into the home with them and one service users room was witnessed to be almost entirely furnished with her own furniture and belongings. The food witnessed on the day of the inspection was freshly cooked, wholesome, nutritious, and attractively served. Hot and cold drinks are offered regularly and the home has now included the offer of a hot drink mid afternoon in addition to the cold drink previously offered. Unfortunately, despite trying, the home has still not been able to obtain the services of a weekend cook and this task is undertaken by the cook working extra hours or by a care assistant who is not on the rota to care working for three hours as cook. Service users are able to choose whether they eat in the dining area, in their rooms, or at a table where they are sitting in the lounge. Service users are able to take a much time as they wish to eat their meals. Service users commented, “The food is good” and “the food is alright”, and “I have no complaints about the food”, and a visitor commented, “the food is very good, mum will not eat red meat but they always make sure she gets white meat or fish”. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 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 standard(s) 16, 17, & 18 Service users complaints are taken seriously and acted upon, their legal rights are protected and they are protected from abuse. EVIDENCE: The home has a clear complaints procedure including details of how to contact CSCI. There have been no complaints recorded since the last inspection but evidence was seen that previous complaints and their outcomes had been properly actioned and recorded. A visitor confirmed that she would know how to complain if this was necessary, and a service user commented, “I have no complaints”. Service users legal rights are protected and they are enabled to take part in the political process. Currently all service users make use of either the postal or proxy voting system. The home completes the annual form for register of electors. Service users are protected from abuse. C.R.B. enhanced disclosures have been obtained for all staffs, and any new staff will be checked against the POVA register prior to employment. The home has received a copy of the new adult protection guidelines issued by Kent County Council; they also have their own abuse and whistle-blowing policies. Currently 4 staffs have attended adult protection training and, although this is ongoing, it is recommended that all staffs attend this training. Staffs who were spoken to confirmed that they would know the correct procedure if they suspected abuse was taking place. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 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 standard(s) 19, 20, 21, 22, 23, 24, 25, &26 Some improvements are needed to make this a safe, comfortable, wellmaintained environment for service users to live in EVIDENCE: The home is accessible, safe homely and well maintained. However the garden at the rear is not as well maintained as the home itself, there are weeds growing through cracks in the concrete and the area generally looks unkempt. A recommendation has been made to remedy this. The dishwasher recommended on the last report has not yet been purchased and this recommendation is therefore repeated. The communal space is appropriate to the needs of the service users with an upper small lounge leading by step or ramp to a lower large, bright and airy lounge/dining area. The furnishings, fittings and lighting in the communal areas are domestic and in keeping with the home. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 Page 16 The home has six toilets; three baths, one currently with an assisted bathing facility and another currently being upgraded to enable bathing with the use of a hoist; and one shower facility. None of the rooms have en-suite toilet facilities. The home has a range of adaptations, raised toilets, assisted bathing provision, hoist for lifting, rails in corridors etc., however they have not had an assessment of the premises and facilities by a qualified occupational therapist with specialist knowledge of the client group catered for and a recommendation that this takes place has been added. Bedrooms are comfortably furnished, with some service users choosing to bring in items of their own furniture and personal belongings. One room viewed was almost entirely furnished by the service user. Double rooms have appropriate screening available to ensure that personal tasks can be carried out in privacy. Currently two of the double rooms are being used for single occupancy. There are no bedrooms with en-suite facilities. Service user comments included “I have a lovely room, if anyone took this away from me I would die”, and “the room is nice, I’ve got my TV and my bird” Bedrooms are all naturally ventilated. The pipe work and radiators are not yet guarded as required on the last inspection report, however they have all been measured, quotes have been agreed, and the home is now waiting for the company to fit the covers. As the work has not yet been carried out the previous requirement is reiterated on this report. With the exception of one bedroom the home is clean, hygienic and free from offensive odours, however in the one bedroom there is still a very strong odour, which the home have not to date been able to eliminate. The previous recommendation regarding this odour has now been made a requirement. The laundry has had a hand wash sink refitted in compliance with previous requirements. There was a recommendation on the last report that a washing machine with sluicing facility be installed, but as a new machine had been fitted in the laundry earlier this year the provider is reluctant to purchase another machine at this stage. The recommendation however remains. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, & 30 A shortfall in staffing hours and lack of training required compromises the care received by service users. EVIDENCE: Looking at the Residential Forum guidance for staffing in Care Homes for Older People, and from studying the duty rotas provided it does not appear that the home is employing sufficient staff to meet the standard. Currently there are two carers on each morning, three each afternoon and two overnight and there would appear to be a shortfall of 25.98 care hours per week. This calculation takes into account time that needs to be allocated for social and recreational activities but does not take into account any additional time which may be required for environmental issues or for service users who need special assistance (e.g. two staff to care). The previous requirement regarding this issue is therefore repeated. Currently there is one cook who is contracted to work from Monday to Friday. Recruitment of a weekend cook has not to date been successful and the current cook has been covering some of these duties with a care member of staff being brought in for just 3 hours to cover specifically as cook on the other days. It is recommended that recruitment of a weekend cook is an ongoing priority. The home also employs a cleaner for 5 days a week, meaning that the care staffs at weekends are expected to undertake domestic chores in addition to the caring duties. The current ratio of care staff holding NVQ 2 or above is 26.6 . However 3 of the care staff are currently in the mid 60’s and taking into account their mature years they will not be expected to undertake this training. Taking them out of the equation gives a revised percentage of 33.3 . The standards The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 Page 18 require 50 of care staff to be trained to this level by the end of this year and a requirement to this effect is added. One member of care staff is considering progressing to NVQ 3 The recruitment process at the home has improved. All staff have received satisfactory C.R.B. enhanced disclosures, 2 written references are obtained for any new staff, and any new staff will be checked against the POVA register prior to being employed in the home. All staffs are employed in accordance with the code of conduct set by the GSCC and all receive a statement of terms and conditions of employment. All new staff undergo induction training in accordance with TOPPS specification, and various training has taken place over the past few months, however not all staff are currently trained and up to date with the mandatory training of first aid, food hygiene, moving and handling, health and safety, fire safety, and infection control and a requirement has been added to address this shortfall in training. Service users comments included, “the staff are wonderful, I have a laugh and a joke with them”, and “the staff are very helpful and some put themselves out a lot”, and staff comments included, “its nice here, I get on with all the other staff”, “I have not got the time or the concentration to do NVQ”, and “its friendly, we like each other”. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, 37, & 38 Management of the home is fairly good but some areas still need to be addressed. EVIDENCE: The registered manager has recently completed her NVQ 4/RMA and attends various other training to keep her knowledge and skills up to date and relevant, she has been manager at the gateway for the past 10 years. There are clear lines of accountability within the home and with external management. A visitor commented, “I get on well with the manager”. The ethos of the home creates an open, positive and inclusive atmosphere with the manager being approachable to service users, staff, and visitors. The home upholds the value of equal opportunities in employment. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 Page 20 The registered provider has started to undertake Regulation 26 visits and one report has been received to date. Although the home does quality assurance questionnaires with the service users they do not at present involve families or visiting professionals in this exercise and there is a recommendation that this should be introduced. When these questionnaires are completed and returned the manager should do a synopsis of the results and make them available to current and prospective service users and to the CSCI. The manager is confident that suitable accounting and financial procedures are in place to demonstrate current financial viability and she is kept regularly informed of this by the bookkeeper. Insurance is at an appropriate level and is in date. Service users their families or representatives control their own monies and the home does not hold, or deal with, any service user money Regular staff supervisions have not been taking place and a requirement is added that this should commence. All records are securely stored. Care plans are locked in a transportable cabinet; all other records are stored in the locked office with confidential files being locked in a filing cabinet within the locked office. Because of the shortcomings in mandatory training mentioned earlier in this report the health and safety of service users and staff is being put at risk. Also, currently the small lounge is used as a smoking area, but as all visitors pass through this room to sign in before seeing the service users, and service users pass through on their way to the lounge/dining area it is recommended that to avoid the danger of passive smoking either an alternative smoking area is identified or a no-smoking within the home policy is considered. However, in the interests of fire safety the home has had automatic release door guards fitted on all doors. The fire book, and certificates of maintenance that were inspected were all up to date. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 1 3 1 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 1 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 2 3 3 1 1 STAFFING Standard No Score 27 1 28 1 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 3 3 2 3 3 1 3 1 The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 Page 22 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 2.1 & 2.2 Regulation 5 (1) (b) Requirement All service users should be provided with a contract or statement of terms and conditions, and a signed copy of this document should be retained in the service users personal file. The registered person shall provide accommodation only to service users who fall within the registration category of the home (Previous timescale of 31/05/05 not met) The activities programme shall be formalised and increased to meet the needs of all service users, including those who have been diagnosed with dementia (Previous timescale of 31/06/05 not fully met) All radiators throughout the home should be guarded (previous timescales of 01/04/05 & 31/05/05 not met) The offensive odour which is present in one bedroom shall be eliminated. The home must be staffed with sufficient staff to meet the minimum standard as Timescale for action 30/11/05 2. 4.1 & 8.7 14 (1) (a) (b) (c) (2) (b) 30/11/05 3. 12.1 16 (2) (n) 30/11/05 4. 25.5 13 (4) (a) (c) 16 (2) (k) 18 (1) (a) 31/12/05 5. 6. 26.1 27.1 & 27.3 30/11/05 31/12/05 The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 Page 23 7. 8. 28.2 30.3, 38.2, & 38.9 18 (1) (a) (b) (c) (i) 12 (1) (a) 18 (1) (a) (c) (i) 9. 36.2 36.3 & 36.4 18 (2) recommended by the Residential Forum (previous timescales of 20/12/04 and 31/05/05 not met) 50 of care staff should be trained to NVQ level 2 or above All staff shall be trained and kept up to date in the mandatory courses of first aid, fire safety, food hygiene, health and safety, infection control and moving and handling Care staff should receive formal supervision at least 6 times per year and all other staff should be supervised as part of the normal management process 31/12/05 31/12/05 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard 1.1 8.8 9.4 18.1 19.3 22.1 Good Practice Recommendations The revised service user guide and statement of purpose should be produced in typed format for circulation to existing and prospective service users. The home should ensure that opportunities are given for appropriate exercise and physical activity in order to meet service users physical and mental needs. A dedicated specialised drugs fridge be purchased and, once in use, the temperature of the fridge be taken and recorded on a daily basis. All staffs attend training on adult protection. Work should be undertaken to ensure the garden area is tidy and attractive. The home should arrange for an assessment of the premises and facilities carried out by a qualified occupational therapist with specialist knowledge of the client group. A washing machine with a sluice facility be installed in the interests of infection control. Recruitment of a weekend cook should be an ongoing priority. H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 Page 24 7. 8. 26.8 27.7 The Gateway Rest Home 9. 10. 33.7 38.1 11. 19.5 Quality assurance questionnaires are introduced for families and for visiting professionals. To avoid the danger to service users and visitors of passive smoking, either an alternative smoking area should be identified or a no smoking within the building policy be introduced. A dishwasher should be fitted into the kitchen in compliance with the recommendation of the environmental health officer. The Gateway Rest Home H56-H05 S23559 The Gateway Rest Home V245143 130905 stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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