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Inspection on 24/08/06 for The Gateway Rest Home

Also see our care home review for The Gateway Rest Home for more information

This inspection was carried out on 24th August 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a friendly and welcoming atmosphere in the home. Service users look happy and well cared for. The interaction between staff and service users is good. The homes new care planning system is comprehensive and aids good care. The food served in the home is freshly prepared, attractively served, wholesome and nutritious.

What has improved since the last inspection?

The statement of purpose and service user guide have been finalised and printed. A new contract has been designed clearly stating what is provided by the home and the fees. Additional domestic staff have been employed. The radiator covers have all been fitted. Nearly all staff have completed mandatory training (first aid, moving and handling, health and safety, basic food hygiene, and infection control) and courses are booked so that all staff are updated. Staff spoken to had undertaken training in adult protection, which was also ongoing for all the team.

What the care home could do better:

It would be of benefit to residents if activities in the home were increased and the opportunity was given for exercise and physical activity. The home is seeking to employ an activities co-ordinator to fulfil this role and develop the social part of residents` lifestyle. A weekend cook needs to be employed to support the current cook. A recommendation has been made for this.The garden area is rather unkempt with weeds growing through broken concrete. A recommendation has been made for this. The bedroom with odour problems still needs to be addressed. A requirement has been made for this. More of the care staff need to undertake training to NVQ level 2 or above. A recommendation has been made to continue providing training. The quality assurance system needs to be developed further. A development plan needs to be designed for the home outlining how the service is going to improve and based on the views of service users and their advocates. A requirement has been made for this. It is also recommended that the home give consideration to moving the smoking area to avoid the danger of passive smoking.

CARE HOMES FOR OLDER PEOPLE The Gateway Rest Home 409 Folkestone Road Dover Kent CT17 9JT Lead Inspector Julie Sumner Unannounced Inspection 24th August 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 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 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) 01304 203650 Mrs Ann Leonard Mrs Patricia Ann Thompson Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users DE(E) whose dates of birth are 29/09/1911 17/10/1920 25/08/1916 and 03/04/1918. 13th September 2005 Date of last inspection Brief Description of the Service: The Gateway Rest Home is a residential home registered for 20 older people. The current fees for the service at the time of the visit range from £303.00 to £340.00. Information on the home’s services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User (residents) Guide. The provider does not currently have a web address and if information is required the home’s telephone number is included on the previous page. The home is a large two-storey 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. The home comprises of 12 single bedrooms and 4 double bedrooms. There is a passenger lift providing access to the first floor for those who need it. In addition to bedrooms there is a large, bright, spacious communal lounge which includes a dining area. There is a small front garden and a rear, hard surfaced area where residents can sit in the summer months. The home has dedicated parking facilities at the rear of the property. The Gateway Rest Home is owned by Mrs. Ann Leonard and managed on a daily basis by Mrs. Patricia Thompson. In addition there is a dedicated care team, a cook who works Monday to Friday, and two domestic staff. The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection. The inspector visited the home during one day to talk to residents, the manager and staff and view records and practices. The time spent in the home overall was 7 hours. Information was gathered for this inspection by a variety of means both prior to and during the visit to the home. The CSCI request information from the home routinely and the home manager provided all the information requested in the pre-inspection questionnaire prior to the inspection visit. Comment cards were sent before the inspection visit, to the residents of The Gateway Rest Home, relatives, health care professionals, care managers and GPs. Completed comments cards were received from residents and relatives. Residents generally ticked all answers to questions positively. Relatives also answered all questions positively and added comments, a sample of which are: “I come and go at different times and the home and staff are always happy and ready to help”, “nothing was too much trouble… and added to the ease of the move ”, “staff are very helpful with my questions”, “my mother is very happy at this home”. If insufficient time has been allowed for all responses to be included in this report then they will be held on file and included in the annual review of the home. Residents spoke individually and in private about the things they do and what they like about the home. Residents made positive comments including: “What more could you want”, “I have everything I need”, “all the staff are really kind”, “the food is good, we get good portions”, and talked generally about aspects of their past lives and their interests. The following methods of inspection and information gathering were used in the home: observing activity in the home, spending time and talking with residents and staff, both individually and in a group, looking at the building and touring the home, reading and discussing policies, plans and records including individual care plans, medication storage and administration, some staff records including induction training programme and training records and other certificates and records in the home. All key standards were assessed at this inspection. 3 out of 9 requirements made at the previous inspection have been fully met. Progress has been made on the remaining 6 requirements that are ongoing and extended timescales were agreed at this inspection for completion. 2 new requirements and 3 new recommendations were made as a result of this inspection. The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: It would be of benefit to residents if activities in the home were increased and the opportunity was given for exercise and physical activity. The home is seeking to employ an activities co-ordinator to fulfil this role and develop the social part of residents’ lifestyle. A weekend cook needs to be employed to support the current cook. A recommendation has been made for this. The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 7 The garden area is rather unkempt with weeds growing through broken concrete. A recommendation has been made for this. The bedroom with odour problems still needs to be addressed. A requirement has been made for this. More of the care staff need to undertake training to NVQ level 2 or above. A recommendation has been made to continue providing training. The quality assurance system needs to be developed further. A development plan needs to be designed for the home outlining how the service is going to improve and based on the views of service users and their advocates. A requirement has been made for this. It is also recommended that the home give consideration to moving the smoking area to avoid the danger of passive smoking. 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 DS0000023559.V301257.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are given sufficient, clear information to make a choice. Residents’ places at the home are protected and they know what they are paying for. The home operates a good assessment process and trial visits. EVIDENCE: The home has produced a newly designed contract. This contains all relevant information including breakdown of fees, trial period and terms and conditions. The registered manager has developed a statement of purpose, which sets out the aims and objectives of the home, and includes a resident’s guide, which provides basic information about the service. The guide is made available in a standard format. Both documents would be more interesting and user friendly if pictures can be included. The assessment process has been reviewed. A sample of completed assessments were viewed and included information on: interests, personal The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 10 details, medical /health needs and medication and form the basis of the resident’s care/support plan. The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team meets the health and personal care needs of the service users and their privacy and dignity are respected. EVIDENCE: A sample of residents’ care/support plans was viewed. All contained relevant information clearly set out in an accessible format. The registered manager initiates the plan and carers carry out the ongoing recording. There was insufficient evidence that the plans are reviewed monthly. The registered manager only records changes that are made when reviewed. Therefore if there are no changes nothing is written. It is recommended that a record is made of the date of the review, who by, and that no changes were made. Variations have been processed for service users with dementia and the registration certificate has been amended. There was a range of evidence, recorded in residents care/support plans and medication records, to indicate that advice is sought and services accessed The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 12 from health care professionals. The mental health team are involved, continence advisor and district nurses have been involved with different individuals. There is still a lack of opportunity for appropriate exercise and physical activity and the recommendation made at the previous inspection has been carried over to this inspection. The medication policy viewed. The registered manager said she has copy of pharmaceutical guidelines but was unable to locate it. A recommendation has been made to keep the guidelines with policy for reference. Medication is stored securely and clearly labelled. At present the home are administering controlled medication. This was stored with additional security and recorded separately. The mental health team are involved with the review of some of the medication prescribed. Residents are encouraged to administer medication themselves if they are able and at present this occurs with external application of products including eye drops and creams. Staff have attended accredited medication training and carry out the medication. MAR sheets viewed. 2 staff give out medication and both sign the sheet. Sample signatures viewed. The registered manager was advised that hand written entries need to be countersigned and that Tipex must not be used to amend records. There is new pharmacist so manager is going to meet and update all prescription sheets where there have been errors. Medication disposal is carried out by the pharmacist still and the log book was viewed. Residents looked clean, had co-ordinating clothes appropriate for the weather and had nice hairstyles. Service users said that they felt their privacy was respected. They have a telephone in their bedroom if they wish. Staff knock on their doors before entering. Staff were observed being polite and respectful when interacting with residents. The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. 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 has a written activities programme which includes large scale ludo and snakes & ladders, reminiscence and hand exercises and the manager said that this is carried out by the staff on duty. Staff were observed doing a newspaper crossword with a resident and chatting to different individuals. Some residents were in their bedrooms reading, watching TV or knitting. One resident likes to knit and makes items for charity. One resident said she would like a little more going on in the home as they did not like the activities that were usually on offer. The registered manager said she has advertised for an activities co-ordinator but so far there has been no interest. A requirement has been made to provide a working activity programme and recommendations to increase the physical activity in the home for residents and employ and activities co-ordinator. The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 14 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 daughter visits me most days” 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 various items were seen that, residents said, made them feel more at home. The inspector had lunch with the residents. The meal was freshly cooked, wholesome, nutritious, and attractively served. Hot and cold drinks are offered regularly throughout the day. 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 “I have no complaints about the food”. Unfortunately, as stated in the previous inspection, 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. A recommendation has been made for this. The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users complaints are taken seriously and acted upon 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. Residents spoken to were aware of how to complain. They said that the manager and staff spoke to them everyday and they could talk about any issues they had then. They also stated that they had no complaints. All staff have had CRB enhanced checks and new staff have had POVA checks also. Adult protection training is ongoing. Six staff have currently attended. Two staff on duty in the afternoon has attended and said that they had found the training interesting and useful. A recommendation has been carried over from the previous inspection for all staff to attend adult protection training. The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, 25, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service provides a homely environment. Residents can personalize their bedrooms. Improvements need to be made to the outside seating area. Most areas in the home are clean and odour free but one area needs urgent attention for residents to benefit from a pleasant environment. EVIDENCE: The manager and inspector walked around the home meeting residents and looking at the environment. Overall the home is clean and looked homely. There is a programme of maintenance and redecoration but some of the timescales slip. The seating area outside at the back of the home needs some The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 17 attention as the concrete is broken and there are weeds. This was identified at the previous inspection and there has been no progress towards making this a pleasant place for residents to spend time in the warmer weather. The recommendation made at the previous inspection has been carried on. Residents said they like the home, the lounge is homely and they like the layout of the furniture because if the furniture were in groups it would be in their way. Individuals have mobility equipment and the home provides a mobile hoist that can be used with the bath. There is a walk-in bath. The home has had all radiators fitted with attractive radiator covers. One bedroom still has a strong odour despite new carpet being laid 2 months ago and using machine washable mats. A specialised odour control carpet shampoo has been used routinely but the odour remains. The manager is now considering washable flooring and mats. The continence advisor has been involved. The home has an industrial washing machine that is in full working order. Alginate bags are used for foul washing and washed on high temperature to maintain infection control. The home has good washing facilities with hand towels, liquid soap and flip top bins in use. The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from sufficient staff on duty to support them. There are robust recruitment processes in place protecting service users. Staff would benefit from individual training and development plans to enhance their skills and knowledge. EVIDENCE: The duty rota was viewed and the staffing level discussed with the manager. One part-time carer and another cleaner have been employed since the last inspection. The number of care staff hours is in line with the hours assessed using the Residential Formula for older people indicating that sufficient staff are employed. 4 staff have achieved NVQ level 2. Another new member of staff is booked to start the course in September. One member of staff has commenced NVQ 3. There is a reluctance for experienced staff to study NVQ but the manager is going to encourage them. One night staff is considering studying. 3 care staff in the team are over 60 and are exempt. The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 19 A sample of staff files were viewed with particular reference to new staff employed. CRB and POVA and all appropriate recruitment checks have been carried out. Staff receive induction training which is in line with Skills for Care guidance. There is a training matrix on the office wall clearly indicating progress with staff training and providing a prompt for booking planned courses. Training is ongoing and staff spoken to were enthusiastic about the training they had attended. There were some gaps in all areas of training and a good cross section of staff who were up to date. Staff do not have individual training and development plans. This is connected to the supervision and appraisal system in the home which needs to be more formalised and form the basis for how staff are working and what their development needs are. A recommendation has been made to formalise this process. The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Management of the home is fairly good but some areas still need to be addressed. The quality assurance process needs to be developed so that it is effective and forms the basis for planned improvements. EVIDENCE: The registered manager has NVQ 4 in care and management and two additional elements for registered managers award. The registered manager carries out a quality assurance audit every six months by giving out questionnaires to residents and their families. There are a variety of questionnaires concentrating on different aspects of care including: about the admission into the home and whether they got enough information The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 21 to make the decision; daily living in the home – lifestyle, have they got what they need, do they get enough to eat; and another design concentrates on privacy and dignity. There is a questionnaire for staff that can also be completed anonymously. The manager has one to one discussions with residents, which residents said they found helpful, and there are resident meetings monthly. The only documentation of feedback was in some completed questionnaires, a sample of random ones were viewed. An overall report needs to be written to summarise the outcomes of feedback and form the basis for the home’s development plan. A requirement has been made for this which needs to include all areas of improvement planned. Service users their families or representatives control their own monies and the home does not hold, or deal with, any service user money. New staff undergo induction training in accordance with Skills for Care specification. Regular staff supervisions have been taking place but less frequently than 6 weekly. The manager records these informally in a record book. Supervisions need to be recorded individually for each member of staff and kept securely. A recommendation has been made regarding record keeping. Mandatory training has been provided and is ongoing. Staff spoken to had up to date training. Training has been provided steadily in adult protection, dementia care, and all mandatory areas of first aid, food hygiene, moving and handling, health and safety, fire safety, and infection control and there has been an improvement in the number of staff having up to date training. However, not all staff have updated training in all areas. A requirement has been made to continue updating all staff in all areas of mandatory training. A sample of home maintenance certificates and records were viewed. The home has environmental risk assessments and carries out safety procedures routinely. Radiators are all covered. Incidents and accidents are reported under Regulation 37 appropriately. The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 x x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x 3 x 1 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 1 x 3 2 2 2 The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 23 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 OP12 Regulation 16(2n) Requirement The activities programme needs to 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, 30/11/05 not fully met) The offensive odour which is present in one bedroom needs to be eliminated. (Previous timescale of 30/11/05 not met.) 50 of care staff should be trained to NVQ level 2 or above. (Previous timescale of 31/12/05 not met.) The service must be reviewed at appropriate intervals in consultation with service users and A quality audit report needs to be produced based on the feedback gained from residents and others advocating or involved in their care. A development plan needs to made from the report outlining future plans to improve the service and how this is going to be implemented. Once produced a copy needs to be kept in the DS0000023559.V301257.R01.S.doc Timescale for action 15/12/06 2. OP26 16(2k) 24/10/06 3. OP28 18(1a-ci) 30/07/07 4. OP33 24 15/12/06 The Gateway Rest Home Version 5.2 Page 24 home and a copy to CSCI to meet this requirement. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP8 OP9 Good Practice Recommendations 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)A dedicated specialised drugs fridge be purchased and, once in use, the temperature of the fridge be taken and recorded on a daily basis. b)No Tipex to be used in records. c)Need to keep a copy of pharmaceutical guidelines with the medication policy for reference. All staff 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. Recruitment of a weekend cook should be an ongoing priority. The supervision and appraisal system needs to be formalised and staff need to have individual training and development plans. All records need to be maintained individually, up to date, accurate and kept securely. 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. 3. 4. 5. OP18 OP19 OP22 6. 7. 8. 9. OP27 OP30 OP36 OP37 OP38 The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Kent and Medway Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI The Gateway Rest Home DS0000023559.V301257.R01.S.doc Version 5.2 Page 26 - 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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