Inspection on 01/02/07 for Two Gates House

This inspection was carried out on 1st February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Two Gates House 26/06/09

Two Gates House 17/04/08

Two Gates House 28/01/08

Two Gates House 24/09/07

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Two Gates House 42-44 Two Gates House Two Gates Lane Colley Gate Halesowen B63 2LJ Lead Inspector Christine Lancaster Key Unannounced Inspection 1st February 2007 09:00 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 Two Gates House DS0000066258.V340328.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. Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Two Gates House Address 42-44 Two Gates House Two Gates Lane Colley Gate Halesowen B63 2LJ 01384 567448 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) Wellmun Care Limited Ms Lynda Jane Smith Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th March 2006 Brief Description of the Service: Two Gates is a large, detached property, located in a residential area of Colley Gate, Halesowen, providing placements for seventeen Residents. Accommodation comprises fifteen single rooms, twelve of which have en-suite facilities and one double bedroom, toilets and bathrooms situated on two floors accessible via a passenger lift. The lounge, dining area, kitchen, laundry, and office are situated on the ground floor. The home has ample car parking space at the front and to the rear a patio area, accessible via the patio doors leading off the lounge area and offering a number of chairs and tables where the service users can sit in the spring and summer months. The main garden area is grassed with flowerbeds and a number of shrubs. The fees for this service are £346 -£350 per week. Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken on an unannounced basis and lasted for four hours. The registered manager assisted, providing the necessary documents. This inspection concentrated on the requirements made at the last visit and covered the key standards. This Report is based on observations made during a tour of the Home, a review of care related documentation and staff duty rotas, plus a range of other documents/records reflecting the general operation of the Home. The Inspector also met the senior member of staff, several members of Staff and several visitors. Comments were received in response t questionnaire sent to residents and their relatives and to professionals who visit the home. These were incorporated in the report. What the service does well: What has improved since the last inspection? The home now has improved access for people with restricted mobility. Some areas have been decorated. Staff have received additional training during the past year. Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5. Quality in this outcome area is good. There are good processes for ensuring appropriate needs assessment, prior to admission. Prospective residents are assured that their needs will be met and have the opportunity to assess the facilities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector sampled three residents’ files at random and found that each contained evidence that the manager assesses the needs of all prospective residents prior to offering a place. She uses a standard assessment tool and takes account of the care plan and assessment produced at their current placement is available. This includes risk assessments relating to tissue viability, nutrition and manual handling. Residents are admitted on a trial basis for a month, and examples were provided of residents who had left the home during this period because their Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 9 needs could be more appropriately met in other settings. After the trial period, the care plan is completed in greater detail and various forms and agreements are signed. Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is good. Residents’ needs are set out in a care plan, which addresses the necessary areas and is delivered in away which ensures that they are met. Residents’ privacy is respected and their privacy is upheld. The storage, administration, and disposal of medicines are in accordance with accepted good practice. The needs and preferences of residents at the time of their death are respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Sampled care plans contained detailed information relating to the needs of the residents, including assessments relating to nutrition, manual handling, the risk of falls and tissue viability. They also contain a life history, with details which have been provided by the residents and their family. These are completed more fully following the month’s trial, when the resident, their family and the manager meet to discuss the future care. The residents’ records include a page which is used to record information known about the Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 11 needs and preferences of the resident in respect of action to be taken after their death. Staff complete daily records to indicate the care delivered and the manager reads through the care plans, making sure that the care needs are still relevant. Records are updated accordingly. Residents confirmed that they receive care in a way which respects their privacy. Several residents prefer to spend time in their rooms during the day and this choice is respected, although staff do make sure that no resident becomes isolated. There are good arrangements for the storage, return and administration of medication and staff involved have received the necessary training. The medication is stored in a locked trolley which is secured to the wall. There are appropriate arrangements for the storage of controlled drugs. The administration record sheets contain clear photographs of each resident. Sheets were seen to be appropriately completed. Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. The routines of daily living appear flexible with residents being afforded the opportunity to achieve a lifestyle, which matches their expectations, interests, and preferences. The staff work actively to enable good contact with family and friends and the continuation of religious practices. The home provides nutritionally balanced meals based on the type of food preferred by the residents This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are opportunities for residents to partake in a range of leisure opportunities, consistent with their individual capabilities. The preferences of residents in this respect are sought at the time of admission and periodically. Some have expressed a clear preference for spending time in their rooms, reading, watching television, or talking with their visitors. The manager and staff described a range of activities which they had tried to implement, with varying degrees of success. Some of the residents enjoy playing bingo. Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 13 Some go out with relatives or friends and the manager encourages residents to go out to use facilities in the community where possible. For example, the services of chiropodists and dentists in the community are used when appropriate. There are visiting entertainers, such as carol singers and other throughout the year. Residents have also participated in painting and knitting. Several like to read the newspaper on a regular basis. The garden is available for residents to sit out in the warmer weather. The manager does publicise residents’ meetings, but these are not popular. Residents have daily access to the manager and senior staff and examples were provided of occasions when residents had requested to talk with the manager about a particular area of their care. Nutritional assessments are completed at the time of admission. The cook develops the menus and these take into account the needs and preferences of the residents. They appear to be well balanced in terms of nutrition and variety. The menu provides choice, including a cooked breakfast and other alternatives are provided. Meals may be taken at times to suit the resident, for example, breakfast is served at any time during the morning. Residents are weighed on a monthly basis and examples were provided of times when GPs had been consulted in relation to diet and specific diets had been followed. Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. There are good arrangements for ensuring that complaints are taken seriously and appropriate action is taken. Residents are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager and staff welcome comments from residents and their visitors. The manager reads the communications book and the daily records and picks up any issues which she considers may require change. She when consults the resident and changes the care plan if necessary. Examples were provided of changes which had been made in response to comments made in daily notes, such as residents not eating well or showing symptoms of being too hot or cold. Examples of changes which had been made in relation to comments received from members of the community were also provided. The security light at the front of the building has been lowered so that the effect on neighbouring houses was minimised. Staff receive training in relation to the protection of residents and they are trained to recognise the signs and symptoms of abuse. They have also received training in managing abusive behaviour which may result from residents who have dementia. Any possible abuse is taken seriously and the manager has demonstrated that she has a very good understanding of the issues involved. Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. Residents live in a clean and comfortable home, which is well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was found to be clean, with no unpleasant odours. On the day of the inspection, the hallway was being decorated and several areas have been improved since the last inspection. The last report by the environmental services inspector required a ramp to be installed to facilitate access to the building and yellow lines to be painted in the garden to highlight the steps. The ramp has been completed and the manager informed the inspector that there are plans to paint the yellow lines. Communal areas are homely and residents confirmed that the furniture is comfortable. Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 16 The kitchen was clean. However, the laundry was found to be very hot, with poor ventilation. Due to the siting of this room, it is not possible to vent the tumble drier to the outside of the property. However, the need for an efficient dehumidifier has been agreed and the manager informed the inspector that this will be obtained. Staff hang the washing out in the garden when the weather permits. Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. There are appropriate arrangements for the recruitment and employment of staff to ensure that the residents are safe. Staff numbers and skill-mix on duty were consistent with that shown on the rota and appeared sufficient to meet the assessed care needs of current Residents. The home is committed to providing introductory and on-going NVQ training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff vacancies are advertised at the job centre and there is a standard process for selection and interview. Checks are made through the Criminal Records Bureau and successful appointees are appointed subject to a three month trial period. They receive induction training through the Skills for Care programme. The manager and senior staff supervise each member of staff through their induction and foundation training. All staff receive ongoing training. With the exception of recently appointed staff, all have attained NVQ level 2 and four members of the team have level 3. There is a detailed training matrix which covers the areas in which training has been provided, such as first aid, manual handling and Health and Safety, and indicates when refresher training is due. The home received the Investors in People Award in 2005. Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 18 The current staffing rota, together with those from the immediately preceding weeks, were reviewed and demonstrated staffing numbers, and skill-mix were appropriate for a service provision which enables residents’ care needs to be met. Staff work hard to ensure that the care plans are implemented. There is a programme for supervision and this is task based. The manager has taken appropriate action when staff have failed to perform to the expected high standards and examples of action taken were provided. Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. Quality in this outcome area is good. The home is managed by a manager who is well able to run the home. Resident’s financial interests are safeguarded. Lines of accountability are clearly set out. There are good arrangements for ensuring that the health and safety of residents and staff are promoted. but there is little evidence that the owners are pro-active in ensuring that the environment is maintained to high standards and meets the needs of the residents, or that there are plans for the further development of the home. This judgement has been made using available evidence including a visit to this service.. Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager is well experienced and appropriately qualified to run the home. She demonstrated a good knowledge of the needs of each resident and a commitment to supporting staff to deliver high quality care. The home does not handle the finances of any resident. However, a small amount of personal spending money is looked after in a suitable secure facility on behalf of a few residents. Appropriate records are maintained of all deposits and withdrawals and the manager is responsible for their maintenance. Appropriate contracts are maintained to ensure that all services to and equipment in the home are in good working order. Sampled records, including those relating to fire safety, were examined and found to be up to date. Some work has been undertaken in response to requirements made by the environmental services inspector and there are plans to complete work to the garden before the warmer weather. There is little evidence that the owners are pro-active in maintaining the standards at the home. Recent improvements have been in response to the report of an inspector, rather than a result of ongoing quality monitoring. The home had a quality assurance system under the pervious owner, but this has not been maintained and used recently and will need to be updated. Some visits have taken place as required by regulation 26, but the reports are brief and of little use for planning purposes. The most recent of these was in October 2006. This regulation requires the owner or a representative to visit and assess the home on a monthly basis and produce a report. This process ensures that areas for development are identified at an early stage. It also provides a degree of supervision and support for the manager. No development plan was available for the home. This is an area where improvements need to be made in the light of increased self-assessment of services. Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP33 Regulation 26 Requirement The owner must ensure that visits to the home take place on a monthly basis as required by regulation 26 and that suitable reports are produced The manager must ensure that there are effective systems for quality monitoring and quality assurance, which take account of the views of residents and other stakeholders and form the basis for annual development planning. The manager must ensure that all work required in the last report of the environmental services officer is completed. Timescale for action 01/05/07 2. OP33 24 01/06/07 3. OP38 23 01/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Two Gates House DS0000066258.V340328.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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