Inspection on 17/04/08 for Two Gates House

This inspection was carried out on 17th April 2008.

CSCI found this care home to be providing an Good service.

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 28/01/08

Two Gates House 24/09/07

Two Gates House 01/02/07

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Two Gates House 42-44 Two Gates House Two Gates Lane Colley Gate Halesowen B63 2LJ Lead Inspector Linda Elsaleh Key Unannounced Inspection 17th April 2008 09:30 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.V362740.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.V362740.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.V362740.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th January 2008 Brief Description of the Service: Two Gates is a large, detached property, located in a residential area of Colley Gate, Halesowen, providing personal care for seventeen residents. The service does not provide nursing care. Accommodation comprises fifteen single rooms, twelve of which have en-suite facilities and one double bedroom, toilets and bathrooms situated on two floors accessible by means of a passenger lift. The lounge, dining area, kitchen, laundry, and office are situated on the ground floor. The service has ample car parking space at the front and to the rear is a garden with a patio area. The home should be contacted for the current range of fees charged for this service. Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this home is 2 stars. This means that the people who use this service experience good quality outcomes. This inspection was carried out by two inspectors. No-one at the home knew that we would be arriving that day. During the inspection we looked at the care records for three of the people who live there, to see what plans have been made for their care. We also looked at two staff files to make sure that the right checks have been made so that the people who live in the home are kept safe. We spoke with the owner, the manager and three members of staff. We walked round the building and looked in three bedrooms, the kitchen, the laundry, the lounge and dining area. We looked at guidance for staff, training records, risk assessments, service and test records for equipment in the building and records of complaints and how they had been dealt with by the home. What the service does well: People who live in this home are very pleased with the care they receive from staff. They told us, ‘everyone here is wonderful’, ‘staff do not make you wait for assistance’, ‘Couldn’t ask for better staff’. We saw staff being friendly, helpful and polite to the people who live in the home. Staff said that they enjoyed their work and they are trained in areas which help them to provide better care. Most of the staff have reached level 2 of the National Vocational Qualifications and some have reached level 3. This means that they know how to provide good quality care and to keep people safe. The home is well-maintained and is homely. It is clean, with no unpleasant smells. There is a welcoming and friendly atmosphere. One person told us, ‘Visitors can come at any time’. The owners and manager encourage people to keep in touch with their family and friends and to visit places that they knew before coming to live in the home. People at this home are helped to stay as independent as possible and they go out either on their own or with relatives or friends. There are activities which are organised by staff and they can enjoy the garden in the warmer weather. The staff give people opportunities to make choices about their care. People Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 6 know who to complain to if something is wrong and the owners and manager try to put it right. The owners are involved in running the home and are making improvements. A person who lives in the home told us, ‘The owners visit several times a week and are easy to talk to’. What has improved since the last inspection? What they could do better: The owner needs to continue to update the information for people who may want to live in the home. This will help people to have a better idea of what the home is like. The home should keep better records of discussions held with people at the home about the running of the home. For example, there should be records about decisions which have been made at meetings of people who live in the home. People who live in the home should have keys to their bedrooms. If they do not want these, there should be a record of this in their file. The owner should continue to develop a system for quality assurance which takes into account the views of the people who live in the home and their relatives. This will help the owners and manager to find areas in which they can make further improvements. Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 7 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.V362740.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 Two Gates House DS0000066258.V362740.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 Quality in this outcome area is good. People’s needs are assessed prior to admission and the home is able to meet these. However, the process of updating the Statement of Purpose and Service User guide needs to be completed so that people can make an informed choice about where to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People using this service told us that they had come to this home because they had heard about it from friends or neighbours and it has a good reputation. Those who we spoke with could not recall being given any written information about the home. The acting manager showed us a Statement of Purpose and Service User Guide and told us the owner is updating these to show the new staffing arrangements. We discussed this with the owner, who said she expects to finish this work soon. We saw that the home has the registration certificate Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 10 displayed in the hallway for visitors to see. The last inspection report is also displayed. The owner or acting manager visit people who are interested in coming to the home. They assess their needs to ensure that these can be met by the staff. The person is invited to visit the home so they can see what it is like. One person living in the home told us, ‘The manager visited me while I was at the previous home after I realised that I would not be able to manage if I went back to my flat’. We looked at the files of three people living at the home and they contained the assessments. These were detailed and very clear. They contained notes about the needs of the person, their health and their preferred ways of being cared for and living. Two Gates House DS0000066258.V362740.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. There are good arrangements to ensure that the health and personal care needs of people who use this service are met and they are treated with respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at the files for three people living at this home and saw that they contain good, clear care plans which are based on the information in the assessments of their needs. They also show that each person has been asked about how they prefer to be cared for. For example, they show what time each person usually prefers to get up and go to bed. They include details about health and the person’s weight is also now included and monitored regularly. Staff follow through instructions from health professionals. For example, one person told us, ‘Staff help me with my exercise, by watching me walk across the room with my new leg.’ Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 12 There is a plan for each person and these have been left in their rooms, so that they and their relatives can see what has been recorded. The acting manager has asked each person and, if relevant, their relative, to sign the plans and return them. She reviews and, if necessary, changes the plans each month, or when important changes occur. The records showed that people had attended appointments with a variety of health professionals such as doctors, dentists and opticians. Staff know about the health needs of the people in the home. The home has obtained suitable storage for controlled medicines. We saw that the medicine trolley was well-organised. There are good arrangements for storing other medicines, including a refrigerator for medicines which need to be kept cool. We looked at the records of what medicine had been given to people who live in the home and these were up to date and completed in the right way. Seven staff have recently been trained in medication and more training is planned for the near future. We saw staff speaking to people in a polite way and treating them with respect. They were asking them about their preferences and giving them choices. Two Gates House DS0000066258.V362740.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. People living at Two Gates House enjoy the friendly atmosphere. They are treated as individuals and helped to stay in touch with people outside the home. They enjoy the meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The people who live in this home are asked about what they prefer to do each day. Staff organise some activities, such as bingo and gentle exercises. Residents also like to sit and chat to each other and to visitors. There is a television in the lounge. The manager told us that after residents had agreed to a change, staff tried to re-organise the main room so there was more room for activities. The people who lived in the home asked for the room to be put back. There were no records of residents agreeing to the first change. We asked the manager to make sure that records are kept when residents are asked about possible changes. Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 14 People who live at this home are encouraged to go out and keep in contact with friends and relatives. For example, one person goes out to the shops and another likes to go to the local pub. They may go out alone, with staff, or with visitors. Staff told us that one resident who likes to go out alone, ‘will telephone us from her mobile…to let us know that she is OK and when she will be back’. Visitors are welcomed at any time and there were three visitors whilst we were in the home. Visitors are requested to avoid mealtimes where possible as staff and residents are busy. However, they are occasionally invited to stay for a meal by by staff and people at the home. One visitor told us, ‘When I take X to an appointment they ask if I would like to have lunch with him when I get back. They say it is no trouble to save me a meal as well. At Christmas I was invited to Christmas dinner. It was lovely’. We looked at the menus and spoke to people who live in the home about the meals. There are two main choices at each mealtime and the staff also know what each person likes to eat and their medical needs. Food is usually prepared by the cook. A member of staff told us, ‘residents have their favourite foods and if they do not like something or fancy something different, the cook will do it for them’. Staff record the likes and dislikes of people as well as their preferred portion sizes in the care plans. Staff offer people drinks throughout the day and people do not always have to eat at the set mealtimes. One resident said, ‘My main meal is kept for me after I have been on a hospital visit or trip to the local shops’. Two Gates House DS0000066258.V362740.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. There are good arrangements to make sure people who live in this home are kept safe and their complaints are be taken seriously. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at the complaints procedure which the owner has recently updated. The manager keeps a record of the complaints received and the basic details of what action has been taken to put things right. We looked at the record and found three complaints. Two had been dealt with and the other is being addressed by the owner. It was not easy to tell what stage the complaint was at and we recommended that the manager should change the recording system to make it easier to see where she had reached in the process. The people who live in the home and their relatives told us they know how to complain. They feel the owner and manager will make the changes which they are asking for. One visitor, who told us she would speak to the owner, the manager or staff if she had a complaint, said, ‘the owners are often here’. Staff have been trained in adult protection and the owner plans to repeat this on a regular basis. There is information for the acting manager and staff so they know who to contact if they have a concern about possible abuse. The Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 16 manager sends the Commission for Social Care Inspection suitable information about events that happen in the home. Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 17 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, 24, 25 & 26 Quality in this outcome area is good. People who use this service are provided with a well-maintained, pleasant and homely environment in which to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked round the building and went into three people’s bedrooms, with their permission. There is off road parking at the front of the building. The owner told us there are three workers who carry out maintenance work and decoration and there is a maintenance programme so the building is kept in good order. The lounge is homely, well furnished and decorated. The people who live in the home told us they like to sit in this room. The garden is tidy, with a patio area, plants, shrubs and a lawn. There is garden furniture so people can sit out and enjoy the warmer weather. Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 18 All areas that we looked at were clean and there were no unpleasant odours. The manager told us about the effort being made to eradicate the odour problem in one of the bedrooms. People living at this home do not have a key to their bedroom door. The owner told us this was because the people had said that they do not want a key of their own. There is no record to show this has been discussed with the individuals. People who live at this home are encouraged to bring some items to make their rooms more personal and we saw these in bedrooms. The en-suite facilities in bedrooms are not used. The owner told us that people prefer to use the walk-in shower or the bathroom. We discussed the possibility of making the en-suite showers more accessible, so that people may find it easier to use them. We looked at the risk assessments for possible dangers to residents, staff and visitors and the measures taken to lessen these. They contained clear information. We also saw records of checks that have been made on equipment in the home to make sure that it is safe to use. Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 19 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): 27, 28, 29 & 30 Quality in this outcome area is good. People who live in this home are cared for by adequate numbers of staff who are trained and have the necessary skills to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at the rotas and spoke to staff and people who live in the home. These helped us to decide there are enough staff to meet the needs of the residents. The increase in staff since the last inspection means care staff now have more time to provide care and spend less time cooking and cleaning. We saw staff had enough time look after residents without being rushed. We heard the call bell ringing several times and staff answered it promptly on each occasion. We looked at two staff files and saw the owner makes sure references are taken up and the necessary checks are made so people who live in the home are protected. When all the checks have not been returned, there is a risk assessment and if the member of staff starts work, he/she is supervised until the checks are completed. Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 20 70 of staff have now completed their National Vocational Training at level 2 and the remainder are being trained or suitable placements are being sought. 40 are trained to level 3. This means a large proportion of the team have been assessed as competent to carry out their work. We looked at other training records and saw staff are provided with training in more specialised areas of their work. They have recently been trained in abuse awareness and dementia. Staff certificates are kept in their files, so they are available for inspectors to see. There are regular staff meetings, where staff discuss the needs of the residents and other issues affecting their jobs and the running of the home. Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 21 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. There are good arrangements for the management of the home so that the needs of the residents are met. The owner needs to complete the development of the quality assurance system so that the home continues to be run in the best interests of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last manager left the home, the deputy is acting as manager, with active support from the owner. There is no registered manager, but the owner told us an application will be submitted to the commission in the next few weeks. The rotas clearly show who is in charge on each shift. Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 22 People living in the home feel pleased with the amount of contact they have with the owners and acting manager. They told us, ‘the owners always visit regularly and chat to us’… ‘ The owners visit several times a week and are easy to talk to’…‘the owners always ask if we are OK and we can talk to them at any time’. There are regular staff meetings and handover sessions so that staff are kept well informed about plans and changes to the care and the home. We saw records of checks on equipment in the home and risk assessments. There are good arrangements to make sure residents’ money is kept safe. These include a process for recording incoming and ougoing money held on a resdient’s behalf and suitable storage facilities are available to ensure all monies are kept safe. The acting manager monitors the records and the owners carry out their own checks and ask people who live in the home how they are and if there are any changes which they feel would improve the home. However, there is no formal system to monitor the quality of care in the home or to record these discussions. The owner explained the progress which she has made in developing a system which will make sure the National Minimum Standards are being met and the views of the users of the service and their relatives are taken into account. Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 23 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 2 x 3 x x N/A 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 3 13 3 14 15 4 X X X X 3 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 N/A 18 3 3 X 2 X 3 X X 2 Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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. Refer to Standard OP1 OP14 OP16 Good Practice Recommendations The Statement of Purpose and Service User guide should be up to date and contain current staffing arrangements. Evidence of involvement in care planning and participation in daily living decisions should always be recorded. The complaints recording system should be developed so that it shows what stage complaints are at in the handling process. Service users should be provided with a key to their bedroom so that their room is private. Any reason why this has not been provided, or is refused by the service user, should be recorded on the file. The owners and acting manager should continue to develop the quality assurance system so that they can identify areas for further improvement. OP24 5. OP33 Two Gates House DS0000066258.V362740.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West Midlands Office West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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. 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