Inspection on 12/06/06 for White Gables Care Home

This inspection was carried out on 12th June 2006.

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

White Gables Care Home 15/10/08

White Gables Care Home 09/05/07

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE White Gables Care Home Lincoln Road Skellingthorpe Lincoln Lincs LN6 5SA Lead Inspector Elisabeth Pinder Key Unannounced Inspection 12th June 2006 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 White Gables Care Home DS0000066035.V299048.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. White Gables Care Home DS0000066035.V299048.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service White Gables Care Home Address Lincoln Road Skellingthorpe Lincoln Lincs LN6 5SA 01522 693790 01522 689725 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) Apta Healthcare (UK) Ltd Mr Stuart Ennals Care Home 53 Category(ies) of Dementia - over 65 years of age (53), Old age, registration, with number not falling within any other category (5) of places White Gables Care Home DS0000066035.V299048.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care with nursing for service users of both sexes whose primary needs fall within the following categories: Dementia - over 65 years of age (DE(E)) -53 Old age, not falling within any other category (OP) - 5 The category old age (not falling within any other category) applies to 5 named individuals as stated in the Notice of Proposal to Register dated 10 December 2004. The maximum number of service users to be accommodated is 53. Date of last inspection 20/02/06 2. Brief Description of the Service: White Gables Nursing Home cares for older people who are mentally frail in a purpose built single storey building, comprising of two separate units. The first being Cedar House which cares for up to 22 people needing personal care, the second Gables House cares for up to 31 people needing nursing and personal care. The home is situated on the outskirts of the historic city of Lincoln and is set in a rural location. The home is on a level site and provides parking for several cars. To the front of the property there is a lawn and to the back is a patio and courtyard. There are a variety of aids and adaptations around the building to allow residents that are able to move around the home more independently. Forty-nine of the bedrooms are single and twenty-five bedrooms have an en-suite toilet. There are 5 communal bathrooms and 7 communal toilets. The current fee range is £335 – 550 per week. Additional charges are made for hairdressing, chiropody and newspapers. White Gables Care Home DS0000066035.V299048.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit was made to the home to form part of a key inspection. It started at 09:15 and lasted 5 ¼ hours. Information was taken from the preinspection questionnaire and notifications to the Commission and used to plan the visit and produce this report. No surveys were received. However, a discussion was held with a relative, comments can be found in the report. This site visit focused on key inspection standards and checking whether requirements and recommendations from the previous inspection have been addressed. A partial tour of the home was undertaken and a sample of records inspected. The main method used for this was “case tracking” a sample of four residents with a range of needs via their records, observation and discussion with staff. What the service does well: What has improved since the last inspection? Some policies and procedures have now been reviewed, and where necessary, updated. A review of the quality of care has been undertaken Re-decoration has commenced and the use of colours and wood effect flooring has been used to enhance the environment for people with a dementia. The name of the residential unit has also changed to avoid confusion and it is now known as Cedar House White Gables Care Home DS0000066035.V299048.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. White Gables Care Home DS0000066035.V299048.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 White Gables Care Home DS0000066035.V299048.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 standard 6 is not applicable for this service Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Information about the service is available to residents and procedures are in place to ensure residents are only admitted into this home after a full needs assessment has been carried out. EVIDENCE: The statement of purpose and service user guide is currently being re-written as the company is now owned by Southern Cross Healthcare, this will be made available on completion. However, the manager has displayed a simple version of who’s who within the home. Files inspected showed that a thorough full needs assessment had been carried out prior to admission. Contractual information is held in the administrator’s office. Whenever possible residents and their relatives are invited to visit the home where information is given for them to read and take away to help them White Gables Care Home DS0000066035.V299048.R01.S.doc Version 5.2 Page 9 make the choice about where they live. However, it is acknowledged that not all residents have the capability to make a choice and this is done by their relatives or representatives. White Gables Care Home DS0000066035.V299048.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 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 the service. Care planning in this home is good, providing detailed information on how the health and social care needs of the people are met. However, there is a potential risk if medication is not recorded appropriately. Residents’ privacy and dignity is respected. EVIDENCE: Care plans are in the process of being re-written as the company have produced a new, more detailed format. Those seen contain details on how the health care needs of residents are to be met and showed that regular reviews are taking place. Since the last inspection signatures of relatives involved in this process have been obtained to show their agreement of the plan of care. Records show that residents regularly see their GP, practise nurse and, when necessary, their consultant. Visits to see the dentist, optician and chiropodist White Gables Care Home DS0000066035.V299048.R01.S.doc Version 5.2 Page 11 are also recorded. However, one record dated 05.06.06 read ‘needs GP urgently,’ on 11.06.06 the record read ‘requested a visit from GP’, but there was no evidence to show that the GP had visited. This was discussed with the nurse in charge who said the GP had visited but the visit had not been recorded. Good risk assessment systems are in place and staff spoken to had a good knowledge of the care and support needed to meet the needs of residents. A period of observation was undertaken in the nursing unit whilst residents were having lunch. During this time staff were observed to be offering a high level of care and support to residents who required help to eat their meals. Medication gaps were noted on a medication recording sheet pertaining to one resident traced. This was brought to the attention of the nurse in charge and the registered manager who agreed to ensure staff complete records using the appropriate codes. This has also been raised during the last two inspections and action must be taken to ensure this does not re-occur. White Gables Care Home DS0000066035.V299048.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 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 the service. Relatives and friends of residents are made welcome in this home and the rights of residents are respected. Activities must continue to be carried out in the absence of the activity coordinator. The arrangements for serving meals in the residential unit must be reviewed to ensure staff are able to meet the needs of residents during this time. EVIDENCE: The home currently uses an external catering company to provide catering staff to cook and draw up menus in the home. However, the manager said that this is due to change in a few months and catering staff will be employed by the company. Menus were available and these showed that a varied, nutritious diet is offered and during the visit tables were laid with clean tablecloths. The lunchtime meal was gammon, or corn-beef hash, potatoes and vegetables, this was nicely presented, and there was a choice of dessert. White Gables Care Home DS0000066035.V299048.R01.S.doc Version 5.2 Page 13 Staff spoken to expressed their concern with regards to the deployment of staff during mealtimes, in particular breakfast. They said that they have to collect food from the kitchen in a hot trolley, serve cereals and make toast and drinks. As there is normally only two staff able to do this, (the third member of staff is administering medication), they feel the needs of residents are compromised during this time. This was discussed with the registered manager and he agreed to look into it. Although many residents are unable to answer direct questions they chatted freely with me, smiling and laughing. Staff gave examples of how they give residents choices i.e showing different clothes to wear when helping residents to dress in the mornings. One resident who can communicate very well said she chooses how to spend her day although she is missing the activity coordinator. One visitor spoken to stated that she visits frequently and at different times and she is always made to feel welcome. Information received in the pre-inspection questionnaire identified the activities available, however, these are not currently taking place as the activity co-ordinator is on sick leave. During the visit no activities were being offered and many residents were asleep. This was also raised by a relative and discussed with the manager who said he has been on leave but is aware of the situation and is taking action to address it. Regular community contact is maintained with the church visiting frequently. White Gables Care Home DS0000066035.V299048.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 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 the service. Residents are protected by the procedures in place for handling complaints and allegations of abuse. EVIDENCE: A copy of the complaints procedure is on display together with an explanation of how to complete it. A record is kept of all complaints made. The commission has not received any complaints since the last inspection. The homes record indicated that one complaint received in May has been dealt with internally using correct procedures. Staff spoken to know the action to take should they receive a complaint and are aware of the meaning of abusive practices and would report any incidents to a senior carer or the manager. No safeguarding adult referrals have been made and staff have annual updates in adult protection training. White Gables Care Home DS0000066035.V299048.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents living in this home live in a safe, comfortable and homely environment. EVIDENCE: During a partial tour of the building the home was seen to be clean and tidy and smelt nice. Bedrooms are spacious and well personalised and some have patio doors with direct access to the garden. However, there is a potential risk to residents from the doorway leading to a patio area off the quiet lounge in the residential unit as this has a small step leading straight onto a slope. Action should be taken to minimise any potential risk/hazard. Bedroom doors have framed pictures and the name of the resident on and all have privacy locks although many residents are unable to use this facility. White Gables Care Home DS0000066035.V299048.R01.S.doc Version 5.2 Page 16 Since the last inspection re-decoration has commenced in the residential unit, wood effect flooring has been laid and the use of colours is being used to enhance the corridors and help people with a dementia to find their way around the home. White Gables Care Home DS0000066035.V299048.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 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 the service. There must be continual assessment of the deployment and number of staff on duty to ensure these are sufficient to meet the needs of residents. Staff are recruited using robust procedures and are provided with training to enable them to have the skills needed to carry out their roles. EVIDENCE: Records show that there are normally three care staff on duty from 07.30 – 19.30hrs in the residential unit with the care manager of this unit having an additional 6 hours supernumerary hours each Monday. In the nursing unit there are five carers and one qualified with the nurse in charge having supernumerary hours to complete records. During the night there are four carers and one qualified covering both units. Information taken from the pre-inspection questionnaire evidenced that there is an ongoing programme of training which staff attend and training recently undertaken includes Alzheimers training, psychotic medication training and updates in statutory training. However, this information states that only 8 of care staff have NVQ (National Vocational Qualification) level 2 or above. White Gables Care Home DS0000066035.V299048.R01.S.doc Version 5.2 Page 18 Two new staff members have been employed since the last inspection and their records show that they have been recruited using robust procedures based on equal opportunities. CRB/POVA records are held within the administrator’s office. Staff spoken to have not been given copies of the General Social Care Council code of conduct and this was raised with the care manager who said that a copy is available for them to read in the home. As previously highlighted staff spoke of their concerns regarding levels of staff in the residential unit. This was raised during the last inspection and a requirement was made. The registered manager said that re-assessments have now been carried out and one resident is waiting to be transferred to the nursing unit. However, staff said they feel they are not providing a quality service and this was also raised by one visitor. Please refer to the management section in this report. White Gables Care Home DS0000066035.V299048.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. This home is well managed and the health, safety and welfare of residents are promoted EVIDENCE: There are clear lines of accountability within this home, the registered manager is suitably qualified and is available most weekdays between 9 and 5. Each unit has a ‘head of department’ and names are displayed around the home and the registered manager is supportive and will offer advice when needed. Since the last inspection resident satisfaction questionnaires have been circulated to all relatives and specific comments from these are: “I think that sometimes you are understaffed but the staff you have do an excellent job” White Gables Care Home DS0000066035.V299048.R01.S.doc Version 5.2 Page 20 “Previously raised issues relating to odour, but improvements have been made re floor covering” “Staff most helpful and caring” Other comments related to the format of the questionnaire as some relatives felt that some questions could only be answered by residents, and many are not able to do this. Therefore, it may be beneficial to have a separate form for residents and relatives. Staff are currently not involved in quality assurance measures other than their supervision and appraisal and it is recommended that a questionnaire is sent out to staff to enable them to express their views anonymously if they wish. Once this information has been collated a report should be sent to the Commission. The pre-inspection questionnaire identified a number of policies and procedures available relating to fire, health & safety and environmental risk assessments. This information detailed dates policies and procedures were reviewed and gave dates of maintenance tests. Regular staff meetings and relative meetings are held where minutes are taken. A regular newsletter goes out to relatives, the last issue is for June, July and August. This gives information of forthcoming activities, care plan reviews and other relevant information. Residents personal allowances are kept in individual bank accounts with an amount of ‘petty cash’ available. Invoices and receipts are kept and two signatures are recorded when accounts amended. White Gables Care Home DS0000066035.V299048.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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X 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 X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 White Gables Care Home DS0000066035.V299048.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Refer to Standard OP8 OP9 OP28 Good Practice Recommendations Detailed records must be kept to support that residents see their GP when needed. Medication given to residents must be recorded and appropriate codes must be used. It is recommended that a minimum ratio of 50 trained members of care staff (NVQ Level 2 or equivalent) excluding the manager and registered nursing staff should be achieved. White Gables Care Home DS0000066035.V299048.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 White Gables Care Home DS0000066035.V299048.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. 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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