Inspection on 09/05/07 for White Gables Care Home

This inspection was carried out on 9th May 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

White Gables Care Home 15/10/08

White Gables Care Home 12/06/06

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 Julie Western Key Unannounced Inspection 9th May 2007 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 White Gables Care Home DS0000066035.V336620.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.V336620.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 white.gables@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Helathcare Ltd. 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) 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.V336620.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 12th June 2006 2. Brief Description of the Service: White Gables Care Home is situated at the edge of the village of Skellingthorpe, on the outskirts of Lincoln and is set in a rural location overlooking fields. It accommodates up to 53 older people who are mentally frail in a purpose built single storey building, comprising three units. Cedar Unit accommodates up to 22 people needing personal care and Cedar and Cathedral units provide nursing care for up to 31 people. The home is on a level site and provides parking for several cars. To the front of the property there is a large lawned area and to the back is a patio and courtyard. There are a variety of aids and adaptations around the building to allow those residents that are able, to move around the home more independently. Forty-nine of the bedrooms are single and twenty-five bedrooms have an ensuite toilet. There are 5 communal bathrooms and 7 communal toilets. The current fee range is £348 - 624 per week. Additional charges are made for hairdressing, chiropody and newspapers. This and other information, such as the statement of purpose and a copy of the last inspection report is available from the office. White Gables Care Home DS0000066035.V336620.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took into account any previous information held by CSCI including the home’s previous inspection reports, its service history, pre-inspection questionnaires completed by the Manager and residents’ questionnaires sent to the home by the Commission prior to the inspection. The site inspection took place over three hours and consisted of case tracking a sample of residents’ care records and assessing the care given. Some policies and procedures were examined and some records concerning the safety of the home were also seen. Three residents, three care and ancillary staff and one visitor were spoken with. The acting manager was present throughout the inspection. What the service does well: What has improved since the last inspection? All the doors to residents’ rooms have been renewed with fire doors. A gardener is now employed weekly to keep the grounds attractive and tidy. There is now secure fencing around the rear of the building. The home has recently purchased a new hoist, a hospital bed, new chairs in communal areas of Cathedral and Castle units and new scales for weighing residents. White Gables Care Home DS0000066035.V336620.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. White Gables Care Home DS0000066035.V336620.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.V336620.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): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have good information about the home in order to make an informed decision about whether the service is right for them. EVIDENCE: Case tracking confirmed good practice. The acting manager or a senior carer usually visited prospective service users at home or in a care setting such as a hospital to undertake a thorough assessment of all their care needs. A resident said ‘I came to the home with my daughter for tea and to look round; we both liked it.’ The statement of purpose was clear and contained enough information about the home for residents and their families to make a decision about living there. White Gables Care Home DS0000066035.V336620.R01.S.doc Version 5.2 Page 9 The service user guide was informative but was not in plain English and the acting manager said a new one was being developed. Written admission documentation was clear and gave staff the information needed to care for the residents. A staff member was able to describe the admission procedure and the importance of making new residents and their families feel welcomed. Contractual information is held in the administrator’s office. This means that residents and their supporters have an opportunity to see how much the service is costing them. A visitor spoken with said that his relative was unable to make an informed choice about homes and he had chosen this home on her behalf because it compared very favourably to another home they had visited. The home does not provide intermediate care [see Standard 6]. White Gables Care Home DS0000066035.V336620.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s records give a clear picture of the health needs of the residents and enable staff to meet their needs with sensitivity and regard for their privacy and dignity. EVIDENCE: The three care plans traced were comprehensive and contained details on how the health care needs of residents were to be met and showed that regular reviews took place. Some signatures were missing and during discussions with the acting manager it was suggested that where residents were unable to sign their care plans, the reason for this should be given. Records showed that residents regularly saw their GP, practice nurse, and where necessary, consultant. Visits to the dentist, chiropodist and optician were also recorded White Gables Care Home DS0000066035.V336620.R01.S.doc Version 5.2 Page 11 Medication records were clear and staff members said they received training in safe handling of medications before being able to distribute medication. A visitor said he felt that his relative was safe and well looked after. The staff team were observed carrying out their duties with kindness and sensitivity towards the residents, especially when attending to their personal needs. White Gables Care Home DS0000066035.V336620.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. This judgement has been made using available evidence including a visit to this service. Social activities are regular and tailored to suit individual residents. Residents can choose which meals they want from a balanced and varied menu. EVIDENCE: The home employs a full-time activities co-ordinator, who has recently been appointed and who on the day of the inspection was chatting with groups of residents and asking what activities they would like to have arranged. Residents spoken with enjoyed the activities; one said she preferred not to go out, but liked the entertainments in the home. A visitor said that there were plenty of things of residents to do and he was always invited to attend with his relative, particularly to the in-house activities. The activities list showed that there is a regular programme of activities including board games, jigsaw puzzles, knitting, watching television, trips out to local shops, pubs and garden centres and contact with various religions. White Gables Care Home DS0000066035.V336620.R01.S.doc Version 5.2 Page 13 The notice board displayed photographs of residents enjoying various activities and events held in the home. The activities co-ordinator has not yet received any training in activities for those with a dementia; the manager said this was being arranged. Residents were seen eating and enjoying the mid-day meal. One resident said ‘it’s lovely grub’ and another said ‘I’ve no complaints at all’. Records demonstrated that menus were planned and based on residents’ dietary needs and preferences. There was evidence of fresh fruit and vegetables in the kitchen. The menu was balanced and offered a choice. Several residents had pureed food and this was given in a sensitive and dignified way. All kitchen staff spoken with had basic food hygiene certificates. White Gables Care Home DS0000066035.V336620.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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is clear and gives residents and their supporters the confidence that comments and concerns will be listened to; residents are kept safe from harm by clear procedures and regular staff training. EVIDENCE: Residents who were spoken with all said they did not wish to complain but would go to their families or the acting manager if they did. The visitor said he had made an observation about a minor issue and this was dealt with swiftly and to his satisfaction. The complaints policies and procedures for safeguarding adults were all up to date and the acting manager confirmed that. The complaints record showed that there had two issues concerning safeguarding adults in October 2006; one related to staff numbers and the other was reported by staff who were concerned about a resident’s activities outside the home. Both had been referred to the POVA [protection of vulnerable adults] Social Work team. There were no ongoing complaints. Staff spoken with received annual training in adult protection and training records confirmed this. White Gables Care Home DS0000066035.V336620.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. This judgement has been made using available evidence including a visit to this service. The residents live in a safe and comfortable environment that is generally suitable for their needs. EVIDENCE: A tour of the premises found that the building was generally well maintained internally and the gardens and grounds offered a pleasant place for residents to sit out in good weather. Rooms were well personalised and well decorated; one resident was sitting in her room and said ‘this is a lovely room; I can look straight onto the garden ’. Environmental improvements have included new doors being fitted onto every bedroom and new chairs in the communal areas. A new hoist, a hospital bed and scales have recently been purchased. A gardener has also been employed White Gables Care Home DS0000066035.V336620.R01.S.doc Version 5.2 Page 16 on a weekly basis and the grounds at the back of the building have recently been made secure with new fencing. Maintenance records showed that any repairs or alterations are recorded by staff and managed by the maintenance person or contractors, depending on the size of the repair. Some of the bath/shower rooms were institutional in appearance; the housekeeper said she had started to put up blinds and wall decorations in one of the bathrooms and this gave it a more homely feel. Chemicals and cleaning equipment were stored appropriately and records showed that risk assessments of the building were carried out regularly. The home was clean and tidy and smelled fresh throughout. White Gables Care Home DS0000066035.V336620.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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff members are suitably trained, qualified and competent to met the residents’ care needs. EVIDENCE: The staff rotas showed that there were enough staff members to meet the needs of the residents. Staff members on the Castle [nursing] and Cedar [residential] units all said they had enough time to manage their tasks but those on the Cathedral [nursing] unit said they were sometimes rushed; the acting manager said this was a long-standing issue and that staff numbers on this unit were constantly being monitored. She added that staff worked across these two units. The visitor said that enough staff members were available to attend to his relative’s needs; he added ‘they’re very good, polite and helpful’. Training records showed that recent training included moving and handling, food hygiene, fire and health and safety and staff members spoken with confirmed this. White Gables Care Home DS0000066035.V336620.R01.S.doc Version 5.2 Page 18 Three members of staff had achieved the National Vocational Qualification [a nationally recognised award] at Level 2, with a further 20 working towards it. One staff member had achieved the NVQ at Level 3. The most recent staff member to be employed confirmed that she had given references, completed an application form and been interviewed. She was currently undergoing induction training and was shortly to commence the NVQ at Level 2. White Gables Care Home DS0000066035.V336620.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. This judgement has been made using available evidence including a visit to this service. The home is well managed and the health, welfare and safety of the residents are promoted. The views of residents are listened to and they are involved in decisions affecting them. EVIDENCE: The home is currently without a manager; the acting manager said that interviews for the post were held last week. Meanwhile, there are clear lines of accountability within the home. Each unit has a head of department; their names are displayed around the home and it is one of the heads of department who is currently acting manager. White Gables Care Home DS0000066035.V336620.R01.S.doc Version 5.2 Page 20 The home has its own quality assurance system, with satisfaction questionnaires being sent to residents and relatives. Their replies are then analysed and the results are acted upon. A quarterly newsletter is produced and as well as being available in the home, is sent to relatives; it gives information of forthcoming activities and other relevant information. A visitor said he was always invited to attend the regular residents’ meetings. Staff members said there were regular staff meetings, where minutes were taken; records confirmed this. Residents’ personal allowances are kept in individual bank accounts with an amount of petty cash available for small items. Invoices and receipts are kept and two signatures are recorded when accounts are amended. White Gables Care Home DS0000066035.V336620.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 3 9 3 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 3 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.V336620.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. 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. Refer to Standard OP7 OP12 Good Practice Recommendations Where care plans are not signed, a reason should be given. The activities organiser should have some training in activities for people with a dementia. White Gables Care Home DS0000066035.V336620.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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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