Inspection on 23/05/05 for White Gables Nursing And Residential Home

This inspection was carried out on 23rd May 2005.

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 Nursing And... 03/08/06

White Gables Nursing And... 16/01/06

White Gables Nursing And... 27/10/04

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 Nursing & Residential Home 21 Willington Road Kirton Lincolnshire PE20 1EP Lead Inspector Sue Hayward Unannounced 23 May 2005 09:30 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 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 Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service White Gables Nursing & Residential Home Address 21 Willington Road Kirton Lincolnshire PE20 1EP 01205 723874 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs J E Nix Mrs H J Newton Mrs A H Hughes Mrs H J Newton Care Home with Nursing 20 Category(ies) of OP Old Age Both 18 registration, with number DE(E) Dementia - over 65 of places Both 2 White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27/10/05 Brief Description of the Service: Whitegables Nursing and Residential care home is a bungalow which has been extended to form a single storey building. The home is situated in the village of Kirton and is near the local shops and ammenities. The market town of Boston is four miles away. There is a courtyard area to the rear and a small car parking area to the front of the home. Whitegables is registered to provide personal and nursing care and accommodation for up to 20 residents over the age of 65, two of these having dementia care needs. On the day of the inspection 19 residents were at the home however one was in hospital. One twin room is currently being ocupied as a single. The home is family owned and run one of the owners also being the manager. The manager was present throughout the inspection. White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced starting at 9:15 a.m. and took place over seven hours. It was carried out by one inspector as the first of two statutory inspections for 2005/6. The main method of inspection used was “case tracking”. This involved selecting three residents and tracking the care they receive through their records, discussions with them and four care staff on duty. It also included discussion with a resident’s relative. A sample of regulatory records policies and procedures was also inspected. In addition the Commission received eight completed questionnaires (one after the date of the inspection) from residents and two from relatives/visitors. What the service does well: What has improved since the last inspection? The home has addressed the requirements and recommendations made at the last inspection which included removing the hand towel from the staff toilet to prevent cross infection and staff training in Basic Food Hygiene and Adult Protection. The policy manual has been numbered for ease of reference and residents or their representatives have signed care plans. White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 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 Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 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 standard(s) 1, 2 & 3. The systems in place for the introduction and assessment of resident’s to the home ensure care needs are identified and met. Written information about the home is made available to residents and their representatives. EVIDENCE: The statement of purpose, which gives information about the home, is on display in the entrance hall for people to refer to, as is the most recent inspection report. Discussion with staff and the manager indicated that there is a thorough assessment process operated at the home. Those residents seen indicated that they had been given written information about the home and that they or their relatives had visited prior to making a decision to stay. All questionnaires completed by residents or their relatives indicated that they all liked living in the home and felt they were well cared for. Records checked all contained information to demonstrate that a thorough assessment is done. This includes writing to residents to confirm that the home can meet needs. Records showed that the home assesses resident’s White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 Page 9 physical and social needs. Risk assessments are done in relation to various matters such as manual handling and outcomes recorded. All care records checked contained information about terms and conditions of residency. White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 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 standard(s) 7 and 10 Care plans are detailed and include information about individual needs and preferences and the action to be taken to ensure resident’s needs are met. The privacy and dignity of residents is respected in this home. EVIDENCE: Each resident has an individual plan of care containing detailed information about care needs and how they are to be met. Care plans had been signed by residents or their relatives. They also contained staff signatures indicating that they were reviewed on a monthly basis. Care plans included information of residents preferred routines such as times of rising and retiring and the drinks they preferred. Staff gave a good description of the needs of residents and how they are met and comments demonstrated how resident’s privacy is maintained. Questionnaires completed indicated that residents were satisfied with the home and did not wish to be more involved in decisions. Two residents said that they felt able to make their own decisions as to how they spent their time in the home. White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 Page 11 Records and discussion with residents provided information, which demonstrated that resident’s health is monitored and appropriate action taken as necessary. One resident said that when she had attended a hospital appointment a staff member had accompanied her. Records also indicated when residents had attended medical appointments. Residents comments all confirmed that they felt their privacy was respected in the home. Bedroom doors are lockable should residents wish to do so. Discussion with staff and observations made when they were assisting residents indicated that they treated residents in a respectful and courteous manner. White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 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 standard(s) 12, 13 and 14. Relatives and friends of residents are made welcome in this home. The home provides a range of activities and leisure interests within the home and community that residents can choose whether to participate in or not. EVIDENCE: Residents and staff said that visitors were welcomed at any time at the home. Questionnaires completed by relatives/visitors confirmed that they felt they were welcomed and could see residents in private if they wished. The home has a policy about visiting and staff were well aware of the details of it. There are a variety of activities and leisure interests provided such as weekly bingo sessions, music and movement sessions, monthly Church services and outings. A supply of books is kept at the home. It was observed and a resident confirmed that he is able to have daily walks into the village accompanied by a member of staff. In addition entertainment is arranged in the home. Staff said that residents are also given opportunities to participate in local events such as fetes and gala’s if they wish. Questionnaires completed by residents in six instances demonstrated that the home provided suitable activities for residents, one did not know and one commented that activities were provided sometimes. It was discussed and recommended that a record be kept of the activities the home provides. White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 Page 13 Discussion with three residents on the day indicated that they have a choice whether they participate in social activities or not. White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 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 standard(s) 16 and 18 There are satisfactory systems in place for handling complaints and for the protection of residents however the home needs to obtain a copy of the recently revised Local Authority Adult protection procedure. EVIDENCE: The home has a complaints and adult protection procedure in place. It is recommended that the latter be reviewed once the home has obtained a copy of the recently reviewed Local Authority Adult protection procedure (February 2005). No complaints or adult protection incidents have been received by the home or CSCI for over a year. Information about how to raise concerns is included in the information provided to residents on admission to the home. Residents spoken to were aware of the management arrangements of the home and who to raise concerns with. One resident said that she had recently made a comment about wanting a specific vegetable at meal times, which had been acted on. There is a safe recruitment process followed and staff and records demonstrated that staff had since the last inspection seen a video and completed a questionnaire about adult protection. All staff were aware of correct reporting procedures should such events occur. White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 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 standard(s) 19, 24 and 26 Residents living in this home live in a clean, comfortable and homely environment. The home is being well maintained. EVIDENCE: Those areas of the home seen on the day of the visit included three bedrooms, the lounge, sun lounge, dining areas and staff toilet. The home was tidy, comfortably furnished, and clean and smelt fresh. A relatives comment described the home as being a “happy, clean and dignified home”. Residents are able to furnish their rooms with personal possessions. Risk assessments have been conducted in relation to the environment including a fire risk assessment of the premises, however it was noticed that in one residents bedroom a radiator was not guarded and records did not indicate that a risk assessment had been done. It is acknowledged that the manager confirmed that there is a programme to cover those radiators that have not yet been guarded and the arrangements in the meantime are that they are checked on a regular basis to ensure that a safe temperature is maintained. White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 Page 16 The home was last inspected by an Environmental Health officer on 05/01/05. The fire officer visited the home on 10th March 2004 and the arrangements were found to be satisfactory. A maintenance person is employed at the home. Staff confirmed that any maintenance issues are dealt with promptly and that they are provided with protective equipment to prevent the risk of cross infection. The recommendation made in respect of the provision of paper towels for the staff toilet has been addressed. White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 The home is well staffed and staff are provided with training to ensure that they have the necessary skills and knowledge to care for residents safely. The process to recruit staff ensures that as far as possible residents are protected. EVIDENCE: Residents spoken to and questionnaires completed by residents and their representatives all commented positively about the care provided by staff, for example one relative commented that “Mum loves the staff” and another “family has confidence in the staff and is happy with the care”. Residents on the day said that staff were “very good” and “extremely good”. Discussion with staff and records confirmed that there are always four carers plus a nurse on duty in the mornings, two carers and a nurse in the afternoons, three carers and a nurse in the evenings from 4.00 p.m. and one carer and a nurse at night. Additionally separate catering, domestic, maintenance and laundry staff are employed. There have been few changes to the staff team since the last inspection. Staff were of the opinion that staffing levels were adequate to meet the needs of residents Discussion with staff indicated that there is a satisfactory recruitment procedure in operation. Records checked also demonstrated this. There is a staff-training programme in place, which ensures that staff have regular updates on some matters such as manual handling and fire training. White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 Page 18 The manager is aware of National Minimum Standards relating to National Vocational Qualification (NVQ) awards for staff and so far six staff have completed level II, three are currently working towards achieving it and one is in the process of registering for this award. White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 37 The home is being well managed. The record keeping systems in place and policies and procedures help to ensure the health and welfare of residents. EVIDENCE: The registered manager is a qualified nurse and has extensive experience in the care profession. She has achieved the NVQ level IV award and the D32 and D33 assessors award. Staff described her as approachable. Residents were aware of who was in charge and said could raise concerns if needed. The sample seen of those records required by law to be kept were well maintained. There are satisfactory arrangements to ensure that personal records are kept securely in the home. The home has a range of policies and procedures (which have been numbered for ease of reference) to ensure residents welfare and has also obtained a quality award, Investors in People. White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 Page 20 The sample of maintenance records seen demonstrated that equipment is serviced regularly. White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 x x x x 2 x 3 STAFFING Standard No Score 27 4 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x x 3 x White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 Page 22 NO 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. 1. Standard 24 Regulation 13 Requirement A risk assessment must be completed in relation to hot surfaces for those radiators that have not yet been guarded. Timescale for action 31.07.05 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. Refer to Standard 18 Good Practice Recommendations It is recommended that a copy of the revised Local Authority Adult Protection Procedures (February 2005) be obtained and if necessary the homes policy be reviewed to ensure that it links with this. It is recommended that a record is kept of all social and leisure activities indicating dates they occur. 2. 12 White Gables Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 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 Nursing & Residential Home C53 C04 S2561 White Gables V226279 230505 Stage 4.doc Version 1.30 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. 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