Inspection on 02/06/05 for White Gables Residential Home

This inspection was carried out on 2nd June 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 Residential Home 14/03/07

White Gables Residential Home 06/03/06

White Gables Residential Home 09/12/04

White Gables Residential Home 28/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE White Gables Residential Home 16 Stanley Road Felixstowe Suffolk IP11 7DE Lead Inspector Joe Staines Announced 02 June 2005 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 Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service White Gables Residential Home Address 16 Stanley Road, Felixstowe, Suffolk, IP11 7DE 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) 01394 282620 01394 283847 whitegables.rch@btinternet.com Mr C Lewis & Mrs J Lewis Mr C Lewis Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 9/12/04 Brief Description of the Service: White Gables is a private, family run care home for older persons, which has operated since 1982. The Home was first registered in 1984 for 15 service users. A conversion and extension provided a further 10 places. A further extension into the adjacent property, completed in 2004, enabled provision of a further 12 beds. The home is now registered under the provisions of the Care Standards Act 2000 to accommodate a maximum of 37 older persons. The home is located in the coastal town of Felixstowe and is within walking distance to the town centre. The local amenities include the post office, shops, community centre, doctor’s surgery, churches, theatre and leisure centre. The home is also close to the main bus routes that serve the town centre.The southern aspect of the home faces the promenade, gardens, lawns and sea views. All bedrooms are single accommodation. En suite toilet facilities are found in thirty-two of the rooms with a wash hand basin in the remaining five rooms. There are three lounges, one is large and the daily social activities take place there. The smaller quiet lounges are used for quiet reflection and / or to receive guests. Access to the home is by a main side entrance where car parking is available. As committed Christians the proprietors are involved with the church life in Felixstowe. A bible reading takes place in the lounge daily for those who wish to participate and a service is held at the home weekly. White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted by Joe Staines (Regulation Inspector) and Jane Offord (Regulation inspector), between 10 a.m. and 4.30 p.m.. The inspection was facilitated by Mr and Mrs Lewis who were present throughout the inspection. This inspection focused on a number of key standards identified in the main body of the report. A total of fourteen comment cards were received from service users and the same amount from relatives/visitors. All of the comments were positive and several relatives/visitors added extra comments of their own, praising, amongst other things, the care given to service users who had passed away whilst at the home, the friendly atmosphere and the approachability and helpfulness of staff. The inspection included the examination of six service user’s files, recruitment records in relation to four recently appointed members of staff, policies and procedures relating to the assessed standards and interviews with just under 20 of service users and three different members of staff. What the service does well: What has improved since the last inspection? The home has responded to previous requirements by improving the quality of medication provision, including ensuring that all of the required records were maintained according to regulation. The home has also improved the safety of radiators by risk assessments and the provision of additional covers where required. White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 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 Residential Home v218322 i54-i04 s24525 white gables v218322 050621 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 Residential Home v218322 i54-i04 s24525 white gables v218322 050621 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) 3 & 4 The home’s policies and practices, in relation to moving into the home provide assurance that service users’ needs will be assessed, although some improvements to the assessment process will increase the scope and quality of these assessments, where needed. The evidence gained at this inspection confirmed that the needs of service users were being met, in line with the statement of purpose and guide given to service users about the services offered. EVIDENCE: The inspection of service user’s files included looking at pre admission assessments. Assessments were based on the social work assessments undertaken prior to admission, and identified the needs of those concerned. The files and other records kept at the home in respect of service users, confirmed that the home was meeting the needs, including individual needs, of service users. Specialist advice and input had been arranged for service users with diabetes, whilst promoting the involvement of the service user in the maintenance of records of blood sugar levels. The feedback from service users, White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 9 both in the form of comment cards received, and statements made during the inspection also clearly evidenced that the home was meeting the needs of service users. White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 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, 8, 9, 10 & 11 Care plans set out the majority of individual service users’ needs and plans to meet those needs. However, some improvements are required in order to fully comply with this standard. The health needs of service users are fully met by a range of efficient and comprehensive policies, practices and procedures, including those relating to the administration, receipt and disposal of medication. The practices observed and evidence provided from service users feedback confirmed that the privacy of service users is respected. The home has a set of policies and procedures, as well as staff training, all geared towards ensuring the death of service users is managed with respect and sensitivity to all concerned. EVIDENCE: All of the care plans examined contained information about how the home intended to meet a wide range of identified needs in respect of service users. Information included details of significant people, contact arrangements, a White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 11 range of care needs, based on the activities of daily living, and risk assessments regarding mobility. It was noted that, although some service users require the use of a hoist for certain transfers, the size of sling required for the task involved was not identified in care plans. One inspector observed the lunchtime medication round. There were photos of the residents with the individual medication administration records (MAR) charts, which is good practice. The MAR charts were completed correctly. After the round the inspector spoke to the carer who had been administering the medication. They demonstrated good understanding of the process and showed clear knowledge of some of the medication they had administered, possible side effects and what they would do in the event of an error taking place. They had not undertaken any recognised training in medication administration since starting in their post two years ago. The inspector was shown the medicines storage cupboard and the Controlled Drug register both of which complied with the Medicines Act 1968 and the Misuse of Drugs (Safe Custody) Regulations 1973. The home had a policy and assessment for self-administration of medication if the resident chose to do so. The home keeps records of all visits to the home by GP’s and healthcare professionals such as district nurses. Service users stated that they were happy with the way their health needs were met, including the response time when professional input was needed. There were no incidents of service users with pressure sores other than one, which had manifested in hospital prior to admission. Care plans included detailed information regarding the health history and needs of service users. The feedback from service users’ comment cards was consistently positive in response to the question, “is your privacy respected?” Observations made during the inspection included staff being seen to knock and wait for a response before entering service users’ rooms. The care given to service users who were nearing the end of their lives was the subject of specific praise from relatives who sent comments to the Commission for Social Care Inspection prior to the inspection. The comments made identified staff staying with service users through the night, burning lavender oil in their room, regular turning, staff popping their heads around the door to ‘say goodbye’ and good contact with the families of service users. Another relative stated that the staff were very supportive during their relative’s final illness. The home also had a policy on how to deal with the death of a service user, and training records confirmed that staff had received training in care of the deceased, bereavement and dispelling the myths of the funeral profession. White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 12 White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 The home provides a range of activities and leisure pursuits for service users, based on their expressed wishes, and which attendance is encouraged but not to the extent that service users individual right to choose whether or not to participate is compromised. This element of choice is not restricted to activities, and is present in relation to choice of meals, personalisation of rooms, financial freedom and access to advocates if required. Contact arrangements are satisfactory, enabling service users to maintain contact with family members/friends, and the local community. The food provided at the home ensures individual choice is respected, within an overall diet, which meets the health and nutritional needs of service users. EVIDENCE: There were notices up around the home, of forthcoming activities. The service users spoken to on the day of the inspection reported that the home catered for their needs in terms of the provision of an activities programme, which service users could choose to attend or not, as the case may be. Each of the 14 comments cards received from service users answered “yes” to the question, “Does the home provide suitable activities?” Comments from White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 14 relatives identified some of the activities as games, crosswords, Monday afternoon session that stimulates conversation and minds, and small concerts. One member of staff had undertaken training on activities in the elderly care setting. Service users confirmed that visitors were made welcome at all times. Comment cards from relatives unanimously answered “yes” to the questions, “Do staff/owners welcome you into the home at any time” and, “Can you visit your relative/friend in private?” The inspection of service users’ rooms confirmed that all of the rooms examined were well appointed, with good natural or artificial lighting, evidence of personalisation by the placing of personal items, pictures and service users’ own furniture. The inspection included joining service users for lunch. During the course of the meal, several service users were spoken to, all of whom congratulated the home on the quality and choice of meals provided at the home. All 14 of the 14 service users comment cards received prior to the inspection answered “yes” to the question, “Do you like the food?” White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 The home has a set of policies and procedures, including staff training and whistleblowing, that meet the requirements for the protection of service users. EVIDENCE: The protection of vulnerable adults policy was updated during the course of the inspection to clarify the issue of consent, making it clear that all allegations or suspicions of abuse must be reported to the appropriate authority. The policy also contained important information in relation to the identification and prevention of abuse. The whistle blowing policy was also examined and found to contain full details of responsibilities incumbent upon staff to refer issues of bad practice and abuse to management, as well as an explanation of their legal right to employment protection under the Public Interest Disclosure Act 1998 when highlighting these issues in good faith. White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 16 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, 25 & 26 The environment at White Gables is safe and well maintained, with relevant risk assessments and cleaning routines. Cleanliness and hygiene standards are routinely kept to a high standard, although one recommendation has been made regarding the provision of disposable hand towels in communal bathrooms. EVIDENCE: The home was constructed on three floors with the southern aspect of the home facing the promenade, gardens and lawns. Several of the bedrooms and communal areas afford the occupants extremely pleasant sea views. Since the last inspection one extra room has been fitted with en-suite facilities. The home’s ongoing programme of redecoration has resulted in the premises continuing to provide clean, well appointed and furnished accommodation to service users. The home provides access to all areas of the home. The home was clean and hygienic on the day of the inspection, with no unpleasant odours noted, and all areas fresh and well ventilated. Cotton hand White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 17 towels were present in some of the bathrooms and toilets. It is recommended that disposable hand towels would enhance the quality of hygiene control within the home. The proprietors had ensured that all of the radiators were covered as a safety measure. White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 18 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, 28, 29 & 30 The staffing levels at this home are sufficient in terms of numbers to ensure service users needs are met. Staff training is provided in a range of areas relevant to the care of people whose needs fall within the home’s category of registration, however, a shortfall was noted in relation to medication training and a requirement was made in respect of this. Staff recruitment practices ensure service users’ safety. EVIDENCE: The staffing levels at the home were agreed with the Commission for Social Care Inspection at the time the home increased it’s capacity in November 2004. The examination of the rota, and information provided by the home at the time of the registration confirmed that 767 hours of care staff time are allocated to service users per week. This is in excess of the number identified as the minimum required by the staffing forum guidance, issued to care homes. Information provided as part of the pre inspection material confirmed that 17 of care staff hold the NVQ level 2 or above, with a further 9 currently undertaking the training at either level 2, 3 or 4. This will take the total percentage of care staff with the required training up to over the 50 identified in the National Minimum Standards. 4 staff files were examined. All the information required by regulation was present, confirming the recruitment arrangements in place offered sufficient protection for service users. White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 19 A central staff training record was maintained, which confirmed that staff receive routine induction and foundation training, as well as ongoing training in areas including, manual handling, fire prevention, food hygiene, COSHH, promotion of continence, dispelling the myths of the funeral profession, 1st Aid, MRSA, supervision & appraisal and diabetes care. Some of the members of staff, identified in the pre inspection material as having responsibility for the administration of medicines, did not have any medication training identified on their training records and the home must address this. One of those responsible for administering medication had received training in a previous post, however, upon discussion, it was clear that the previous post was specifically related to a particular client group, whose needs were not the same as those occupying this home. White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 20 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) 33, 35, 36 & 38 The home’s quality assurance systems provide the basis for ensuring the home is run in the best interests of service users, whose views will be sought and acted upon. The financial interests of service users are protected through robust recording procedures. Staff supervision arrangements were found to be marginally below the levels required to fully meet the outcome of the standard. EVIDENCE: The home had recently been granted “Investors in People status”, demonstrating that the staff management arrangements in place were sufficient to meet the needs and responsibilities of staff and management alike. The home had a quality assurance system, based on questionnaires and seeking the views of service users on an ongoing basis. White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 21 Individual service users finances, held at the home were stored securely in the office safe, with appropriate records kept. A sample of records were examined and found to correspond with the monies held. Feedback from staff confirmed that care staff were receiving supervision at regular intervals, although the frequency of supervision provided to senior staff was not recorded as occurring at 2 monthly intervals as identified in the National Minimum Standards. Records of servicing contracts and waste disposal arrangements were present at the home. Fire extinguishers were identified as having been services within the last 12 months. Records of fire drills and fire prevention seminars were both present and demonstrated that all staff had access to fire safety training. White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 22 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 x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 3 x 3 2 x 3 White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 23 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 7 Regulation 13(4) Requirement The registered persons must ensure that care plans include clear guidance for staff in relation to the size of sling required when service users need a hoist for transferring. The registered persons must ensure that all staff who administer medication have received relevant training. Timescale for action 15/8/05 2. 30 18(c)(i) 15/9/05 3. 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 Good Practice Recommendations White Gables Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection St Vincent House Cutler Street Ipswich Suffolk, IP1 1UQ 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 Residential Home v218322 i54-i04 s24525 white gables v218322 050621 stage 4.doc Version 1.30 Page 25 - 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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