Care Home: Gables Residential Care Home Ltd

What the care home does well Generally the home was found clean, warm, well lit and free from unpleasant odours. The atmosphere of the home was noted to be relaxed; individuals living in the home looked well cared for in their homely environment. Staff were interacting with service users in an informal, respectful, personalised and dignified manner. Prospective service users are assessed before admission to the Home and the Home ensures that a Service Users Guide is sent or given to them when they make enquires to enable them to make an informed choice about moving to the Home. Individuals and their relatives are informed on admission about the onemonth trial period to enable them to make a decision whether to stay. In order to ensure adequate nutrition for residents, good meals are provided and are not hurried. One service user told the inspector " food is very good, plenty of choice. It is beautifully cooked and attractively presented. We all have likes and dislikes and it is all catered for. There are a lot of vegetables and fruits". The Home provides varied meaningful and stimulating activities and outings for the residents and ensures that individual interaction is provided as a routine and as necessary. The home has a well-established team of care staff and generally a stable work force that treats the service users with respect.One comment card received from a relative states "Gables Residential Home is run efficiently in all respects. The carers are extremely kind and each resident is treated with dignity and respect that is of utmost importance to people of advancing years. In fact as far as visitors are concerned it appears to "Run by Clockwork". To further help us make judgements about the services provided at the home we sent comment cards to the relatives of people who use the service and also people from the outside who visit the home for various reasons. The comments they sent to us are written below: "I am more than satisfied with my mother`s care". "Residents of the home always look happy and well looked after. The staff are helpful and cheerful, communicate well and address any problems that arise to the best of their ability". "I feel that mum is much happier in the home than she could have imagined. She didn`t want to leave her home and we delayed it as long as possible till crisis happened. It has been an enormous relief to us as a family that she is in such a loving and caring environment that welcomes us too". "All aspects of care are first class. Residents are treated as individuals. The residents/staff relationships couldn`t be better". "There is a lovely, homely, friendly atmosphere with plenty of activities for the residents". "The care home is excellent in looking after the residents. Nothing is too much trouble for them. Their attitude towards the residents is thoughtful and kind. It`s a very warm and welcoming place". People using the service are always given written notice of social events and are kept up to date with things in the Gables newsletter. What has improved since the last inspection? The home told us in the Annual Quality Assurance Assessment that it had purchased new dining room furniture that has improved the area. All halls have been decorated, along with the service users` rooms. A handyman had been employed recently to ensure regular on-site maintenance and decoration are regularly undertaken. The home manager also told us that the home had purchased new beds new curtains, new chairs, new television, new washing machine and made improvements to the garden to ensure that people who use the service are comfortable and feel at home. The home has developed new care review methods that include bath rotas to check when an individual had a bath or shower. What the care home could do better: To ensure that an individual`s needs are adequately met, care plans must be developed in line with assessments undertaken by the home and Social Services and in agreement with the individual concerned in a way that they are confident that the home is able to meet their needs. The manager stated that care plans for the identified needs would be written before the report is completed. The information was received and was found satisfactory. To minimise accidents to identified individuals, the accident must be followed up and the risk assessments reviewed. The risk assessments have been reviewed and care plans completed/reviewed where necessary. To ensure that the people living in the home are adequately protected the generic risk assessment must include the lounges and the dining area. CARE HOMES FOR OLDER PEOPLE Gables Residential Care Home Ltd 1a Sydenham Way Hanham Green South Glos BS15 3TG Lead Inspector Grace Agu Key Unannounced Inspection 11th December 2007 09:15 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 Gables Residential Care Home Ltd DS0000003397.V352136.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. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gables Residential Care Home Ltd Address 1a Sydenham Way Hanham Green South Glos BS15 3TG 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) 0117 914 0799 0117 914 0799 annaubrey1960@yahoo.co.uk Gables Residential Care Home Limited Ms Ann Katharine Aubrey Mrs Linda Marie Cooke Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 20 persons aged 65 years and over requiring personal care only 9th May 2007 Date of last inspection Brief Description of the Service: The Gables Care Home provides personal care for up to 20 residents aged 65 years and over. Mr David Cooke owns the home. Mrs Ann Aubrey is the registered Manager. The home is situated in a suburb on the eastern outskirts of South Gloucestershire. There are shops, a post office and public house nearby. The home is close to Avon ring road and the motorway network. The home has a purpose built extension providing bedrooms and utility areas. There are attractive communal areas. The well-maintained garden extends to the front and back of the building and includes a courtyard space and sitting areas. The residents have individual rooms with en suite facilities and these exceed the spatial National Minimum Standards. Fees range from £450 to £650 per week. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit which was undertaken as a part of key inspection over eight hours to review the requirements made at the last inspection and also to review the care practice to ensure that it is in line with the legislation and that best practice is followed at the home. At the last inspection one requirement was made in relation to care planning. It was pleasing to note that the home has made efforts to ensure that the requirement had been met. I met with Mrs Aubrey, the home manager. Whilst touring the building. I spoke with a number of service users, staff, one relative and a number of records were viewed. What the service does well: Generally the home was found clean, warm, well lit and free from unpleasant odours. The atmosphere of the home was noted to be relaxed; individuals living in the home looked well cared for in their homely environment. Staff were interacting with service users in an informal, respectful, personalised and dignified manner. Prospective service users are assessed before admission to the Home and the Home ensures that a Service Users Guide is sent or given to them when they make enquires to enable them to make an informed choice about moving to the Home. Individuals and their relatives are informed on admission about the onemonth trial period to enable them to make a decision whether to stay. In order to ensure adequate nutrition for residents, good meals are provided and are not hurried. One service user told the inspector “ food is very good, plenty of choice. It is beautifully cooked and attractively presented. We all have likes and dislikes and it is all catered for. There are a lot of vegetables and fruits”. The Home provides varied meaningful and stimulating activities and outings for the residents and ensures that individual interaction is provided as a routine and as necessary. The home has a well-established team of care staff and generally a stable work force that treats the service users with respect. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 6 One comment card received from a relative states “Gables Residential Home is run efficiently in all respects. The carers are extremely kind and each resident is treated with dignity and respect that is of utmost importance to people of advancing years. In fact as far as visitors are concerned it appears to “Run by Clockwork”. To further help us make judgements about the services provided at the home we sent comment cards to the relatives of people who use the service and also people from the outside who visit the home for various reasons. The comments they sent to us are written below: “I am more than satisfied with my mother’s care”. “Residents of the home always look happy and well looked after. The staff are helpful and cheerful, communicate well and address any problems that arise to the best of their ability”. “I feel that mum is much happier in the home than she could have imagined. She didn’t want to leave her home and we delayed it as long as possible till crisis happened. It has been an enormous relief to us as a family that she is in such a loving and caring environment that welcomes us too”. “All aspects of care are first class. Residents are treated as individuals. The residents/staff relationships couldn’t be better”. “There is a lovely, homely, friendly atmosphere with plenty of activities for the residents”. “The care home is excellent in looking after the residents. Nothing is too much trouble for them. Their attitude towards the residents is thoughtful and kind. It’s a very warm and welcoming place”. People using the service are always given written notice of social events and are kept up to date with things in the Gables newsletter. What has improved since the last inspection? The home told us in the Annual Quality Assurance Assessment that it had purchased new dining room furniture that has improved the area. All halls have been decorated, along with the service users’ rooms. A handyman had been employed recently to ensure regular on-site maintenance and decoration are regularly undertaken. The home manager also told us that the home had purchased new beds new curtains, new chairs, new television, new washing machine and made improvements to the garden to ensure that people who use the service are comfortable and feel at home. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 7 The home has developed new care review methods that include bath rotas to check when an individual had a bath or shower. 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. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The process of admission of prospective residents is comprehensive, detailed and well planned to enable residents to make a positive choice of moving to the home with the assurance that their needs will be met EVIDENCE: One care file of a recently admitted service user viewed contained preadmission assessment information on activities of daily living and other relevant information to enable staff to support the person in order to meet her needs. The individual confirmed at a discussion that the home manager and her deputy visited her in hospital and that she also visited the home twice before coming to live at the home. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 10 The individual stated that she is happy at the home and that her needs are adequately met. “They meet my needs over and above the call of duty”. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers support to residents throughout their lives and towards the end; it also protects residents by reviewing their health needs, appropriate drug administration and satisfactory care planning documentation. EVIDENCE: One of the completed care files viewed contained pre-assessment information, activities of daily living, likes and dislikes of the resident, Dr’s visits and medical history. Individuals spoken with stated that they chose when they wake and when they retire. Two people spoken with stated that staff respected their privacy and dignity when providing them with personal care. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 12 The records seen were able to give staff clear information on how individuals at the home are supported in areas of personal care as well as individual’s social, emotional and physical support requirements. These are followed up by monthly reviews and intervention as needs change. One of the completed care files showed evidence of professional visits, to include General Practitioner, Chiropodist, Optician, Dentist and Community Psychiatric Nurse (CPN). Whilst touring the building the inspector met a service user who was admitted six months ago with both physical and mental health needs along with other specialist medical condition. The pre-admission assessment identified clearly the needs of the individual to include right-sided paralysis due to significant stroke and depression. However no care plan was seen in the care file to enable staff to support the person in meeting the identified needs. The manager stated that care plans would be put in place for the identified needs before the report was completed. Procedures for medication administration, handling, records and storage were assessed. The home had policy and guidelines on medication. A local pharmacy provides medication using a monthly monitored dosage system. A check of the blister packs indicated that medication had been administered as recorded. All medication seen was stored securely. A Medicines trolley is used to transport medication around the home. The home has a medicine fridge and temperatures are recorded daily. Controlled drugs were stored correctly and recorded in a register. A policy is available to enable residents to look after their own medicines. All medication is ordered and received by staff. The pharmacy supply printed medicines administration record sheets each month. Records of administration of medicines were clear. Records are kept of medicines received into the home. Waste medication is recorded and disposed of via the supplying pharmacy. The home has a Death and Dying policy and procedure to enable staff to care for people who use the service in the event of a terminal illness and at death. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home enables the residents to maintain contact with families, friends and the local community. It provides meaningful activities and choice in respect of meals and meal times. EVIDENCE: People living at the home told us that the home provides them with weekly activities information in a newsletter to enable them to decide which activities to attend. Evidence from the records we looked at showed that the home had activities and entertainment for the Christmas season to include 07/12/07 Cheese and wine party, 09/12/07 Church Service, 12/12/07 creative skills with Glaze and Shine, 13/12/07 Sing Along with Danny, and 14/12/07 Service users, Friends, family and staff for the Gables Grand Christmas meal at Woodford Lodge. Other activities noted include Annual mince pies and mulled wine evening with Andy for friends and families on 17/12/07 and a game of bingo on 24/12/07. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 14 People we spoke with told us that they enjoyed the activities provided at the home and that their relatives, friends and families visit the home regularly and at any time. One person “My son comes regularly, he lives not far from here, another individual told us that that her daughter visits every weekend and some times took her out. People living in the home spoken with on the day told us that they have a choice of when to get up and when to retire and would have their breakfast in bed or in their rooms if they wanted to. One individual stated that she usually gets up to go down to the dining room for breakfast with few other people and that this was her choice. The menu for the day was noted displayed on the residents’ notice board in the small lounge and the dining room. The lunch menu on the day included Chicken breast with new potatoes or Ham salad followed by assorted deserts The home stated in the Annual Quality Assurance Assessment that service users have a choice of menu at breakfast and teatime also and that hot drinks are available day and night. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are enabled to complain and are confident that the home is able to protect them from abuse. EVIDENCE: The home has a complaint procedure, which is displayed, at the entrance hall. The complaint procedure has information about the Commission for Social Care Inspection (CSCI) to enable residents and their representatives to contact the Commission if they were not satisfied with the outcome of their complaint. People spoken with on the day stated that they would complain to the manager if they had any concerns. No complaint was noted in the complaint book viewed. The manager stated that staff would normally record any complaints/ concerns in the communication book and she would transfer it into the complaints book. This is to ensure that all complaints are dealt with and action taken where necessary. The home has a Whistle Blowing policy to enable staff to report any bad practices without fear of any reprisal and staff files showed evidence of training on Protection of Vulnerable Adults. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 16 It was also noted that Criminal Record Bureau disclosures have been obtained for recently employed staff members before commencement of employment to ensure that the people who use the service are adequately protected. Records of service users’ monies viewed tallied with the amount in the individual accounts in the safe. People spoken with stated that they felt safe at the home. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a safe well-maintained environment where residents feel happy to live. EVIDENCE: The home is situated in a suburb on the eastern outskirts of South Gloucestershire. There are shops, a post office and public house nearby. The home is close to the Avon ring road and the motorway network. The home has a purpose built extension providing bedrooms and utility areas. There are attractive communal areas. The well maintained gardens extend to the front and back of the building and include a courtyard space and sitting areas. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 18 The service users have individual rooms with ensuite facilities and these seemed to exceed the spatial National Minimum Standards (not measured). Service users rooms seen whilst touring the home looked clean and pleasantly tidy with personal objects displayed and in use. The rooms appeared well maintained in a domestic style of decoration. The home was found clean and tidy and some residents were noted relaxed and enjoying each other’s company in the lounges. There is an infection control policy in place. The manager told us at the visit that all halls have been decorated along with service users’ rooms. The home manager stated that staff found it easier to deal with any maintenance work with the newly employed handyman on site. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment procedure of the home is robust and offers protection to residents at the home. There are adequate numbers of staff that are competent to meet the needs of the service users. EVIDENCE: The home has a robust recruitment procedure to ensure that suitable staff are recruited to meet the needs of people living in the home. Record of one recently employed staff member contained required information to include personal details’ previous employment details, two satisfactory references, Criminal Records Bureau disclosure and relevant qualifications. The Home manager stated that five care staff have achieved NVQ level 2 in care two staff members have commenced NVQ level 3, one staff member has almost completed NVQ level 3 All staff have completed fire awareness update. Ten staff members have completed safe handling of medicines accredited training from City of Bath College. The home has booked Food Hygiene, First Aid and Manual Handling training updates for all staff for January 8 2008. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 20 All staff have also completed Protection of Vulnerable Adults from Abuse Training update. This is commendable. In relation to induction training for new staff members, it was pleasing to note from the records that the home has adopted the Skills for Care Induction and foundation training programme to ensure that new staff are well equipped with their responsibilities of meeting needs before working with service users in an older peoples’ setting. Topics noted in the programme include ‘Understanding the Principles of Care, Safe Working Practices and Understanding the Organisation and the Role of the Worker’. One staff member spoken with confirmed that she had attended training courses to enable her to perform her duties effectively. Individuals living at the home stated that staff are very kind and are sensitive to their needs. Some of the comments we received from the people who live at the home and their relatives and visitors include: “The staff are very helpful and cheerful, communicate very well and address any problems that arise to the best of their ability”. “The staff are caring, supportive, friendly, sympathetic to service users’ needs.” “I feel that my mother gets a very high level of attention from the friendly staff team at all times”. “I am always amazed at the kindness and concern shown to my mother by all the staff at the Gables. Their willingness to help and respond to her demands goes well beyond the call of duty”. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33 35 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is supported by the registered provider and staff to provide clear leadership at the home. All staff demonstrate understanding and awareness of their roles and responsibilities to the needs of the service users. People living at the home are protected by satisfactory health and safety measures. EVIDENCE: On the day of inspection there was a good, friendly interactive atmosphere at the home. Residents looked well care for and were interacting with staff in an informal and friendly way. Staff and residents spoken with were complimentary about the manager’s ability to manage the home. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 22 Service Users spoken with stated, “Ann is very good, Ann is a nice person, Ann is very good manager. Staff are very kind, ”One staff member spoken with, stated, “ Ann is very good, very caring, approachable and will listen to your concerns”. Some of the comments we received from relatives about the manager include: “Mrs Ann Aubrey is always available to answer any questions”. “The manager Mrs Ann Aubrey is always willing to listen and spend time talking to you and is always reassuring”. Mrs Ann Aubrey has many years senior management experience in a care setting. Mrs Aubrey has a qualification at level 4 NVQ and has undertaken other statutory training to include, Manual Handling and Protection of Vulnerable Adults from Abuse update. The manager stated that she is supernumerary but helps out on the floors to enable her to discuss issues with service users. There was evidence of regular staff and service users meetings. Records evidenced that the last residents’ meeting was on 14/11/07 issues discussed includes, Christmas entertainment. Also the last staff meeting was on 16/10/07 and issues discussed included Medication, communication book report writing and service users’ needs. The home had a generic risk assessment in relation to various areas of the home to include the stair lift and front door steps. The manager stated that the dining and lounge areas would be undertaken to ensure that people living in the home are adequately protected. The fire logbook was found up to date and well maintained. There is evidence that staff have attended regular fire drills. Maintenance book is also up to date. In relation to other health and safety measures, there was a. central heating check on 26/06/07. Portable fire safety appliances were checked on 6/12/07. The Liability insurance is current and the nurse call system was checked on 12/06/07. There was appropriate storage and risk assessment of substances hazardous to health. It was agreed that the manager sends a copy of the 5 yearly Electrical Installation Certificate to the Commission for Social Care Inspection. Accidents to service users were recorded. It was agreed that all accidents need to be reviewed following falls and where appropriate care plans and risk assessments reviewed to ensure that the individuals are adequately protected and to prevent further occurrences. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 23 The home’s Quality Assurance systems were reviewed. The manager stated that the home assesses the quality of its services through questionnaires to residents, relatives, visitors and health professionals visiting the home and health and safety audits. The manager stated that she visits the resident’s daily and talks to them on a one to one basis regarding their care and any other concerns that they may have. The Home regularly sends Regulation 26 monthly visit reports from the provider to the Commission for Social Care Inspection The October report contained details of different aspects of the service reviewed and actions to be taken on problems identified. The Service Users care reviews from Social Services enables the home to receive feedback on the care provided to individuals living in the home. The home also has a newsletter to inform residents and relatives of things happening at the home. A relative’s comment regarding the newsletter include: “They send us a periodic Newsletter about changes in staff, activities in the home, fetes and Christmas plans which helps give an overview of all staff and plans providing the context of daily life through the seasons”. Training and employment practice have already been covered in this report. The manager confirmed that regular supervision of staff was taking place. This was evidenced in the staff records viewed. The home has policies and procedures to include Recruitment of Staff, Complaints, Confidentiality Whistle Blowing and Equal opportunities. Residents’ monies were reviewed and it was noted that the amount recorded in the book corresponded with the amount found in the individual pockets in the safe. All residents’ information was securely locked away. Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 24 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 X 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 3 18 3 3 X X X 3 3 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 X 3 3 X 3 3 3 3 Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 25 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. 1. Standard OP7 Regulation 15 Requirement Ensure that care plans are in place to meet the holistic needs of identified individual. The care plan must be agreed and reviewed as required. Ensure that generic risk assessment includes the lounges and the dining area. Ensure that accident are reviewed and risk assessments are in place in order to prevent further occurrence. Timescale for action 11/01/08 2. 3 OP38 OP38 13 13 11/01/08 11/01/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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. Extracts may not be used or reproduced without the express permission of CSCI Gables Residential Care Home Ltd DS0000003397.V352136.R01.S.doc Version 5.2 Page 27 - 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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