Care Home: Gallimore Lodge

What the care home does well The team at the home care for the residents well and are proactive in relation to their health care. The care planning and management of care is well recorded. The home is clean, safe and inside, well maintained. The residents benefit from a stable staff team who have a good skill mix and are generally well trained. What the care home could do better: The team need to work on improving the provision of a more varied in house activity programme for individual residents. Risk assessments for the use of bed safety rails should be completed and the fire safety risk assessment should be kept under regular review. Random inspection report Care homes for adults (18-65 years) Name: Address: Gallimore Lodge Meesons Lane Grays Essex RM17 5HR two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Diane Roberts Date: 2 9 0 4 2 0 1 0 Information about the care home Name of care home: Address: Gallimore Lodge Meesons Lane Grays Essex RM17 5HR 01375396174 01375396174 gallimore.lodge@familymosaic.co.uk www.familymosaic.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Family Mosaic Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 8 Excluding any person who is liable to be detained under the provisions of the mental Health Act 1983 Date of last inspection Brief description of the care home Gallimore Lodge is a purpose built double bungalow situated on a private residential road in Grays. Public transport by both rail and bus is available approximately one mile away. The home has its own minibus. The accommodation consists of single bedrooms with lounge, dining room and kitchen facilities. Appropriate bathroom and toilet facilities are also available. The home has its own car parking facilities and a garden area is also made available for the use of residents. Care Homes for Adults (18-65 years) Page 2 of 9 Brief description of the care home The home provides nursing and personal care for 8 adults with learning disabilities. Services provided include personal, psychological, social, emotional and educational care by a multidisciplinary team and enabling residents to remain as independent as possible. Residents are actively encouraged to participate in leisure pursuits within the local community but formal day care placements which were provided by the local Social Services Department, are no longer available. The Service User Guide and Statement of Purpose are available for residents or their representatives. The current range of fees are between £71.15 and £110.30 per week for rent charges and a block payment arrangement is in place with the local funding authority which covers the remaining fees. The Registered Provider also contributes £250 a year, (per resident) towards holiday expenses. Residents are responsible for extra charges to cover items such as hairdressing, newspapers/magazines and toiletries. Care Homes for Adults (18-65 years) Page 3 of 9 What we found: The service user guide was updated in March 2010. It is primarily aimed at relatives due to the dependency levels of the residents. The manager is aiming overall to use more pictorial methods of communication with any information that is for residents to read. We reviewed a care plan at random. Since being in post the manager has expanded the care plan records and these now include more monitoring tools such as a monthly risk assessments in relation to pressure areas and nutritional screening. This is positive and appropriate in relation to the age and dependency of the residents living in the home. The manager also plans to introduce a pictorial content to some aspects of the care plans for specific residents who can have an active input. The care records and care plans were detailed, written in the first person and were quite person centred. For example, the plan we saw had a good social profile and family history, detail on how the resident communicates, the choices that they are able to make in relation to their dependency and what their interests are and how they like to spend their time. The care plans were seen to be up to date and there was evidence of reviews with placing social workers. The care plans have short and long term goals and daily notes are in place for every care plan and this enables a full evaluation to take place. Residents have a yearly activities plan in place that include key events such as holidays etc. This year residents are going to Norfolk where specially adapted bungalows have been rented. Residents also have an individual weekly activities plan in place and records seen show that this includes, shopping, swimming, family visits, lunches out with friends, cooking, painting, karaoke and the cinema. These are kept under review and the manager is working with staff to develop the in house activities more, as overall this is the weakest area with staff identifying basic activities instead of thinking in a more proactive and expansive way. Residents also visited friends at other homes in the group for activities. Educational activities are limited due to the dependency of the residents. Where possible residents are helped and encouraged to take part in daily living activities and, for example, one resident likes to help in the office and with washing up etc. The provider has an allotment in Colchester and residents from the home are going to visit in order to get ideas for their garden. Residents are involved in food shopping for the home and the menus are planned around residents preferences. Themed nights have recently been held at the home and this means that residents are experiencing food from other countries. The manager is currently in the process of working with the pharmacist to ensure that where those residents who take their medication in their food, the medication is still viable. Where appropriate risk assessments will be completed. Within the care plan, the manager has put in place very good, detailed transfer sheets for, if/when the resident needs to go to hospital, so that hospital staff are aware of their needs and abilities. The manager would send staff to the hospital, if required, at mealtimes etc. to ensure that the resident got the input that they needed. The care plans showed evidence of medical reviews and input from dietitians etc. The manager has also been completing mental capacity assessments. Care Homes for Adults (18-65 years) Page 4 of 9 Residents have a range of risk assessments in place and this now includes nutritional risk assessments. Residents are being weighed regularly. Risk assessments need to be considered for those residents using bed safety rails to see if the rails themselves are safe to be used for the individual resident. A complaints procedure is in place in the service users guide and around the home. This needs updating to ensure that the procedure is correct and that people can refer their complaint, if they wish, to their referring authority. A pictorial version is displayed in the home. The manager has a system in place for logging complaints although no complaints have been received in the last 12 months. We walked around the home with the manager. The home was clean and tidy and no odours were noted. The decor and furniture are in good order. The bathrooms were somewhat clinical and could be made more homely and pictures put up on the walls could be at a height that residents could see them. Since we last visited a new central heating system has been installed. Some bedrooms have also been redecorated and rooms were seen to be personalised including the choice of colour. Records in relation to fire safety were checked and found to be in order. A risk assessment is in place but this requires a review as it was last check in March 2009. The manager plans to update some areas of the garden, including two large raised beds which are currently left unkempt. The manager plans to train staff soon on the Essential Steps of Infection Control and she has the resources necessary to undertake this in house. The current staffing levels are 3/4 staff during the day , including a trained nurse and 2 at night. The team try to be flexible with the staffing levels and these are adjusted in relation to activities and shopping days etc. The managers hours are in addition to this. Out of the 10 care staff working in the home, 4 have achieved an NVQ qualification and 3 are working towards this, which should bring the home over the desired 50 standard. The manager has qualified nursing staff working at the home, who have a good skill mix as they are trained differently, having qualified in mental health, general nursing and learning disabilities. Staff turnover at the home is low. Occasionally there is agency use and we checked that the manager has the staff profiles in place that are required in order to check that the person is suitable to work in the home. These were in place. The manager has increased the level of staff supervision in the home and says that she is up to about 80 compliance and is on line to achieve 100 . The manager supervises the nursing staff and any new staff until their probationary period is over. There is recorded evidence of staff supervision in the staff files along with personal development plans. Staff files were reviewed in order to check the recruitment procedures for the home. Overall the recruitment process was sound with applicants having all the required checks and documentation in place. Interviewers should evidence that they have explored any gaps in employment with the applicant where appropriate. Records showed evidence of staff induction. Staff training records were reviewed and overall compliance with training is good. The manager said that she is working on improving the level of training with bank staff who Care Homes for Adults (18-65 years) Page 5 of 9 occasionally work at the home. Staff training in relation to nutritional care and monitoring may be of value as the residents in the home get older and often have more complex needs and activity based living in order to get staff to think more about what they could provide in this area. The manager informed us that an update session is planned in relation to the protection of vulnerable adults and from the records, this would be recommended. The manager has been working in the home nearly a year, seconded from another home in the group. She has recently been confirmed as the manager of the home and plans to apply for registration soon. She has completed the registered managers award and is undertaking the NVQ in care management. Records were seen that show that the Regulation 26 monthly reports are now being done by the provider. It was possible to see the results of the most recent satisfaction surveys. These showed that overall people are satisfied with the facilities and services at the home. The manager has an action plan in place to cover information and communication with residents, themed activities to support diversity, improvements to the garden and the encouragement of family member involvement in the home to to support residents. The manager is also planning to restart relatives meetings if possible and is going to write to them in the near future for their thoughts on the matter. The accident book was reviewed and this shows that accidents are minimal at the home and staff complete the records fully. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 9 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 12 19 24 Develop the in house activities programme for individual residents. Undertake risk assessments in relation to the suitability of using bed safety rails. Keep the fire safety risk assessment under regular review. Care Homes for Adults (18-65 years) Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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