Care Home: Gorselands

What the care home does well The service is well managed, and offers a homely environment for the residents that have chosen to live there, and they are supported by a well trained staff team. Facilities are available to ensure that all their needs can be met, and these needs are detailed in individual care plans. A range of activities and events are available, and peoples likes and dislikes recorded in their care plans, and for those who do not choose to take part in the more organised activities, individual time is spent with them A good range of home cooked food is served, and choices are available at all meal times. Residents and their families are able to make their likes and dislikes known to staff, and changes have recently been made. to reflect this. What has improved since the last inspection? Since our last inspection, the care plans in use in the home have been reviewed, and now contain more detail about the social likes and dislikes of the residents, as well as showing how the person themselves contributed to their plan. An activity worker now spends one afternoon a week on specific activities for the people living in the home, as well as some one to one activities for those unable or unwilling to join in group activities. Since our last visit, residents have become more involved in decisions affecting their everyday lives, through annual quality surveys, residents meetings and care plan reviews, and changes have been made in response to this consultation, for example a quarterly newsletter, availability of fruit at any time and changes to the menus. What the care home could do better: Over the coming months, continued refurbishment of the home will take place, and as rooms are vacated they will be redecorated. The service should ensure the accuracy of records, and ensure that staff remain up to date will all training. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Gorselands 25 Sandringham Road Hunstanton Norfolk PE36 5DP     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alan Buttery     Date: 2 4 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Gorselands 25 Sandringham Road Hunstanton Norfolk PE36 5DP 01485532580 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : RSIVA91@hotmail.com Cieves Limited care home 21 Number of places (if applicable): Under 65 Over 65 21 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Gorselands is a care home providing personal care and accommodation for up to twenty-one older people. The home is privately owned by Cieves Limited. Gorselands is located in the seaside town of Hunstanton and is adjacent to all facilities. It is a large detached property and provides accommodation on the ground and first floors. There are 17 single rooms and two double rooms. Eight of the bedrooms have en suite toilets. A shaft lift allows easy access to the first floor There is a large paved car parking area at the front of the home. The gardens, which are well maintained, have a range of ornamental flowers and a fountain feature. The garden at the rear of the home is suitable for wheel chair users. Mrs Siva confirmed that the current fees are between #362:00 and #440:00. There are additional charges for items such as hairdressing, private chiropody and personal items. A copy of the last inspection report is available on request. Care Homes for Older People Page 4 of 25 Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection, carried out over a period of about four hours. During our visit, we were provided with information and records required by the manager of the service, and were also able to speak to a number of residents and staff members, whose views are reflected within the report. An Annual Quality Assurance Assessment (AQAA) was also submitted prior to our visit, and a number of residents and staff completed our survey forms, and again all of these have been used in compiling the report. Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? 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 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prior to anyone moving into the home, a detailed assessment is undertaken, to ensure that the identified needs that person has can be met in a way suited to the individual. Evidence: The service continues to ensure that a full assessment is undertaken before any new resident moves into the home, which is generally undertaken by the manager of the service who would usually visit the person in their own home, or in hospital If it is not possible to carry our their assessment with the prospective resident, then information would be obtained from the family and from any other health or social care professionals involved in that persons support package. Initial referrals come either directly from the prospective resident or family or from the local health care team, and many of the residents come from the local area, or have Care Homes for Older People Page 10 of 25 Evidence: family living locally. A number of respite cases have been admitted in the past 12 months, some leading to a permanent placement, but the same process is followed irrespective of the planned duration of the stay. We looked at four individual plans, and these showed evidence of the pre admission assessment and initial care planning that had been done. The service does not offer intermediate care. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual plans are in place that show how the individual residents can expect their needs to be met, and how they participate in the planning of their care. Evidence: Once the person has moved into the home, the initial care plan that has been prepared in readiness for their move is reviewed again, to ensure that the needs identified in the initial assessment are still applicable, and the care to be given meet the requirements of the individual. Likes and dislikes are discussed to ensure that activities suited to the individual can be provided, and that their individual food preferences, and routines are known. The plans are discussed with individual residents or their families every month to ensure that they are still relevant to that persons needs, and changes made if necessary. Care Homes for Older People Page 12 of 25 Evidence: The individual files that we examined during the inspection, all showed the plans that are in place and that they have been discussed with the resident involved. Staff record daily tasks of living and any health visits also noted, and families kept informed. The service has a good relationship with their local surgery, and access to a range of health professionals as required. They should however ensure that health recording is in place for all residnets, as one of the records we examined did not show the initial weight of the person, who had recently been admitted. Medication procedures are in place, and should anyone choose to look after their own medication, the service would offer appropriate support, and ensure that such practice was safe. Medication is audited two weekly to ensure accuracy. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers a range of activities and events suited to the likes and dislikes of residents, and residents living in the home have a choice of well presented and nutritional home cooked food. Evidence: As discussed earlier, the likes and dislikes of the individual are discussed when they move into the home to ensure that activities that are suited to them are available, wherever possible. A good range of activities and events are arranged, including the traditional Bingo and games as well as musical entertainment. The home also arranges exercises and music to movement sessions on a regular basis, visits from a pat a dog scheme, and a local choir and bell ringers have visited the home to entertain the residents. The home has a monthly Holy Communion for those who wish to participate, although many have chosen not to take part. Visitors are made welcome at all times, and regular relatives and residents meetings Care Homes for Older People Page 14 of 25 Evidence: are held. One of the main topics at these meeting is always the food, and menus are discussed and changes introduced, for example bowls of fresh fruit are now provided in the lounge areas and cheese and biscuits introduced as an option for deserts and tea time meals. A good range of home cooked food is provided with choices always available, and particular dietary requirements identified and met, with diabetic and gluten free options available to meet the specific needs of some of the residents. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures are in place to ensure that any concerns, complaints or allegations are dealt with and residents know who they should speak with to make any concerns known. Evidence: The service continues to have a suitable complaints procedure, which has been reviewed in the past year, and everyone living in the home is familiar with their procedure,and who they should speak with if they had concerns. A log of all complaints is maintained which was viewed during our visit. Over the past year the service have not received any complaints, and minor concerns are quickly dealt with. During our inspection, we were able to speak with some of the residents, and they told us that they were happy with the process and knew who they should speak with if they did have a problem. Safeguarding procedures are in place, and all staff receive suitable training, and regular updates, although no issues have been reported in the past year. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides spacious accommodation for the residents which is well maintained, clean and safe. Evidence: Since our last visit, a number of bedrooms have been redecorated, and following a visit from the local fire officer, the office door relocated. We looked around the building, and at some of the individual rooms (with the permission of the residents) and these were all well equipped, and it was obvious that people are allowed to bring their own possessions and some furniture with them. The service employs specific domestic staff and the home was clean and free from any odours on the day we visited. Residents that we spoke to on the day were all happy with the facilities provided, one gentleman telling us he had lived in 26 different home during his life, and this was the best he had ever lived in. Since our last visit, the rear staircase, which we felt may be a hazard has had gates installed at the top and bottom. Care Homes for Older People Page 17 of 25 Evidence: The home is in attractive grounds which residents are able to access, and close to local facilities. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment processes and appropriate training ensure that people living in the home are supported by suitable staff. Evidence: The service operates with at least 3 care staff during the morning and 2 in the afternoon, along with a wake in night carer and a second support person sleeping on the premises. Recruitment procedures were discussed with the manager and proprietor, and staff records examined, and these showed that the required employment checks are made before any new staff are employed. The records also included details of the training undertaken by staff, and along with a training plan in the office, this ensures that all staff are receiving the required mandatory training as well as other more specific training based on resident need, such as diabetes. Most of the staff working in the home have already completed NVQ training to at least level 2, 2 staff have level 3 and the manager has a level 4 qualification. One of the senior staff is also about to undertake her level 4 NVQ training. Care Homes for Older People Page 19 of 25 Evidence: Residents that we spoke to told how well the carers look after them, and how they always knock at doors before going into their room, and this was observed during our visit. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run, and people living in the home are able to make their views known in a variety of ways and are involved in day to day choices and decisions that affect their lives. Evidence: The manager of the service, who has worked in the home for the last three years, is experienced and well qualified for the role. In the past year, the process of supervision and staff appraisals has improved, and more regular Staff and Resident/Relative meetings are held, which were discussed during our visit. The service also undertake an annual quality assurance survey, and this , together with the regular meetings, does ensure that the service is aware of the views of their residents, and also means that the residents are able to contribute to changes that are Care Homes for Older People Page 21 of 25 Evidence: planned. People that we spoke to during our visit all felt the home was well run, and that their needs were being met, and also felt the staff treated them with a lot of dignity and respect. Health and safety procedures are in place to ensure the safety of people living and working in the home, which is supported by regular maintenance on the building from the homes handy,man and ongoing health and safety training for staff. The AQAA indicated that all the required maintenance checks on equipment are all up to date and that procedures are in place to manage and control any infectious outbreak. Care Homes for Older People Page 22 of 25 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 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, Care Homes 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 8 Weight records should be taken for everyone on admission, to ensure any change of significance is monitored and necessary action taken. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!