Latest Inspection
This is the latest available inspection report for this service, carried out on 10th September 2009. CQC found this care home to be providing an Good service.
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.
For extracts, read the latest CQC inspection for High Gable House.
What the care home does well Residents told us that they felt that their needs were understood and met. A resident told us, “Staff understands my needs.” Admissions to the home are made on the basis of a detailed initial assessment that makes sure the needs of prospective residents can be met. There have been no new admissions to the home since the last inspection. We found that the needs of the residents had been reviewed by both the home, and their social workers. Residents told us that they had been involved in and receive feedback from their reviews. A resident said, “I had a long chat with High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 my social worker about living here.” Changes in the needs of residents had been addressed to make sure that they receive care that meets the needs. The care plans for the three residents case tracked were detailed and Person centred. The home involves individuals in the planning of care that affects their lifestyle and quality of life. Risk assessments were found to cover all areas that affected the resident’s daily life. Changes to the level of risk had been addressed to make sure that residents were safe. Residents spoken to gave examples of activities. These included going for walks, listening to music attended day centres and church. A resident said, “I like going out for a walk to the shops.” Residents are involved in meaningful daytime activities of their own choice, according to their individual interests and capabilities. The menu is prepared at a regular meeting of residents. A resident said, “The food is ok.” A variety of meals are provided that reflect the individual preferences of residents. Staff explained that residents are encouraged to discuss their views of the home. A resident spoken to said, “I know to tell someone if things are not right.” The home has an open culture that allows residents to express the views and concerns in a safe and understanding environment. What has improved since the last inspection? There were no areas for improvement identified at the last key inspection. Last year an Annual Service Review (ASR) of the service was completed. An ASR is a review of the service and how it is meeting the needs of people who use the service. We found that High Gable House has continued to provide good outcomes for people living at the home. What the care home could do better: High Gable HouseDS0000010676.V377699.R01.S.doc Version 5.3 There are no areas for improvement identified at this Inspection. Key inspection report CARE HOME ADULTS 18-65
High Gable House 292 & 295 Lincoln Road Enfield Middlesex EN1 1SY Lead Inspector
Tony Brennan Key Unannounced Inspection 10th September 2009 11:00 High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 2 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION
Name of service High Gable House Address 292 & 295 Lincoln Road Enfield Middlesex EN1 1SY 020 8804 1115 020 8443 5070 highgable@btinternet.com/kevin.kowlessur@bti nternet.com Mr V Kowlessur 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) Mr V Kowlessur Care Home 9 Category(ies) of Learning disability (9) registration, with number of places High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 4 persons of either sex with learning disabilities in 295 Lincoln Road and 5 persons of either sex with learning disabilities in 292 Lincoln Road. Mr Kowlessur must have regular documented supervision and support from the company until he has successfully completed his NVQ level 4 in management. Two specified service users who are over 65 years of age may remain accommodated in the home. The home must advise the regulating authority at such times as either of the specified service users vacates the home. 10th October 2007 Date of last inspection Brief Description of the Service: High Gabel House is a private care home of two separate semi-detached houses located on either side of Lincoln Road, Enfield. One house has four registered places (No. 295) and the other has five (No. 292). Both houses have similar ground floor layouts, a lounge and dining area with kitchen attached to the rear. Each of the houses has a small front garden and a larger back garden that is partly paved and accessible to users. The home is close to a good selection of shops, restaurants, transport links and other community facilities located along the A10 and within Enfield Town. The fees are between £450 and £600 a week. This report is available through the internet. Copies may also be obtained from the provider of this service. High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means the people who use this service experience good quality outcomes.
This unannounced key inspection was undertaken as part of the annual inspection programme. We sought to confirm that the home continues to provide good outcomes for residents. Prior to the inspection the home had completed its Annual Quality Assurance Assessment. The Annual Quality Assurance Assessment provided us with information about the home and how it was seeking to provide the best outcomes for people. We also looked at any other information we had received about the home since the last inspection. This included any information regarding incidents that the home had told us about. The inspection took place over one day. We were assisted by the registered manager, Mr Kowlessure, with the inspection. We spoke with three residents and two members of staff. We observed care practice and interaction between staff and people living at the home. We toured the building and examined a number of records relating to the care, health and safety and management of the home. At the end of the inspection feedback was given to the registered manager, and areas for improvement were discussed. We would like to thank the staff that assisted us by answering questions about the running of the home. We would also like to thank the residents who discussed their views of the service they receive. What the service does well:
Residents told us that they felt that their needs were understood and met. A resident told us, “Staff understands my needs.” Admissions to the home are made on the basis of a detailed initial assessment that makes sure the needs of prospective residents can be met. There have been no new admissions to the home since the last inspection. We found that the needs of the residents had been reviewed by both the home, and their social workers. Residents told us that they had been involved in and receive feedback from their reviews. A resident said, “I had a long chat with
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DS0000010676.V377699.R01.S.doc Version 5.3 Page 6 my social worker about living here.” Changes in the needs of residents had been addressed to make sure that they receive care that meets the needs. The care plans for the three residents case tracked were detailed and Person centred. The home involves individuals in the planning of care that affects their lifestyle and quality of life. Risk assessments were found to cover all areas that affected the resident’s daily life. Changes to the level of risk had been addressed to make sure that residents were safe. Residents spoken to gave examples of activities. These included going for walks, listening to music attended day centres and church. A resident said, “I like going out for a walk to the shops.” Residents are involved in meaningful daytime activities of their own choice, according to their individual interests and capabilities. The menu is prepared at a regular meeting of residents. A resident said, “The food is ok.” A variety of meals are provided that reflect the individual preferences of residents. Staff explained that residents are encouraged to discuss their views of the home. A resident spoken to said, “I know to tell someone if things are not right.” The home has an open culture that allows residents to express the views and concerns in a safe and understanding environment. What has improved since the last inspection? What they could do better:
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DS0000010676.V377699.R01.S.doc Version 5.3 Page 7 There are no areas for improvement identified at this Inspection. 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 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. High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The statement of purpose is an accurate description of the service provided. People’s needs are assessed prior to admission to the home to make sure they receive the care and support they need. EVIDENCE: The statement of purpose clearly sets out the philosophy and objectives of the home. The statement of purpose was available in an easy read format. We found that the needs of the people case tracked were within a range of those specified in the statement of purpose. The statement of purpose also identified the skills and staffing resources that are available to meet the needs of residents. The home provides a statement of purpose that is specific to the individual service, and the residents who live there. The statement of purpose confirmed that staff would support people to express their religious beliefs. The statement of purpose emphasise resident’s right to be involved and active in their communities. We discussed the issue of equalities and diversity with the registered manager. . He demonstrated that he would respond positively to resident’s diversity. Care plans showed that a
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DS0000010676.V377699.R01.S.doc Version 5.3 Page 10 number of residents attend church regularly. They are supported by staff to attend church and other community groups. A resident told us, “I like to go to church with the staff.” Residents are supported to maintain active links with their faith groups. Residents told us that they felt that their needs were understood and met. The annual quality assurance assessment highlighted that a full needs assessment is carried out to establish whether the home can meet the prospective resident’s needs. The registered manager explained that initial assessments are carried out with the involvement of the person who was considering whether they would come to live at the home. We found that the initial assessments for the two people case tracked were detailed. The initial assessment highlighted behavioural issues. Staff were able to describe how they met the needs of residents. A resident told us, “Staff understand my needs.” Admissions to the home are made on the basis of a detailed initial assessment that makes sure the needs of prospective residents can be met. There have been no new admissions to the home since the last inspection. We found that the needs of the residents had reviewed by both the home and their social workers. Residents told us that they had been involved in and receive feedback from their reviews. A resident said, “I had a long chat with my social worker about living here.” Changes in the needs of residents had been addressed to make sure that they receive care that meets their needs. High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 679 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans provide detailed guidance on how the needs of people are to be met. People are consulted about their preferences and how they wished to be supported. People are supported to make decisions about their lives and they know staff will maintain the confidentiality. Risks to people are assessed to ensure their safety and independence. EVIDENCE: The care plans for the three residents case tracked were detailed and Person centred. This meant that care plans were based on how people wish to be supported by staff. In the annual quality assurance assessment it was stated that care plans are drawn up in partnership with residents, their families and
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DS0000010676.V377699.R01.S.doc Version 5.3 Page 12 professionals. The care plans for the residents case tracked were personalised and detailed how their needs would be met. Care plans were found to provide detailed information on the support provided to meet the needs of individuals. Care plans were personalised and referred to the cultural needs of people. This included whether or not they wish to take part in religious activities. We found that care plans had been developed with the involvement of residents. We observed that staff took time to understand residents and do things in the way they had been asked. The home involves individuals in the planning of care that affects their lifestyle and quality of life. Details of the resident’s behaviour that might challenge the service were identified in their risk assessments and care plans. Actions to address and manage these behaviours were outlined in detail. This included giving guidance on how to respond to specific behaviours. Staff spoken to understood the specific needs of the residents with regards to managing challenging behaviour. Behaviour that may challenge the service is addressed sensitively to support and maintain people’s well being. Risk assessments were found to cover all areas that affected the resident’s daily life. Risk assessments identified the specific risk facing residents. Risk assessments were detailed based on the history of previous risk-taking on the part of residents. These are reflected in care plans. Risk assessments had been reviewed. Changes to the level of risk had been addressed to make sure that residents were safe. Staff were able to describe how they prevented risks to make sure that residents were safe and were supported to exercise control over how they live. Risks relating to behavioural issues were identified. We observed that staff engaged with residents in an appropriate adult way. Comprehensive risk assessments that are reviewed regularly are in place to ensure the safety and independence of residents. Residents told us that they felt that staff kept confidential issues private. There were clear policies on how confidentiality must be maintained. Both observation and discussions with staff showed us that they were sensitive and aware of the importance of maintaining resident’s confidentiality. People told us they had seen their records and had discussed their needs with staff. Residents know that their confidentiality will be maintained at all times. High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12 13 15 16 17 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are supported to engage in a range of activities that meet their needs. People have community contacts and are supported to maintain personal relationships. People are supported to have a nutritious diet that reflects their personal choice. EVIDENCE: The annual quality assurance assessment explained that residents were supported to take part in a range of activities. Records showed that residents are attending day centres and colleges. Residents confirmed that they were participating in courses and activities. Staff told us they regularly assist
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DS0000010676.V377699.R01.S.doc Version 5.3 Page 14 residents to participate in activities in the local community. We observed that residents were planning a trip to the shops. Staff supported them to do this. Residents spoken to gave examples of activities. These included going for walks, listening to music attended day centres and church. A resident said, “I like going out for a walk to the shops.” Residents spoken to told us that they had been consulted and could choose from a range of activities. Residents are involved in meaningful daytime activities of their own choice, according to their individual interests and capabilities. Daily notes and care plans confirmed that residents were regularly involved in activities both in and outside of the home. This included household tasks such as shopping, washing and general cleaning. People who use the service are involved in the domestic routines of the home to further develop their daily living skills. The annual quality assurance assessment confirmed that residents were enabled to develop contacts in the local community. Daily records showed that residents were supported to maintain contacts with family and friends. A person spoken to confirmed that he regularly went and visited members of his family. People who use the service have an opportunity to develop and maintain important personal and family relationships. The menu is prepared at a regular meeting of residents. We saw minutes of these meetings that confirmed people’s suggestions for meals were recorded. Residents spoken to confirmed that they had been involved in preparing the menu. We found that the menu was varied and reflected the cultural and dietary needs of individuals. A resident said, “The food is ok.” We observed that residents were able to have a hot drink when they wished. A variety of meals are provided that reflect the individual preferences of residents. High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 15 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. People are supported with their personal care needs to maintain their independence. People are able to access the medical care they need. People are not protected by safe procedures for handling medication. EVIDENCE: Care plans outlined the support residents require to maintain their independence when being assisted with their personal care. We spoke with residents who explained that staff provided support and encouragement to maintain their personal hygiene. The annual quality assurance assessment confirmed that where necessary residents would be supported with their personal hygiene. Staff explained that they remind and encourage people if
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DS0000010676.V377699.R01.S.doc Version 5.3 Page 16 they need to support them with their personal care. Staff were able to explain the personal support needs of residents. A resident told us, “Staff are very helpful.” Personal support is responsive to the varied individual needs and preferences of people who live at the home. Medical needs had been identified as part of the initial assessment and were referred to in care plans and risk assessments. Daily notes recorded that residents had access to the opticians, dentists and chiropodists. People are supported to access the healthcare they need. Peoples health needs are addressed to ensure their well being. We found that records for the administration of medication were complete. Records of medication received and returned were also complete. We checked the records of medication for the residents who were part of case tracking. They were receiving all the medicines that had been proscribed for them by their doctor. The home has developed an effective medication policy that ensures records of the administration of medications are maintained to keep people safe. There is clear guidance on the use of medication as part of managing residents challenging behaviour. This outlined when it was appropriate to use this medication. It clearly stated the types of behaviour that would indicate when it was appropriate to use medication. Medication is only used to manage peoples behaviour when it is clearly required to meet their needs. Daily notes showed that health professionals had been consulted to ensure that residents were receiving the medicines they needed. Training records and discussions with staff confirmed they had training on the safe administration of medicines. Staff are trained to administer medication safely. High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 17 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. People can be confident that their complaints are listened to and acted upon. Adult protection procedures protect people from abuse. EVIDENCE: The complaints policy explained how to make a complaint and how it would be dealt with. The policy is available in both easy read and pictorial formats. This makes it more accessible to residents. Copies of the complaints policy were available around the home for residents to consult. Residents said that as part of the regular house meetings issues are discussed and resolved. Staff explained that residents are encouraged to discuss their views of the home. A resident spoken to said, “I know to tell someone if things are not right.” The home maintains a record of any complaints. The home has an open culture that allows residents to express the views and concerns in a safe and understanding environment. The registered manager explained that he regularly discusses with staff issues regarding safeguarding. Records showed that safeguarding issues had been discussed. Staff had received training in adult protection. Staff spoken to
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DS0000010676.V377699.R01.S.doc Version 5.3 Page 18 showed us they understood what to do if they suspected that a resident was being abused. There have been no adult protection issues since the last inspection of the home. Residents feel safe and well supported by an organisation that has their protection and safety as a priority. High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 19 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live in the home are always provided with a safe and homely environment that is personalise to meet their needs. The home is clean and hygienic. EVIDENCE: The home consists of two houses on the same road. They are close to public transport links and the local shops. We walked round both houses and found that they were adapted to the specific needs of residents. Toilets and bathrooms were accessible to residents. Both houses have gardens that were accessible at all for residents. We found that the home was in a good state of repair. Maintenance records showed that there were no outstanding repairs to
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DS0000010676.V377699.R01.S.doc Version 5.3 Page 20 be carried out. The home is well maintained, providing a comfortable and safe environment for residents. Residents said their bedrooms were personalised with items of furniture and other personal items. Residents told us that they had chosen how they wanted their bedrooms to be decorated. A resident told us, “I like my bedroom.” We observed that each bedroom had a different colour scheme will. Residents are encouraged and supported to personalise their bedrooms. Appropriate measures are in place to prevent cross infection. The home has detailed policies on the prevention of cross infection. The annual quality assurance assessment stated that staff had training on infection control. We found that training records confirm this. Staff spoken to understood how to work to minimise the possibility of cross infection. Staff confirmed that they had access to disposable gloves and aprons. Liquid soap and paper towels were available throughout the home. A proactive infection control policy makes sure that the risk of infection to residents is minimised. High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 21 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 35 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Sufficient staff, with the necessary skills and support are available to meet the needs of people. People are fully protected by the home’s recruitment procedures. EVIDENCE: We found that the rota showed that a consistent staffing level was maintained. The registered manager explained that four staff are on duty throughout the day and one staff on duty at night. Residents spoken to confirmed that there were enough staff to meet their needs. Daily notes showed that staff were on duty to provide escorts to appointments. We observed that support with activities was available. Staff spoken to told us that they felt sufficient staff were available to support resident’s needs. We saw that sufficient staff are provided at busy times of the day, and to meet the changing needs of people. The service has plentiful staff available at all times to support the needs, activities and aspirations of residents.
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DS0000010676.V377699.R01.S.doc Version 5.3 Page 22 New staff are given a full induction. Records were available to confirm that staff had been on the necessary induction training. All areas of statutory require training had been provided. Discussions with staff showed that they had a detailed knowledge of the needs of residents. Records showed that training had been provided on managing behaviour that may challenge the home and the Mental Capacity Act. The registered manager explained further training person centred care is being planned. The training plan was in place this detailed how future training needs would be met so that staff continue to develop their skills. Residents are supported by staff that has the necessary skills to understand and meet their needs. Training records showed that over 50 of staff had either level 2 or 3 in the National Vocational Qualification in care. As part of this training staff had covered equality and diversity issues. Residents told us that they felt staff understood how to meet their needs. Staff have the relevant experience in working with people who have learning disabilities. The home makes sure that all staff receives relevant training that is focused on delivery of improved outcomes for residents. We looked at the file of the member of staff who had started work at the home since the last inspection. It contained all the necessary documentation to make sure that this member of staff was safe to work with residents. Two references and a POVA first/CRB check had been obtained prior to them starting work at home. This showed that the home followed a clear recruitment procedure that makes sure that residents are safe. Residents said they felt that staff could be trusted. Robust recruitment procedures are followed to ensure the safety and well being of residents. High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 23 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Effective management systems are in place to make sure that people’s will being and safety is promoted. People’s views of the service are sought and used as the basis for improvement. People who live at home and staff’s health and safety is always promoted and safeguarded. EVIDENCE: The home has a stable management team. The registered manager has experience and understands the needs of people with learning disabilities. Staff and residents told us that they felt that the registered manager was both approachable and supportive. The registered manager has a number of years
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DS0000010676.V377699.R01.S.doc Version 5.3 Page 24 experience of managing services for people with learning disabilities. The registered manager has the necessary qualifications and experience to manage High Gable House so that the residents receive good care outcomes. The annual quality assurance assessment contained clear, relevant information that was supported by a range of evidence. The annual quality assurance assessment told us about the changes that the registered manager plans to make to improve the service. A system is in place to monitor the quality of the service provided by the home. The registered manager explained that he carries out quality monitoring on a regular basis. Residents are consulted about how the home is run. Minutes were seen of meetings held with residents to discuss the quality of the service provided. Residents said that they are encouraged to discuss their views of the service. Theres a strong emphasis on being open and transparent in all areas of the running of the home. The registered manager ensures that the safety risks to people living at the home and staff are identified. Measures are put in place to provide a safe living and working environment. Records showed that fire equipment was tested regularly and maintained. Drills were taking place. The fire risk assessment provides details of potential risks of fire. All health and safety policies were available. Certificates for gas and electrical testing were in date. COSHH guidance is in place and chemicals were stored safely. Residents are aware of safety arrangements and have confidence in the safe working practices of staff. High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 25 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 3
Version 5.3 Page 26 High Gable House DS0000010676.V377699.R01.S.doc 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. Standard Regulation Requirement Timescale for action 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 High Gable House DS0000010676.V377699.R01.S.doc Version 5.3 Page 27 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk
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