Care Home: The Gables

What the care home does well Care plans are now up to date and contain details of individuals changing care and health needs. Risk assessments are up to date and support people to be as independent as possible. The statutory requirement notice was in relation to care plans and risk assessments therefore the home has achieved compliance. Training data is available and it is easy to track which mandatory training staff have received and when. All permanent staff have received all their mandatory training except a minor amount which is booked or dates are to be advised. The statutory requirement notice was in relation to staff training therefore the home has achieved compliance. What the care home could do better: No requirements or recommendations are made but the individual habit which can result in sore thumbs should be detailed in the care plan. Records of activities should evidence the variety of activities and opportunities available to individuals. Where individuals are involved in household chores or a house-day their skills and abilities in relation to this should be recorded in the care plan. Inspecting for better lives Random inspection report Care homes for adults (18-65 years) Name: Address: The Gables 22 Beacon Close Crowborough East Sussex TN6 1DX one star adequate service 15/12/2008 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Sally Gill Date: 1 4 0 4 2 0 0 9 Information about the care home Name of care home: Address: The Gables 22 Beacon Close Crowborough East Sussex TN6 1DX 01892655260 01892660154 peter.langley@eastsussex.gov.uk www.eastsussex.gov.uk/socialcare 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) : East Sussex County Council care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 5 The maximum number of service users to be accommodated is 5 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home is within the following category: Learning disability (LD) Date of last inspection Brief description of the care home The Gables is registered to provide accommodation for up to five adults with a learning disability and admits people with low to medium dependencies. The home is part of services provided by East Sussex Social Services. The registered manager is Peter Langley who has day-to-day control of the home. The premises is a large bungalow situated in a small residential cul-de-sac. There are five bedrooms all with a wash hand basin. People have access to two bathrooms one of which is assisted and also has a walk in shower and a large lounge/diner. There is also a laundry and kitchen accessed with staff support. The home is non-smoking. To the rear and sides there are garden areas one of which has a level paved area with table, chairs, garden swing and raised Care Homes for Adults (18-65 years) Page 2 of 10 1 5 1 2 2 0 0 8 Brief description of the care home flower tubs. Some areas of the garden are not maintained. The home is suitable for wheelchair access. There is limited parking on the drive and additional on street parking in cul-de-sac. The home is situated approximately 10 minutes walk from the centre of Crowborough and its town centre amenities. Approximately 250 metres from the nearest bus stop, which could take you into Uckfield or Tonbridge. The staff compliment consists of the team leader (registered manager), senior care officers and care officers. Care staff work a rota 7am - 9.30pm with a minimum of two staff on duty during the day. One wake night member of staff and further staff on call at another establishment. Fees are based on a financial assessment and people make a contribution although this does not reflect the cost of care. Details of the unit cost per person are available from the registered manager. Previous inspection reports are available from the home or can be viewed and downloaded from www.csci.org.uk Care Homes for Adults (18-65 years) Page 3 of 10 What we found: The reason for this inspection was to check the compliance of the statutory requirement notice issued following the last key inspection on 15th December 2008. Timescales for compliance was 31st March 2009. In the period since the previous inspection there has been a temporary change to the management of the home. There has been a temporary manager in place who has had day-to-day control of the home. The registered manager has now returned and currently there is a handover between the two managers. There has been improvement in care plans and risk assessment reviews. The care plans and risk assessments for all service users were examined in varying degrees. One person had signed their care plan and management advised another would be encouraged once their review was completed. Where people are not able to sign a statement is present. All care plans have been reviewed within the recommended timescales. Apart from two risk assessments just outside all have been reviewed within the recommended timescales. Individuals skills and abilities in relation to peoples personal care was detailed to aid independence wherever possible. Changes previously highlighted in an individuals personal care routine have now been incorporated into the care plan. It was previously highlighted that an individual had a habit which can result in sore thumbs although staff advised this is not the case at present but this is still not detailed in the care plan. Information relating to health appointments and checks up is now detailed and followed through into the care plan. Two people had household chores or house day included in their schedules. However only one had their skills and abilities detailed in their care plan in relation to this. There have been improvements in the organisation of medication. A different chemist is now supplying the medication to improve safe administration. Each person now has an individual medication folder. This contains an up to date detailed list of all medicines including start and stop dates, the Medication Administration Record (MAR) chart, instructions for medicines as required and guidelines for the individual approach to take when administering medicines. Medication systems were not examined further. Records and discussions confirmed people are having opportunities for activities both within the community and in house. Records to evidence this are not always consistent and therefore do not always reflect the variety of activities provided. For example one individuals care plan had in house activities listed and coded and then a code was entered on a monthly matrix when the activity took place this was not so for another individual. The level of detail in reports also varied when recording activities. For example some would recorded where the individual went for a drive or lunch others just recorded lunch out or drive out. People are having the opportunity to voice their opinions. Management advised that residents meetings have been introduced. This has been successful in that some people have already made suggestions and management hope to build on this. There have been improvements in staff training. A new training matrix has been Care Homes for Adults (18-65 years) Page 4 of 10 implemented to summarise information and certificates stored in the training file. Further mandatory training has taken place in infection control, administration of medication, fire, first aid, moving and handling, and adult protection. A further place is booked on a moving and handling course. There are three staff still to undertake food hygiene and the manager to undertake first aid. Management agreed to advise the Commission of dates booked by 30th April 2009. Two staff have attended visual awareness training arranged by the East Sussex association for the blind. These staff then cascaded the knowledge gained to other staff at a team meeting. Discussions with staff confirmed that they have gone through a period of hard work and many changes including a temporary change to their manager and the manager above. They have embraced these changes which is evident is their renewed enthusiasm and also records within the home. It is pleasing to hear staff feel the changes have improved outcomes for people living in the home. During this period they feel they have been well supported and confirmed they have received on going support in addition to monthly supervision which was also evidenced on the supervision matrix. Staff also confirmed that staff meetings have increased from every two weeks to weekly. 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 5 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 1 5 The registered person shall have a service user guide in place in accordance with the regulations and National Minimum Standards To ensure people and their representatives have access to comprehensive information 28/02/2009 2 1 4 The registered person shall 28/02/2009 have a statement of purpose in place in accordance with the regulations, schedule 1 and the National Minimum Standards To ensure people and their representatives have access to comprehensive information 3 5 5(1)(bb) & (bc) The Terms and Conditions of 29/02/2008 residence/licence agreement must be expanded to include additional information about insurance and about the discharge process including rights of both individual residents and the homes responsibilities. The registered person shall 28/02/2009 have written contract of terms and conditions in place Page 6 of 10 4 5 5 Care Homes for Adults (18-65 years) 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 in accordance with the regulations and National Minimum Standards with each service user To ensure people and their representatives have access to comprehensive information and are protect by this information 5 20 13 The registered person shall 26/01/2009 make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home To ensure that systems for medication are safe to protect service users 6 22 22 The registered person shall 28/02/2009 have written complaints procedure in accordance with the regulations To ensure service users have a clear and effective complaints procedure 7 39 24(1) As part of the homes quality 29/02/2008 assurance system the views of relatives and other stakeholders must be sought about the quality of the service provided. In relation to residents satisfaction questionnaires, a revised system must be found that will the seek views of the residents in such a way as to inform practice. Care Homes for Adults (18-65 years) Page 7 of 10 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 8 39 24 The registered person shall 28/02/2009 establish and maintain a system for reviewing at appropriate intervals and improving the quality of care provided at the care home in accordance with regulation 24 To ensure service users, relatives and other stakeholders views underpin the monitoring and development by the home 9 39 26 The registered person shall undertake visits in accordance with regulation 26 To monitor, review and improve the quality of care delivered 15/01/2009 10 42 37 The registered person shall report events in accordance with regulation 37 To ensure service users are protected 15/01/2009 11 42 13 The registered person shall ensure that all parts of the home are free from hazards to peoples safety. In particular have a valid electrical wiring certificate To ensure peoples health and safety 15/01/2009 Care Homes for Adults (18-65 years) Page 8 of 10 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 Care Homes for Adults (18-65 years) Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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 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). 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