Care Home: The Gables Nursing Home

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What the care home does well We observed good staff interaction with people living on the first floor of the home. We also observed good moving and handling techniques taking place on the first floor of the home. What the care home could do better: There must be an improvement in the way the home assesses, monitors and evaluates the care of people with pressure area care needs. The home should audit the bed linen and ascertain what is fit for purpose and start a replacement programme. A review of staffing levels and deployment of staff should be carried out to ensure that needs are being meet in a timely manner. The practice of people sitting in wheelchairs for excessive periods of time should cease. The use of the second sitting room`s should be reviewed on both floors and should be staffed appropriately. Accident should be monitored in depth to establish whether there are any trends and whether these risks can be reduced. Random inspection report Care homes for older people Name: Address: The Gables Nursing Home 1595 Wolverhampton Road Oldbury West Midlands B69 2BJ three star excellent service 06/01/2009 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: Karen Thompson Date: 3 0 0 6 2 0 1 0 Information about the care home Name of care home: Address: The Gables Nursing Home 1595 Wolverhampton Road Oldbury West Midlands B69 2BJ 01215443988 01215443989 Telephone number: Fax number: Email address: Provider web address: www.schealthcare.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Kim Young Type of registration: Number of places registered: Conditions of registration: Category(ies) : Exceler Healthcare Services Limited care home 51 Number of places (if applicable): Under 65 Over 65 51 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 51 The registered person may provide the following category of service only: Care Home with Nursing (Code N); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 51 Date of last inspection Brief description of the care home The Gables Nursing Home is situated on the A4123 Wolverhampton Road, Oldbury. It is easily accessible by public transport and ample off road parking is available. The Home is registered to provide care for a maximum of 51 elderly persons. It is a Care Homes for Older People Page 2 of 9 0 6 0 1 2 0 0 9 Brief description of the care home purpose built property with three floors. Lounges and dining rooms are available on the ground and first floors. The bedrooms are also located on both floors. The kitchen, laundry and staff facilities are situated on the lower ground floor. All floors can be accessed via lifts or stairways. Access into and around the Home is suitable for wheelchair users. The reception area is comfortably furnished with a couch and occasional chairs and the piped music provides a relaxing atmosphere for visitors entering the Home. Residents and visitors may access the information kept in reception about the Home and the service it provides. Visitors are welcome at any time and for health and safety reasons are requested to sign the Visitors Book with their details, arrival and departure times. Care Homes for Older People Page 3 of 9 What we found: We visited the home after carrying out an Annual Service Review on 23 March 2010. We informed the home in this report we had received information that concerned us and would be carrying out an unannounced random inspection at some time in the future. We looked at four areas of concern, which were staffing levels, care of tissue viability needs, accidents and falls. We looked at care documentation for two people living in the home specificially in relation to meeting tissue viability needs. We found that one person had recently returned from hospital and the assessment which had been carried out by staff at the home within twenty four hours of their return identified a change in pressure area care needs. Despite this the home did not provide the equipment necessary to meet these needs and the person continued to be nursed on a divan bed and mattress. Their moving and handling needs had also changed and the divan bed was not suitable to meet these needs. The nurse in charge was shown the assessment and daily records indicating the beginings of pressure area damage and whilst we were in the home asked for the bed and mattress to be changed to one that met this persons pressure area care and moving and handling needs. This is concerning as the home had identified a change in need but had failed to act upon it. We visited the bedroom of the person identified by us as having pressure area care needs. This was a double room with two people sharing the room. The bed arrangement was unusual in that both beds were placed lengthwise along the back wall of the room. Meaning the foot of the first bed was three feet approximately from the back of the headboard of the second bed. The second beds foot rest was placed against the other wall of the room. This meant that when both people were in their beds they could not see the other person. We questioned with staff the reason for this unusual layout. No explaination could be offered. We ascertained later that both people in this room need to be hoisted in and out of bed. Therefore the beds have to be put at this angle to allow the door of the room to open and the hoist to be bought into the room. This room is not suitable for people who require hoisting. We observed on both floors that there is a dining room and two sitting rooms. The sitting room on the ground floor on the day of our visit was in the process of being redecorated. No one was sitting in the other sitting room. When we observed twelve people sitting in the dining room area at 11am, four people were sitting on a dining room chair and the others were in wheelchairs. We asked how long people had been sitting in the wheelchairs we were told that they had been there since they had been brought into the room for their breakfast. We were told that they were moved out of the wheelchairs if taken to the toilet and this acted as a form of pressure relief. Twenty minutes later weobserved three of the people in this room sitting in armchairs. No one else was moved from the wheelchairs into armchairs. The other sitting room was not used by anyone living at the home for the period we were there from 11am to 14:30hrs. We visited upstairs and saw only the one sitting room being used. The room felt crowded. We had received information prior to our visit that the: lounges generally appeared overcrowded, with residents often sat in wheelchairs Our conclusion is that we agree with this statement. The home needs to review the use of its sitting rooms and the length of time people sit in wheelchairs. Wheelchairs are a means by which people can be transported Care Homes for Older People Page 4 of 9 from one place to another and are not an alternative to sitting in an armchair. The high use of wheelchairs may be a symptom of not having enough staff to meet peoples needs. This may have become a culture in the home in response to not enough staff being available to meet peoples needs. Staff on duty told us they thought that they had enough staff but if needs are not being fully met, questions must be asked as to why. The home needs to carry out a review of staffing levels in relation to the needs of people who live at the homes. The rotas we found on the day of our visit were not an accurate reflection of all the staff on duty. We did find however that there were two trained nurses and 8 care staff working at the home. We looked at the accident records for May 2010 concentrating on the number of falls within the home. We found that of the ten accidents for the month of May 4 were for people who had slipped out of chairs in communal areas. This would indicate that people are being left unattended in lounges. We observed that bed linen was grey in colour. We discussed this with the staff working in the home that confirmed that previously the bed linen would have been white. We did see some white linen sheets but these were in the minority. We asked staff whether they would like grey sheets on their bed at home and they stated that they would not. 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 Older People Page 5 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 Older People Page 6 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 1 7 15 The home must ensure that people care plans are kept up to date and reflect the care that is needed in relation to tissue viability. This will give staff clear guidance about peoples care needs and give people reassurance that staff know what they need to do. 31/07/2010 2 8 12 The home must review each 31/07/2010 persons pressure sore risk. They must also make sure that people have the correct pressure relieving equipment for their needs. This will reduce the risk of pressure damage to people who are at risk. 3 38 13 The home should carry out an indepth review of the accidents occuring in the home. To establish if there are any patterns or trends and what can be done to reduce these. 31/07/2010 Care Homes for Older People Page 7 of 9 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 The home should review the practice of people spending excessive amounts of time in a wheelchair and alongside this look at the use of second sitting room on both floors. Share room dimensions and layout options should ensure there is room on either side of the bed to enable access for caeres and any equipment needed. The home should audit the bed sheets and replaces those not deemed fit for purpose. Staffing levels should be reviewed in the home so that people living in the home receive care in appropriate manner. 2 23 3 4 24 27 Care Homes for Older People 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 Older People 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. Care Homes for Older People Page 9 of 9 - 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. 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