Care Home: The Gables Residential Care Home

What the care home does well Information is available to prospective residents in the form of a service user guide and a statement of purpose to enable them to make a choice is they wish to live there. The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.2 Residents living at the home are settled and are cared for by a number of staff that have worked there for sometime and therefore are aware of their support needs. Residents interacted well with the staff on duty and appeared settled in their environment. Residents have their say in choosing meals, activities and how to spend their day. What has improved since the last inspection? The manager has met all the requirements made at the last inspection. Care plans are now reviewed and updated on a monthly basis and made available to all care staff so that they are aware of the current and changing needs of the people they care for. Improvements to the environment have been made, which include some refurbishment and redecoration to improve the standard of the accommodation for the people who live there. This needs to continue as outlined in `What they could do better.` Staff are now recruited following the correct procedures to ensure the people they care for are not at risk. A programme of training has been developed to provide all staff with the knowledge and skills needed to support those living at the home. Staff now have formal supervision and regular staff meetings to support them in their job roles.The Gables Residential Care HomeDS0000065390.V378512.R01.S.docVersion 5.2 What the care home could do better: The manager should keep the Commission informed regarding the progress of new admissions/discharges to the home. Written entries on the Medication administration record (MAR) should be countersigned at all times to ensure the correct medication is given to keep the residents safe. `When required` medication should be recorded on the rear of the MAR to show the medication has been given. The manager should continue his refurbishment plan of upgrading rooms to improve the standard provided for the people who live there. It was recommended that the manager regularly updates the staff training plan so there is a clear record of training completed and those staff who need refresher courses. Records showed that work on the boiler was recommended on 9/1/09. This was discussed with manager and a recommendation made for the work to be completed. Key inspection report CARE HOMES FOR OLDER PEOPLE The Gables Residential Care Home Thrush Drive, Huntley Mount Road Bury Lancs BL9 6JO Lead Inspector Elaine Stoddart Key Unannounced Inspection 25th November 2009 09:45 DS0000065390.V378512.R01.S.do c 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 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 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. The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.2 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 The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Gables Residential Care Home Address Thrush Drive, Huntley Mount Road Bury Lancs BL9 6JO 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) 0161 764 6593 0161 764 6593 Mr Ghennessen Pumbien Mrs Radha Rajcoomaree Pumbien Mr Ghennessen Pumbien Care Home 14 Category(ies) of Dementia (1), Mental disorder, excluding registration, with number learning disability or dementia (14), Old age, of places not falling within any other category (14) The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only Code PC 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 - Code OP Mental Disorder, excluding learning disability or dementia - Code MD Dementia - Code DE (maximum 1) The maximum number of service users who can be accommodated is: 14 Date of last inspection 8th December 2008 Brief Description of the Service: The Gables is a privately owned care home providing care and accommodation for up to 14 older people. The current fees for the home are £365.00 per week. The home is situated in a residential area of Bury approximately one mile from the town centre. There are bus routes, shops, and other community facilities close by. The home is on two floors and it has 6 single and 4-shared bedrooms. None of the bedrooms have en-suite facilities. There is one large comfortable lounge, a separate dining room and a conservatory, which is the designated smoking lounge. There is a garden and limited car parking at the front of the home. A Service User Guide and a Statement of Purpose describing the home’s services are available A copy of the latest inspection report is also available on request. The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. A site visit took place as part of this inspection and this was conducted by one inspector over one day for approximately six hours. Information for this inspection was gathered in a number of different ways. This included the unannounced site visit where time was spent reading service records, looking at areas of the building and speaking with residents, visitors, staff and management. All of the key standards and other standards were looked at. The manager and three staff were present for the inspection. Feedback was provided to the manager at the end of the visit. Case tracking was used as part of the site visit. This involves looking at the support residents receive from the manager and staff. This also includes looking at the residents care plans to obtain information on how their care needs, medication and finances are managed. Two residents were case tracked; however this was not carried out to the detriment of other residents who also took part in the inspection process. Time was spent meeting with residents and staff to gain their views on the overall service. An AQAA (annual quality assurance assessment) was completed by the manager in good detail prior to the visit. The AQAA comprises of two selfquestionnaires that focus on the outcomes for people. The self-assessment provides information as to how the staff and manager are meeting the needs of the people who live there. The data set gives basic facts and figures about the service, including staffing numbers and training. Some information provided by the AQAA is included in this report. The people accommodated at the home wished to be called residents and this term is used in the report. What the service does well: Information is available to prospective residents in the form of a service user guide and a statement of purpose to enable them to make a choice is they wish to live there. The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.2 Page 6 Residents living at the home are settled and are cared for by a number of staff that have worked there for sometime and therefore are aware of their support needs. Residents interacted well with the staff on duty and appeared settled in their environment. Residents have their say in choosing meals, activities and how to spend their day. What has improved since the last inspection? The manager has met all the requirements made at the last inspection. Care plans are now reviewed and updated on a monthly basis and made available to all care staff so that they are aware of the current and changing needs of the people they care for. Improvements to the environment have been made, which include some refurbishment and redecoration to improve the standard of the accommodation for the people who live there. This needs to continue as outlined in ‘What they could do better.’ Staff are now recruited following the correct procedures to ensure the people they care for are not at risk. A programme of training has been developed to provide all staff with the knowledge and skills needed to support those living at the home. Staff now have formal supervision and regular staff meetings to support them in their job roles. The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.2 Page 7 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 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. The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 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): Standards 1 and 3 assessed. Standard 6 was not assessed as this is not provided. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is available about the home to prospective residents to enable them to make a choice if they wish to live there. EVIDENCE: ‘The AQAA reported that the statement of purpose and service user guide outlines what the home provides to enable people to choose before being admitted.’ We found that the home has a statement of purpose and service user guide, which provides information on the service so that prospective residents can The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 10 make a choice should they wish to live there. A copy of the most recent inspection report is also available for visitors to view. We spent some time talking with the manager regarding the present levels of occupancy at the home. The manager informed us that there have been no new admissions made since February 2009. The manager agreed to keep the Commission informed regarding the progress of new admissions/discharges to the home. At the time of the visit there were six residents accommodated. The residents were observed to be relaxed and comfortable in their surroundings and interacted well with the staff. Sufficient staff were seen on duty to maintain the standard of care and support required to meet the needs of the residents living there. A resident spoken with commented: “I am very happy here. The staff look after me well” Assessments of need were viewed for two residents and contained the information required to enable the home to determine if they can meet their care needs. The assessments identified all areas of care, such as personal care, medication needs, financial assistance and identified risks. The assessments form the basis of the plan of care, which outlines the actions to be taken by the staff to meet the needs of the people they care for. The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 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): Standards 7, 8, 9 and 10 assessed. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have a plan of care, which outlines their individual needs and is reviewed monthly to reflect any changes in their support. Residents have access to health care professionals to enable them to keep well. EVIDENCE: The AQAA reported that the residents ‘have a choice regarding their health and personal care needs. More training has been provided in courses relevant to the client group, these include mental health awareness, food hygiene, and diabetes and risk assessments. Care plans and risk assessments are now being updated regularly to meet their personal needs.’ Care plans seen now show the individual care needs of each resident. These include details of their health care needs, personal care and support required, The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 12 financial assistance, mobility and medication needs. Two care plans were viewed and these were seen to be reviewed monthly by the manager/or key worker to ensure any changes in care are recorded and acted upon. The care plans identified the actions to be taken by staff to meet the residents’ needs and targets are set to enable positive outcomes for the people they care for. Both residents had recently been reviewed by their placing authorities and the recorded outcomes showed that they were satisfied with the care and support received at the home. Care staff spoken with were knowledgeable regarding the care and support to be provided to the residents and expressed that the care plans outlined the needs of the residents they care for. Thus enabling them to provide the care in the way the residents prefer. The residents are involved in drawing up their plan of care and sign to acknowledge their agreement. Records viewed showed that the residents have access to health care professionals when they need it. These include opticians, chiropodist, GP and community psychiatric nurses. Daily records are completed by staff to enable them to monitor residents’ progress and all visits by health care professionals are recorded. One resident had recently been seen by her GP and the staff are monitoring her progress closely. The residents care plan was in the process of being updated to reflect her changing needs. The resident was spoken with and confirmed she was satisfied with her care. The home completes nutritional assessments on the residents to ensure specific needs are recorded and met by the staff. The cook is informed of any special diets’ such as diabetes, to ensure the residents are provided with the food intake they need and prefer. Daily reports record the resident’s food intake to assist the staff in monitoring their nutritional needs. Moving and handling assessments record any difficulties the residents may have in mobilising and the action to be taken by staff to support them safely. These are also reviewed monthly within their care plan to reflect changing needs. Risk assessments are completed for each resident and identify any areas of risk, such as falls or personal safety. These are updated regularly to reflect changing needs and encourage the residents to take responsible risks were possible. All residents are assessed regarding the risk of developing pressure sores and these are updated regularly should their needs change. The district nursing service is available should the residents need their support. Medication was observed to be administered by care staff at lunch time. We found staff to follow the medication procedures and all administrations made were seen to be recorded. Medication policies and procedures are available for staff to access. Only trained staff are able to give medication to the residents. Medication was securely stored to ensure resident safety. The manager assesses the staff competency by undertaking a ‘medication observation’ with The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 13 staff. The outcomes are recorded and any actions taken, such as further training for staff. Leaflets on medication given were available on the medication file. This provides information for staff on the side effects to be aware of whilst caring for the residents. Any changes to resident’s medication, the GP is requested to put in writing, thus ensuring the medication is correct and safe for the resident. Handovers take place at the end of each shift to pass on of any changes in the residents’ medication. Residents are risk assessed to determine if they are able to administer their own medication should they wish to do so. A number of written entries were found to be recorded on the medication administration record (MAR), which had not been countersigned. It is recommended that this be provided at all times to ensure the correct medication is given to keep the residents safe. ‘When required’ medication should be recorded on the rear of the MAR to show the medication has been given. This was seen to be completed for some residents but not all. This was discussed with the staff and manager during the visit and a good practice is recommendation made in this report. Staff were observed to treat the residents with dignity and respect at all times and always knocked on doors prior to entering their rooms. Care plans identified resident’s personal requests and staff respect their wishes. The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above 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): Standards 12, 13, 14 and 15 were assessed. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive varied and flexible meals to suit their needs and are provided with activities of their choice. EVIDENCE: The AQAA reported ‘there is a weekly schedule of activities.’ Two care plans were viewed and recorded resident’s interests and hobbies. A number of residents are able to go out independently to attend day care facilities and go to the local shops. The activity plan is displayed in the hallway for the residents to view. Residents spoken with confirmed they attend exercises classes every two weeks at the home. Other activities include karaoke nights, summer BBQs, trips to Blackpool, Halloween celebrations and weekly communion. Pictures were displayed to show the staff and residents taking part. Staff and residents The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 15 spoken with confirmed many activities are undertaken on a 1-1 basis as there are only six residents accommodated. Staff commented: “It is nice to have time to spend with the residents” Plans are in place to celebrate Christmas and to attend the local community centre Christmas party. All activities are recorded daily by staff in daily report records. Residents maintain their own finances were possible and risk assessments are in place when staff handle finances. Records are kept for all financial transactions made to ensure residents are safe from abuse. The menus are displayed in dining room for the residents to view. A three week menu is in place, however discussion with staff and residents confirmed they can have ‘what they want’ and menus are not always followed if the residents prefer something else. A resident spoken with said “The food is good.” Alternatives are offered and snacks, tea and coffee were seen to be served during the day. Meals are served in the dining room or residents room if they wish. Staff confirmed the residents usually have their meals in the dining room. We spent some time talking with the cook who has worked at the home for two years and confirmed all equipment is in working order and there are plenty of food supplies. Food stores were checked and were found to be well stocked. The cook works six days a week and the manager’s wife cooks when she is on her day off. The cook is qualified in food hygiene and has a national vocational qualification (NVQ) Level 2. The care staffs speak with the residents daily to find out what they wish to have for their meals. The cook is notified of any residents who require special diets, such as diabetes or vegetarian. The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are aware of how to complain and know they will be listened too. Residents are protected from abuse by the home’s policies and procedures in place. EVIDENCE: Information provided on the AQAA stated that there had been no complaints raised within the home since the last visit and no complaints have been raised with us. A complaints policy and procedure is in place and contained in statement of purpose and service user guide with Commission’s contact number. Residents spoken with said they had no complaints but were aware of how to make a complaint. One resident said: “If I have any problems I will tell my key worker. I have no complaints.” The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 17 Two staff spoken with confirmed their understanding of how to deal with complaints and any safeguarding issues should they arise. Both confirmed they had completed protection of vulnerable adults training (POVA). The manager confirmed that he is to deliver training to the staff on the Mental Capacity ACT and Deprivation of Liberty. This will ensure they are aware of how to help people who may lack the capacity to make certain decisions. The manager confirmed that no Deprivation of Liberty applications had been made at this time. Information on the above is available in the entrance hall along with contacts for advocates should these be required by the residents or visitors. The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 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): Standards 19, 20, 21, 24 and 26. People using the 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 provides a comfortable and clean place for the residents to live. EVIDENCE: The AQAA reported that some improvements have been made since the last visit. These included the provision of several new beds, some residents rooms have been decorated, new wardrobes purchased and new carpets fitted in a number of rooms. A full tour of the premises took place with the manager to view the improvements. A small number of repairs were noted and the manager agreed to undertake the repairs during the visit. Rooms viewed were found to be clean and tidy with plenty of clean bedding and fresh daily towels The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 19 for the residents. A number of rooms are vacant due to the low occupancy levels at the home. Private rooms viewed were found to contain the residents personal items brought with them from home. Residents have the choice to have a key to their rooms if they wish. None of the resident’s rooms have en suite facilities. Some rooms have double occupancy and screens are available to allow residents privacy. Bathrooms are located close to the resident’s rooms for access and have equipment available for those with mobility needs. The manager should continue his refurbishment plan of upgrading and modernisation of rooms to improve the standard provided for the people who live there. This is recommended in this report. The manager has private accommodation on top floor for his own use when on duty. The office located on top floor. A large lounge was observed to be used by the residents to sit and watch TV during the day. The lounge has a karaoke machine, which the residents and staff use for entertainment on occasions. The entrance hall contained copies of past inspection reports and other information for visitors and residents to access. A list of staff who are on duty and the times available is posted in the hallway so residents and visitors know who to contact. The dining room was found to provide a clean and comfortable setting for the residents to have their meals. A smoking area is designated for residents in the conservatory. The AQAA stated all certificates for services, such as electricity are in date. A selection of these were checked and found to be correct. Emergency lighting checks are made regularly to ensure the equipment is working correctly. Radiators are covered for the residents’ safety. The laundry is located in the basement and was found to be organised. Hand washing facilities are available in the laundry for staff to use and paper towels and soap dispensers are in place in the communal bathrooms. These help to avoid cross infection. The home no longer has a domestic worker employed. Care staff carry out daily tasks to keep the home clean and tidy. Staff spoken with confirmed that extra hours are provided to allow them to carry out domestic duties over and above their caring roles. Staff said this was not a problem due to the small number of residents they are presently caring for. Residents spoken with commented they are satisfied with the accommodation and appeared comfortable in their surroundings. The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 20 The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are 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): Standards 27, 28, 29 and 30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient trained staff are on duty to meet the resident’s needs. EVIDENCE: The AQAA reported that improvements have been made in the home’s staff training plan and staff supervision is now in place. At the time of the visit sufficient staff were found to be on duty to meet the needs of the residents. These included the manager, two care staff and a cook. Night cover is provided by one awake and a sleep in should they be needed. The manager lives on site at the home when on night duty cover. The manager agreed to maintain the present staffing levels to meet the needs of the residents accommodated. A selection of staff records and the training plan were viewed to confirm that since the last inspection the manager has made improvements to ensure staff are trained to carry out their roles safely. The training plan includes mandatory training, such as moving and handling. Additional training is also provided in areas relevant to the client group they care for. These include mental health The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 22 awareness, dementia care and diabetes. Training records, staff files and certificates for training viewed confirmed that training had been put in place as required at the last inspection. Over the last twelve months staff have received training in a number of areas which include food hygiene, fire safety and mental health awareness. A number of training courses have been arranged for the near future and confirmation of these were provided on the day of the visit. These include moving and handling (arranged for February 2010). It was recommended that the manager regularly updates the staff training plan so there is a clear record of training completed and those staff who need refresher courses. Three staff records were viewed to confirm staff are recruited following the correct procedures to ensure the safety of the residents. These include an up to date criminal record bureau check (CRB) and two references. Staff have contracts of terms and conditions and job descriptions. They are also provided with an induction into their job by the manager to assist them in understanding their roles and responsibilities. Staff spoken with commented: “I love working here I have been here for twelve years. The training is good we have been doing a lot recently and more is booked.” “We all get on very well. The residents are well looked after.” Residents provided positive comments on the staff and were seen to interact well with them throughout the day. The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 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): Standards 31, 33, 35 and 38. People using the 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 run in the best interest of the people who live there. EVIDENCE: The manager is experienced, qualified and registered with the Commission. The AQAA reported that staff have regular supervision to support them in their roles. Records viewed showed that supervision now takes regularly and staff spoken with also confirmed this. The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 24 Team meetings take place with staff to keep them informed of developments in the home. A pleasant atmosphere was present throughout the day as staff, residents and the manager interacted well together. The views of the residents are listened to within their regular meetings and through annual surveys completed. The last survey was undertaken in May 2009 and their views on the care and support provided obtained. Financial procedures are in place for dealing with residents monies. Records are maintained for all transactions and a selection of records were checked to confirm this. A selection of certificates for services such as electricity were checked and found up to date. A fire risk assessment is available, fire alarm checks are conducted and all accidents and injuries are recorded. Thus ensuring the residents safety is closely monitored within the home. Policies and procedures are available to staff on safe working practices to help them keep the residents safe. Records showed that work on the boiler was recommended on 9/1/09. This was discussed with manager and a recommendation made for the work to be completed. Discussion took place with the manager regarding the low occupancy levels and the future of the home. The manager agreed to keep the Commission informed of any progress and developments made. The Gables Residential Care Home DS0000065390.V378512.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 Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 26 Are there any outstanding requirements from the last inspection? No 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. 1 2 Refer to Standard OP3 OP9 Good Practice Recommendations The manager should keep the Commission informed regarding the progress of new admissions/discharges to the home. Written entries on the MAR should be countersigned at all times to ensure the correct medication is given to keep the residents safe. ‘When required’ medication should be recorded on the rear of the MAR to show the medication has been given. The manager should continue his refurbishment plan of upgrading rooms to improve the standard provided for the people who live there. It was recommended that the manager regularly updates the staff training plan so there is a clear record of training completed and those staff who need refresher courses. Records showed that work on the boiler was DS0000065390.V378512.R01.S.doc Version 5.3 Page 27 3 4 5 6 OP9 OP19 OP30 OP38 The Gables Residential Care Home recommended on 9/1/09. This was discussed with manager it is recommended the work be completed. The Gables Residential Care Home DS0000065390.V378512.R01.S.doc Version 5.3 Page 28 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. 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