Care Home: White Gables Nursing And Residential Home

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What the care home does well White Gables provides a homely, comfortable and safe environment for the people who live there. From the minute you enter the home there is a feeling that this is a home and not an institution. The nursing and care provided is of a very high standard and everyone is treated as an individual. Feedback from residents was excellent they said `White gables is home from home.` Another resident said `the care is wonderful, they are so caring.` Another said `I get really well looked after here, the nurses are very good to us no matter what we ask for.` Feedback from relatives was also excellent they said `this is a very good caring and supportive care facility.` And `This is a very happy well run home.` And the care of the clients is very much tailored to individual needs.`Feedback from healthcare professionals was also excellent they said `excellent provision of care. Excellent communication with the care team, patients and relatives.` And `very good service in the main.` One of the most positive comments from residents was about the food. They said `the food is always goods and appetizing.` And `Meals are exceptionally good at the moment.` The service is very well managed and the provider and Managers ensure that residents receive good quality care that is in line with current good practice. The service was re-awarded Investors in people this year. What has improved since the last inspection? The home has fitted new carpets in some of the lounges and a new patio area with sun awning has been added in the garden. This enables people who use wheelchairs to access the garden. The home has employed a dedicated activity co-ordinator who ensures that stimulation is provided to all of the residents in the home and not just those who are able to join in-group activities. Staff have received further specialist training in order to keep up with new legislation and good practice guidelines. Resident`s personal finances are being managed on a more individual basis. What the care home could do better: We have not made any recommendations or requirements following this visit to the service. CARE HOMES FOR OLDER PEOPLE White Gables Nursing And Residential Home 21 Willington Road Kirton Lincs PE20 1EP Lead Inspector Alison Jessop Unannounced Inspection 3rd September 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service White Gables Nursing And Residential Home Address 21 Willington Road Kirton Lincs PE20 1EP 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) 01205 723874 Not on internet Mrs Joan E Nix Mrs A H Hughes, Mrs H J Newton Mrs H J Newton Care Home 20 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (18) of places White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd August 2006 Brief Description of the Service: White Gables Nursing and Residential care home is a bungalow, which has been extended to form a single storey building. The home is situated in the village of Kirton and is near the local shops and amenities. The market town of Boston is four miles away. There is a courtyard area to the rear and a small car parking area to the front of the home. White Gables is registered to provide personal and nursing care for up to 20 residents over the age of 65, two of these having dementia care needs. The home is family owned and run, one of the owners also being the registered manager. On the day of the Inspection the Manager indicated that the current range of fees are from £540 - £580 per week. Hairdressing, newspapers and chiropody are charged additionally to the fees. The home also offers an escort service which residents pay for if they require support with non-emergency hospital appointments. The Service User Guide and Statement of Purpose can be obtained from the Manager along with a copy of the most recent inspection report. The service also has a video, which provides information and a tour of the home. White Gables Nursing And Residential Home DS0000002561.V371349.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 3 star. This means the people who use this service experience excellent quality outcomes. For the purpose of this inspection report the term ‘we’ will be used to described the Commission for Social Care Inspection. One Regulatory Inspector carried this unannounced inspection out over 5 hours. On arrival we were greeted by the duty nurse, as the registered Manager was attending a training course. Later the registered Manager and registered provider arrived back at the service in order to assist with the inspection and answer any questions the inspector had. Prior to the site visit surveys were sent out to residents, relatives, staff and other health care professionals who work with the service. The response was very positive. During the inspection we gained feedback from several residents and staff. We spent time looking closely at the care of two residents. We looked at their general state of being, care plans and other records, medication and personal finances. We call this process ‘case tracking’. What the service does well: White Gables provides a homely, comfortable and safe environment for the people who live there. From the minute you enter the home there is a feeling that this is a home and not an institution. The nursing and care provided is of a very high standard and everyone is treated as an individual. Feedback from residents was excellent they said ‘White gables is home from home.’ Another resident said ‘the care is wonderful, they are so caring.’ Another said ‘I get really well looked after here, the nurses are very good to us no matter what we ask for.’ Feedback from relatives was also excellent they said ‘this is a very good caring and supportive care facility.’ And ‘This is a very happy well run home.’ And the care of the clients is very much tailored to individual needs.’ White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 6 Feedback from healthcare professionals was also excellent they said ‘excellent provision of care. Excellent communication with the care team, patients and relatives.’ And ‘very good service in the main.’ One of the most positive comments from residents was about the food. They said ‘the food is always goods and appetizing.’ And ‘Meals are exceptionally good at the moment.’ The service is very well managed and the provider and Managers ensure that residents receive good quality care that is in line with current good practice. The service was re-awarded Investors in people this year. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 7 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 White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The admission and assessment process ensures that equality and diversity issues are considered and that prospective residents needs can be met. EVIDENCE: All prospective residents are fully assessed before being accepted for admission to the home. The registered Manager normally carries out this assessment and then a decision is made about suitability. The Manager said that she also considers the needs of the other residents in the home. The service has made a DVD, which can be shown to prospective residents who may not be in a position to visit the service. The DVD can be played on a portable DVD player and offers a tour of the home and tells people what they can expect from the service. This service does not provide intermediate care. White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home receive good person centred care, which respects their privacy, dignity and diversity. Resident’s health is closely monitored and responded to promptly and appropriately. EVIDENCE: Each resident has an individual, person centred care plan. The plan explains the care needs of the person for their mobility, sleeping, medication, skin integrity, nutrition, oral health, mental state and expressing sexuality. There is also a comprehensive social profile which is completed with the resident and if appropriate their family. Although the staff are all fully aware of the residents individual needs, the care plans do not fully explain how to carry out care. More detail would also ensure that new or temporary staff would be able to carry out person centred care by reading the plan. Residents have access to health care services as required. Nurses ensure that resident’s health is closely monitored and they report this to the care team at the beginning of each shift. Monitoring charts on food and fluid intake and White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 10 turning charts are maintained and action taken when concerns are identified. One staff survey said ‘the service sees to the needs of every service user with regular assessments regarding health.’ One particular nurse manages the medication systems. Storage and recording systems are very organised. The pharmacist carries out medication audits regularly. All residents spoken to said that they are treated in a dignified manner. One resident said ‘the staff are very good, no matter what we ask them for and they are always kind to us.’ We observed dignified care practice throughout the inspection and staff appeared to treat this as the resident’s home and not a place of work. White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The People who live at the home can enjoy a stimulating lifestyle, which is tailored to their individual needs. Meals are nutritious and appetising with plenty of choice. EVIDENCE: The home has employed an activity co-ordinator who organises regular group activities such as bingo and exercises and religious services. On the day after the inspection there was a visit from an accordionist. All the residents spoken to said they particularly enjoyed this entertainment. One resident said ‘I get really well looked after, we play bingo and we can sit in the garden where the staff bring us tea, its lovely.’ One resident was observed playing cards and said she enjoys this very much.’ Another resident had some cards that were in large print. One resident in particular has a very active social life and enjoys going out to clubs and on social trips with the blind club. The service carried out a survey asking what social activities residents would like and the Manager tries to accommodate this however stated that this can be difficult when the majority of residents may not be able to participate or just prefer not to. White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 12 The Manager stated that the activity co-ordinator also spends time on a one to one with those residents who cannot or do not want to participate in-group events. The Manager is also arranging visits from various speakers and people from the community. One resident who was being cared for in bed looked very comfortable and staff left the TV on low so that there was some light background noise. The service also utilises the blind society for reading materials. Residents are involved in domestic routines, one resident said ‘I enjoy dusting my own bedroom, it keeps me going.’ Another resident was observed collecting teacups. Visitors are welcome to the home at any time and as often as the residents wish. One of the residents enjoys her husband visiting on a daily basis. He said ‘they always make me feel welcome here.’ Feedback about the food was excellent. Comments included ‘the food is always good and appetising’ and ‘meals are exceptionally good at the moment’ and ‘the food is out of this world, we get choices and we can have what we want.’ One resident said ‘the food is marvellous now, something different everyday, I would like some fresh fruit left around.’ The food is all freshly cooked and on the day of the inspection the meal was home made chicken pie, potatoes and cabbage. The pudding was home baked spotted dick with custard. Menus are displayed around the home so that residents are aware of what’s on for that day. One gentleman was observed enjoying a glass of larger with his lunch. White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can feel confident that their complaints will be listened to and acted upon and can feel that their safety is being protected. EVIDENCE: All of the residents spoken to said that they are aware of how to make a complaint if they are unhappy with the service. The service has not received any complaints since the last inspection and the Commission for Social Care Inspection has not received any complaints or concerns about the service. The home also provides information about local advocacy services. Staff spoken to are aware of the policies and procedures in relation to Adult protection and receive training on induction. There have not been any adult safeguarding alerts since the last inspection. White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. White Gables provides a comfortable, homely, clean environment to the people who live there. EVIDENCE: The home is attractively decorated and well maintained. There are several lounges where residents can relax. Each resident’s bedroom is nicely decorated and residents are encouraged to bring personal items of furniture, ornaments and pictures etc. One resident was observed sitting in a recliner chair in the lounge. She had a nice view out of the window into the garden and looked very comfortable. Some of the carpets have been replaced since the last inspection. The courtyard garden contains lots of flowerpots and a water fountain. The patio area has been upgraded so that it is wheelchair accessible. An electronic awning has been fitted so that residents can sit out in the hot weather. White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 15 Although there is a keypad on the front door, each resident has a risk assessment and those that are safe to go out have a key to the front door. The home was very clean throughout. Staff observe good infection control procedures and there is hand gel dispensers around for residents and visitors to use. White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people who use the service can expect to receive a consistent service from a highly qualified and dedicated team of nurses and carers. EVIDENCE: Staffing levels are adjusted according to the level of need. All residents said that there are sufficient staff and that they do not have to wait long periods of time to receive help. Very positive feedback was received about the staff team including ‘the nurses are very good to us no matter what we ask for’ and ‘I can’t praise the staff enough,’ and ‘staff are always willing and helpful.’ The home has very low staff turnover and most of the staff have worked there for many years. Three of the nurses including the registered Manager have their Registered Managers Award. This is above the recommended level and 70 of care staff have an NVQ level 2 or above. The recruitment procedures for the home are satisfactory and pre-employment checks for the recruitment of new staff are carried out to ensure that residents are safe. All staff are subject to an enhanced criminal Record Disclosure. White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 17 We looked at the training records for the staff. Staff attend mandatory training courses as part of their induction and this is reviewed as required. The company provide the Skills for Care Common I Induction Standards. Staff also attend specialist training courses such as dementia care, Mental Capacity Act, diabetes and others. A representative from the Royal College of Nursing visited to talk about duty of care and advocacy. District nurses also visit the home to do talks about various health care subjects. White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The providers and Manager are highly committed to ensuring that people who live in the home receive good quality, safe and individualised care. The ethos of the home is open and transparent and the views of the people who live there are listened to. EVIDENCE: The Manager of the service is a qualified nurse and has gained her Registered Managers Award. She is very dedicated and ensures that the people who live in the home are treated as individuals with diverse needs. The providers are willing to spend money to ensure that equipment and other items required are available. A DVD was also made to ensure that people can see what the service like if they are unable visit. The Manager and provider said ‘we want to White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 19 move with the times and make sure we have knowledge of current good practice.’ A long discussion was held with the Manager about equality and diversity. The Manager was keen to ensure that people are treated fairly and with respect. A training session has been held on the Mental Capacity Act and two nurses have attended specialist training courses on dementia care to ensure that staff are aware of current good practice. The service consistently reports 100 occupation and vacancies are normally snapped up. One professional said ‘I wish they had more beds! Its always at the top of my list when relatives ask for nursing or residential homes.’ Residents are asked on a regular informal basis if they are happy with the service. A more formal survey is completed annually. Residents said that they speak to the Manager if they need to. Policies and procedures are in place to protect the personal finances of residents. An individual record is now maintained of income and expenditure. The service commissions a specialist company to consult on health and safety in the home. All records relating to health and safety in the home were satisfactorily maintained. White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 20 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 X X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 21 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. Refer to Standard Good Practice Recommendations White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI White Gables Nursing And Residential Home DS0000002561.V371349.R01.S.doc Version 5.2 Page 23 - 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. 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