Care Home: White Gables Residential Home

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What the care home does well The service offers high quality individual care to older people ensuring they make use of information supplied by residents and their family to support people in the way they would wish. Care plans are very detailed and compiled and reviewed with the input of the resident. Independence is encouraged and maintained for as long as possible. The environment of the home is well maintained and attractively decorated. Efforts are made to use colours in individual rooms that the resident prefers and encouragement is given to personalise the rooms with favourite items of furniture and pictures.Staff training has a high importance with many staff undertaking an NVQ in care at level 2 or above. Staff have regular supervision to discuss personal development and training needs. What has improved since the last inspection? Following the two requirements made in the last inspection report evidence was seen at this visit that skin integrity was assessed for residents to identify the risk of developing pressure sores. People who wished to self medicate also had an assessment of their ability to manage their medicines safely. The service has introduced a new care plan format that is comprehensive and informative when completed correctly. An ongoing redecoration programme has meant that a number of individual bedrooms and some communal rooms have been redecorated and had new carpet laid. Plans are in place to renew the lift machinery, which has been causing difficulties. Residents and visitors have all been notified of the work and the possible disruption it may cause but provision has been made to limit that. CARE HOMES FOR OLDER PEOPLE White Gables Residential Home 16 Stanley Road Felixstowe Suffolk IP11 7DE Lead Inspector Jane Offord Unannounced Inspection 16th January 2008 10:45 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 Residential Home DS0000024525.V358144.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 Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service White Gables Residential Home Address 16 Stanley Road Felixstowe Suffolk IP11 7DE 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) 01394 282620 01394 283847 whitegables.rch@btinternet.com Mr. C Lewis & Mrs. J Lewis Mr Clifford Lewis Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th March 2007 Brief Description of the Service: White Gables is a private, family run care home for older persons, which has operated since 1982. The Home was first registered in 1984 for 15 service users. A conversion and extension provided a further 10 places, and a further extension into the adjacent property in 2004 enabled the provision of 12 more beds. The home is now registered under the provisions of the Care Standards Act 2000 to accommodate a maximum of 37 older persons. The home is located in the coastal town of Felixstowe and is within walking distance of the town centre. The local amenities include the post office, shops, community centre, doctors’ surgeries, churches, theatre and leisure centre. The home is also close to the main bus routes that serve the town centre. The southern aspect of the home faces the promenade, gardens, lawns and sea views. Access to the home is by a main side entrance where car parking is available. The accommodation is over three floors that are accessed by stairs, lifts or platform lifts where some floors have slight changes in levels. All bedrooms are single accommodation, with en suite toilet facilities in thirty-six of the rooms. There are three communal lounges, two on the ground floor and one on the first floor. The main lounge on the ground floor is where activities take place and has level access to a small patio area. The other two lounges are smaller and quieter and can be used to meet visitors in private without the need to take them to a resident’s bedroom. There is a large attractive dining room on the ground floor. As committed Christians the proprietors are involved with the church life in Felixstowe, and a daily bible reading and weekly service take place in the lounge for those who wish to participate. Fees for the home range between £341.00 and £540.75 weekly and do not include toiletries, hairdressing, chiropody and transport. The home provides a daily newspaper to the lounge but individual residents purchase other newspapers and magazines. White Gables Residential Home DS0000024525.V358144.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 that people who use this service experience excellent quality outcomes. This key unannounced inspection looking at the core standards for care of older people took place on a weekday between 10.45 and 15.30. The owners were both present during the day and assisted the inspection process by providing documents and information. This report has been compiled using information available prior to the inspection, including a completed annual quality assurance assessment (AQAA) and a number of survey forms completed by residents, staff and visitors, as well as evidence found on the day. During the day a tour of the home was undertaken with one of the owners but all areas were revisited later. Three new residents’ files, care plans and assessments and three new staff files and records were seen. The policy folder, the menus, the duty rotas, the fire log and maintenance records were some of the documents inspected. The lunchtime meal serving was seen and the medication administration round was followed. Several staff and residents were spoken with and care practice was observed. On the day residents and visitors were using all areas of the home and enjoying the sunshine coming in the large windows. People looked relaxed and comfortable. The home was clean, attractive and tidy with no unpleasant odours noted. The lunch served in the pleasant dining room looked and smelled appetising and residents spoken with said they had enjoyed the meal. Residents who chose to take lunch in their room were served individually. Interactions between staff and residents were friendly and caring promoting respect and dignity. Medication practice observed was safe. What the service does well: The service offers high quality individual care to older people ensuring they make use of information supplied by residents and their family to support people in the way they would wish. Care plans are very detailed and compiled and reviewed with the input of the resident. Independence is encouraged and maintained for as long as possible. The environment of the home is well maintained and attractively decorated. Efforts are made to use colours in individual rooms that the resident prefers and encouragement is given to personalise the rooms with favourite items of furniture and pictures. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 6 Staff training has a high importance with many staff undertaking an NVQ in care at level 2 or above. Staff have regular supervision to discuss personal development and training needs. 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 Residential Home DS0000024525.V358144.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 Residential Home DS0000024525.V358144.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): 1, 2, 3, 6. Quality in this outcome area is excellent. People who use this service can expect to have sufficient information prior to admission to make an informed choice about the service and have their needs assessed and assurance given that they can be met by the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides a statement of purpose that clearly sets out the philosophy and aims of the home and, on request, is available in specialised format to meet people’s needs such as large print. Prospective residents and their representatives have available a folder that contains a copy of the statement of purpose, a complaints policy, a copy of the contract with terms and conditions of residence at White Gables, details of local amenities such as banks, churches, shops, health provision, bus services, theatre and leisure centre. The pack includes an application form for an advocacy service that offers advice and guidance for people making a decision to live in a care home. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 9 The service users guide that is also included in the pack emphasises that the home encourages independence and seeks to promote respect and dignity. Introductory visits and a trial period after admission, for both parties, are part of the admission procedure. The contact details for some useful agencies listed need to be updated as services have moved accommodation. The three new residents’ files that were seen all contained a copy of their contract with White Gables and of four residents’ surveys received by CSCI only one said they had not had a contract. The four residents’ surveys and four relatives surveys all said they had received sufficient information about the service prior to making a decision about living there. Residents spoken with said they had been able to visit the home prior to admission or already knew the service by reputation. The home’s admission policy states that an assessment of need will be undertaken on all prospective residents who do not come to the home as an emergency. The three files seen all contained documentary evidence of a preadmission assessment. Physical care needs such as personal hygiene, diet, mobility, recent falls, communication, continence and pressure area care were assessed. Other areas, where potentially support could be required, that were assessed included the person’s mental state, family situation, social interests and finances. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 10 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 excellent. People who use this service can expect to have their health needs met and a care plan in place to identify the support they require to meet daily activity. They can expect that medication practice will protect them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has recently changed the documentation they use for recording information about residents and developing their care plan from the recorded assessments. The files seen of three new residents all contained detailed information about the residents’ past medical history and present health needs. Contact details for their GP and community nurse together with other health professionals, such as dentist and chiropodist, were recorded. Visits to or by any health professional were noted with details of any treatment prescribed or changed. A record of the resident’s medication regime on admission was made together with any known allergies. The documents were full and informative. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 11 Care plans were developed from the assessments and clearly included residents in the process, who had signed the documents. Some areas of support with individualised interventions that encouraged independence were for personal care, communication, managing continence, night needs, mobility and nutrition. There was evidence that monthly reviews of the interventions took place with the resident and changes were made to reflect changing needs. The care plan for one resident in relation to their personal hygiene needs originally stated they were independent a later review changed that and stated that the resident now needed more help to manage their personal hygiene. The resident had signed the change. Each file had a number of risk assessments completed for areas of care that could potentially be of concern and need specialised input. An assessment of skin integrity was made looking at possible contributory factors for vulnerable skin condition such as the use of steroids, and the interventions or equipment required to protect the resident from skin breakdown if a risk was identified. A malnutrition universal screening tool (MUST) that includes the body mass index (BMI) for a person to help identify any risk from poor nutritional intake and a falls risk assessment were seen in the files. Daily records seen were very sparse and did not give an impression of the dayto-day experience of the resident living in a care home. Staff comments in the surveys received by CSCI indicate that they find the new care plan format, ‘excellent - much more detail’, ‘more informative - can use the life history work to connect better with a resident’. The owner agreed that some of the detail needed to be reflected in the daily records. Verbal feedback from residents showed they were generally happy with their lifestyle and health care. One relative said in their survey, ‘our Dad has improved mentally and physically since being in White Gables’. The management of medication policy was seen and gave good general guidance, and had a list of authorised signatures from staff trained to administer medicines, but needs to be expanded and/or cross-referenced to give more specific guidance for special areas of medicine management such as the covert administration of medicines or ‘homely’ remedies. On the day of inspection the home had no controlled drugs (CDs) on the premises but had suitable storage and a register if any were prescribed. The lunchtime medication administration round was observed. The carer doing the round said they had received recognised medication training prior to undertaking the task and had recently completed their NVQ level 3 where medication management had been covered again. The medication administration records (MAR sheets) were seen and no signature gaps were noted. The home uses a monitored dosage system and the packs had identification photographs attached to them. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 12 Medicines were given sensitively with residents being offered a choice for ‘as required’ drugs and what drink they wished to take tablets with. The medicine trolley was secured to a wall with a chain when not in use. In following the philosophy of promoting independence the home encourages residents who wish to manage their own medicines to self-medicate. During the last inspection a requirement was left to review the procedures for selfmedication and develop risk assessments to cover this area of support. None of the three residents whose files had been supplied were self-medicating so a further two files were supplied of residents who were managing their own medicines. These files contained an agreement between the home and the resident for the person to self-medicate and an assessment of their ability to do so. The person’s ability to read labels and manage bottles and packs was assessed. The owner said they were reviewed monthly to ensure skills did not deteriorate. One assessment noted that the resident used a dossett box that needed to be filled by the pharmacist. Both residents had a lockable drawer in their room for the safekeeping of medicines and valuables. The residents’ files seen recorded the resident’s preferred name and staff were overheard addressing residents with respect and care. Staff knocked on doors prior to entry and residents were offered choices about where they wished to spend their time. Care practice observed promoted independence and carers were aware of the need to give residents time to complete tasks at their own pace. Throughout the day there was constant friendly conversation taking place between residents and carers. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 13 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 good. People who use this service can expect to be encouraged to maintain contact with family and friends and receive an appetising diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose offers a welcome to visitors at any time convenient to the residents and this is reflected in the AQAA that says White Gables has an open visiting policy. Visitors were seen to come and go during the day of inspection and were welcomed by staff with offers of refreshment and indication of where to find the person they were visiting. The home has three lounges, two of which are smaller, quieter areas that offer sympathetic room to meet people in private without using personal bedrooms. There is also at least one attractive seating space on a landing that can be used as well. The three residents’ files seen all contained contact details for the next of kin and the relationship to the resident. Life history work in the files detailed family trees and children and grandchildren. The home has three married couples among their residents, one couple who met and married in the home. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 14 There is an activities programme that shows that a pastime is organised each day for residents who wish to participate. Activities included carpet skittles, a beetle drive, bingo, a musical session and quizzes. A number of residents had recently taken part in a Scrabble tournament and comment was made in surveys received by CSCI of how much it had been enjoyed. A weekly religious service is arranged in the home with visiting speakers and residents who wish to are supported to attend their local church. A resident’s religion was recorded in their personal details and one file seen noted that the person wished to attend their church every Sunday and Wednesday. Regular bible study sessions are organised in the home for people who wish to participate and comments in one survey showed how these were appreciated. Photographs around the home show outings are arranged during the year to various venues including the beach, Easton Park Farm, the zoo and the theatre. As this inspection was just after Christmas residents talked about the carol singing, a visit from the mayor and the Christmas party that had been part of the celebrations. The Salvation Army had visited the home and some residents had been to see the turning on of the Christmas lights in the town. Copies of the menus were seen and showed that at lunchtime and teatime there was a choice of cooked meals. The lunch started with a soup and offered choices such as cottage pie or pork chops in tomato sauce with a sponge and custard or Bakewell tart for dessert. The tea menu always had fresh fruit and yoghurts available and a hot snack such as tuna pasta bake or cheese on toast. There was a full roast dinner each Sunday. White Gables has a large attractive dining room on the ground floor that has a number of small tables for residents to have their meals socially. The tables were laid with attention to detail including napkins and cruets. Vegetables were served in tureens for each table and residents helped themselves to a portion as they wished. On the day of inspection the meal was cottage pie or poached chicken with a choice of vegetables followed by trifle or jelly and ice cream. Carers assisted residents sensitively if they required help and were attentive offering fresh drinks or second helpings. People spoken with later said they had enjoyed their lunch and that ‘the food here is always lovely’. The kitchen was visited and found to be clean and tidy. Food stores were varied and plentiful and the manager said they had deliveries from local merchants two or three times a week. A comprehensive cleaning regime was seen and the records showed that the refrigerators and freezers were all functioning within safe limits for food storage. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 15 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, 17, 18. Quality in this outcome area is excellent. People who use this service can expect to have complaints taken seriously and be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four residents’ surveys and four relatives’ surveys received by CSCI all state that they are aware of the complaints policy and who to approach if they had a concern. One visitor’s survey said they thought the staff had responded completely appropriately following a complaint about some mislaid clothing from their relative. The complaints policy, which is given to all new residents with a folder containing other useful information, was robust offering full investigation and a written response to any issues raised. The contact details for CSCI need to be updated since the office has recently moved. CSCI is not aware of any complaints about this service since before the last inspection. The complaints log was seen and showed three issues recorded. One concerned the supply of some glucose testing strips and two were about mealtime arrangements. There was evidence that they were all looked into and resolved to the satisfaction of the residents concerned. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 16 All the residents’ files seen contained a document completed by the resident about how they wished to exercise their voting rights during an election. The choice was to attend the polling station, use a postal vote or vote by proxy. If the resident required help then they also identified the person they wished to assist them to exercise their right of vote. During the day a training session updating staff on the new Safeguarding Adults initiative was taking place led by the deputy manager who had been trained as a trainer. The training matrix showed that regular updates were done for staff. Staff spoken with said that recognition of abuse was covered in their induction programme and again during further training if they undertook an NVQ course. They were clear about their duty of care towards residents and knew that the home has a whistle blowing policy to protect staff who report concerns. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 17 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. People who use this service can expect to live in an attractive, clean home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the day a tour of the home was undertaken with one of the owners and all parts were revisited later in the visit. All areas were fresh and clean with no unpleasant odours noted. The décor throughout the home was attractive with co-ordinating soft furnishings and comfortable furniture. An ongoing programme of redecoration has meant that much of the interior of the home has been redecorated in the last year as well as a facelift for the exterior of the building. The manager said that residents’ bedrooms are redecorated when they fall vacant, in neutral shades so that when a new resident is identified they can choose soft furnishings and curtains in colours they prefer to personalise the room. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 18 Work was taking place to replace old fire doors that contained asbestos. The work had been carefully planned and risk assessed with a timescale to minimise disruption to the running of the home and the residents’ lifestyle. Likewise planning for the replacement of one of the lifts had been undertaken. Residents and relatives had been notified when the work will take place and the measures to be put in place during that period, for example additional staff will be available to ensure that residents who are unable to descend by the stairs have all they require in their rooms. A Stairmatic Mobile Stair Climber has also been purchased so residents can move around the home if they choose to. The maintenance system for reporting faults and repairs shows that all areas of repair are addressed rapidly. Records were seen showing that staff had reported light bulbs that needed renewing, a flat tyre on a wheelchair, a hanging curtain rail and broken furniture. All these issues were signed and dated as completed within a short timescale from being reported. The policy for infection control was seen and did not give guidance on the management of soiled linen. In discussion with the manager it was clear that soiled linen is managed using alginate bags that are put on a sluice wash. In the laundry there was evidence of the alginate bags and protective clothing for staff to use when performing tasks that could have a risk of cross infection. Staff spoken with were able to explain the infection control measures used in the home and the training matrix showed updates had been given on infection control issues. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 19 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 good. People who use this service can expect to be supported by adequate numbers of correctly recruited and trained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The duty rotas were seen and showed that on an early shift there were two senior carers and six other carers. The late shift was covered by one senior and four carers and the nights by one senior and three carers. An ancillary team of domestics, a cook and kitchen assistant and a maintenance person supported the care team. The owners are in the home daily, one working with the care team and the other as registered manager undertaking a lot of the administration work. Staff spoken with said that the staff team worked well together and supported each other as well as the residents. There has been no use of agency staff at the home for a number of years as permanent staff cover shifts themselves. One resident spoken with said, ‘the staff are lovely – always there when you need them’. The home employs thirty-two care staff of whom twenty have achieved an NVQ in care at level 2 or above with a further five enrolled on the course. This exceeds the national minimum standard recommendation that 50 of the care team should have an NVQ level 2 or above. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 20 The files of three newly appointed staff members were seen and all contained documentary evidence that the person’s identity had been verified. Each one had a POVA 1st check, two references and a criminal records bureau (CRB) check completed. There was a recent photograph of the person and a full work history. Each file contained evidence that an induction programme had been undertaken that covered health and safety, fire awareness, first aid, management of complaints, moving and handling and care practice. Staff spoken with confirmed they had had a comprehensive induction period and this was backed up by the surveys received from staff that all ticked ‘very well’ in response to the question, ‘did your induction cover everything you needed to know – when you started’. The training matrix showed evidence of a rolling programme of up dated training covering subjects such as infection control, moving and handling, food hygiene, management of medication, fire awareness, safeguarding adults and dementia awareness. Comments from the staff surveys say, ‘training is first class and I have been encouraged to study NVQ 2 3 with good support’ and all agree that the training is relevant and up to date. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 21 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): 31, 33, 35, 36, 38. Quality in this outcome area is good. People who use this service can expect to be consulted about their preferences and have their health and safety protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is jointly owned by Mr. and Mrs. Lewis and Mr. Lewis is the registered manager. Mr. Lewis has a background of working in residential care with nineteen years experience with older people. He also holds the registered managers award. Mrs. Lewis is a registered general nurse and also has experience in residential care of older people. Staff spoken with said they found the management team gave clear direction and were approachable if there were concerns or issues that needed discussion. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 22 Comments made in the surveys returned to CSCI included, ‘the ethos and environment of the home is recognised by its good reputation and that reflects the commitment of the management staff’, and ‘I always feel supported by my manager’. Residents are consulted on all aspects of their experience in the home. The most recent questionnaires were completed in October 2007. Responses to questions about personal care, cleanliness of the home, food, the décor, staff attitudes and social activities were mainly ‘very good’ or ‘good’. There was evidence that if a resident made a comment it was followed up so one resident had commented that it would be nice to see a newspaper sometimes, unaware that the home provided a daily paper in the main lounge. The manager had made a point of telling the resident of the provision. A new questionnaire has been devised for distribution later this year with questions based on the outcome groups of the national minimum standards (NMS). Since the last inspection the management team has taken the decision that they will not manage residents’ personal money in the interests of transparency and accountability. Residents and relatives were informed of this by letter and have made their own arrangements. Locked drawers are provided in residents’ rooms for safekeeping and there is a safe available for the storage of valuables. Staff spoken with said they had formal supervision with their line manager every two months and were able to contribute to the agendas for the meetings. Staff surveys confirmed that supervision takes place regularly and staff feel supported by the process. Minutes of staff meetings were seen and showed the wide range of issues raised from training to food and cleaning to care routines. A number of maintenance and service certificates were seen showing that equipment was correctly maintained. Hoists had been serviced in September 2007 and the hoist slings undergone a Loler inspection in October 2007. The gas safety certificate had been issued for a year from April 2007 and the nurse call system checked in November 2007. A comprehensive fire risk assessment has been completed during the year for the home with records of the testing and inspection of fire equipment. As noted earlier in this report planning for essential work is done and residents, relatives, staff and other stakeholders, such as CSCI, are kept informed of arrangements. White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 23 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 4 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 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 4 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 3 X 3 X 3 3 X 3 White Gables Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 24 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 Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 25 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 Residential Home DS0000024525.V358144.R01.S.doc Version 5.2 Page 26 - 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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