Inspection on 17/05/07 for Glyn Residential Care Home

This inspection was carried out on 17th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Glyn Residential Care Home 22/04/08

Glyn Residential Care Home 12/12/05

Glyn Residential Care Home 12/07/05

Glyn Residential Care Home 01/11/04

Glyn Residential Care Home 23/06/04

Glyn Residential Care Home 19/02/04

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Dalewood Respite Care

Orchard,The

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Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Glyn Residential Care Home 6 Dudley Avenue Hordle Lymington Hampshire SO41 0HY Lead Inspector Chris Johnson Unannounced Inspection 17th May 2007 11:00 Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 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 Glyn Residential Care Home DS0000011739.V335187.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 Adults 18-65. 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. Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glyn Residential Care Home Address 6 Dudley Avenue Hordle Lymington Hampshire SO41 0HY 01425 614595 01425 614595 info@glyn-residential.co.uk 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) Glyn Residential Limited Mrs Suzanne Bull Care Home 7 Category(ies) of Learning disability (7), Physical disability (7) registration, with number of places Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Dispensation has been given to one named service user in the MD (E) category to remain accommodated in the home. 18th March 2003 Date of last inspection Brief Description of the Service: Glyn Residential Care Home is one of three homes owned by Glyn Residential Limited and currently provides personal care and accommodation for seven people with learning and physical disabilities. An additional three service users, from one of the other homes, go daily to Glyn for day care. The home is located in a quiet rural area of the New Forest but is within reach of local shops. Glyn has a mini-bus to access wider community networks. The home is a large chalet style bungalow accommodating six people on the ground floor and one person upstairs. Six of the bedrooms have en-suite facilities. Communal space consists of a lounge/dining room, conservatory and a good size and accessible garden. The cost of living at the home ranges from £1,6042 - £3,800 per month. Additional charges are made for hairdressing, chiropody, holidays, toiletries, some activities and transport. Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this inspection was to assess how well the home is doing in the meeting of all key National Minimum Standards and compliance with regulations. The findings of this report are based on a number of different sources of evidence. These included: An unannounced visit to the home, which was carried out on 17th May 2007. During this visit a tour of the premises was completed that included looking at people’s bedrooms and all communal areas of the home. Staff and care records were inspected; staff, people living at the home and the manager were spoken with and staff were observed during their day-to-day interactions with those living at the home. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection. The manager completed a pre inspection questionnaire prior to the visit. Six people who live at this home and three of their relatives completed questionnaires prior to the visit. What the service does well: People’s needs are fully assessed prior to admission so that the individual and the home can be sure that the placement is appropriate and will meet the person’s needs. The opportunities for people to engage in activities and keep in contact with friends and family are good. They are free to choose how they live their lives and to pursue their individual hobbies, pastimes leisure and educational interests. One person commented, ““I go to church on Sundays and meet lots of people. I enjoy rides out to the country and I go to art work classes”. Satisfactory systems are in place for people to address any concerns or complaints that they may have. Procedures are in place to offer them protection from harm. People say that they feel safe at the home and well treated. One person said, “The staff are very nice and treat me like a lady”. The food in the home is good offering both choice and variety. People have access to a full range of healthcare support as necessary. The home provides a safe and well-maintained environment. The home is well furnished, homely and comfortable. Good standards of hygiene are maintained. The home maintains adequate staffing levels for the needs of those living at the home. Staff receive appropriate support and supervision in order to carry out their role. The home has a good level of staff retention and this provides consistency to the people living there. Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 6 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. Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4 and 5 People who use 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’s needs are fully assessed prior to admission so that the individual and the home can be sure that the home is right for them and will meet the person’s needs. EVIDENCE: The majority of the people who live at this home have lived there for several years and there has only been one new admission to the home since April 2001. Five of the six people living at the home who completed a comment card said that they had received sufficient information enabling them to make a decision as to whether the home was right for them. Through discussion with the manager and evidence seen it was evident that a suitable assessment procedure is followed. This includes: Liaising with all relevant parties such as the person and their family, social and healthcare professionals and obtaining care management assessments. People have the opportunity to visit the home prior to deciding whether to move in to assess if the home and staff skills can meet their needs. People are initially offered a place at the home for a trial period this enables both the resident and the home to make certain that the home is the right place for them. Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 9 Whilst everyone living at this home had been issued with a contract detailing their rights’ not all of these had been signed by either the person or their representative and none of them stated the cost of living at the home and were outdated. The manager agreed to rectify this. Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 and 10. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples’ care needs are generally met. The lack of detail within care plans means that there is a likelihood that needs’ will be overlooked. EVIDENCE: The care plans of two people were looked at during the site visit. Whilst plans were available for both people they were basic and lacked sufficient detail and guidance in some areas of the persons care needs. Care plans did not adequately address all assessed and identified needs or risks and did not provide sufficient detail regarding how risks were to be managed. This includes the management of challenging behaviour. However in discussion with members of staff they were all able to demonstrate a good understanding of each persons’ care needs and describe their care needs and any associated support and methods to be used in good detail. Care plans need to be more specific and provide more detail regarding the person’s abilities as well as their care needs to ensure that independence is fully promoted. This is especially pertinent where people require assistance with Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 11 personal care such as washing and dressing. It was found that some peoples’ files held conflicting information regarding their needs and the level of support required. This was partially due to the organisation of the files and it would be beneficial to archive old material. Also care plans, risk assessments and associated risk management plans are not being consistently and thoroughly reviewed. This could lead to important changes in a person’s needs being overlooked. This was noted in some of the moving and handling assessments. People spoken with were aware of their care plans although there was little evidence of their involvement in this process or that they were ‘personcentred’. The manager was in agreement with these findings and showed the inspectors a prototype of a care plan that had previously been in use at the home. It was discussed how if these were to be fully implemented within the home they would provide much greater detail and would be more person centred. Currently people do not hold their own care plans, the manager said that they had been asked and declined. This should be reviewed and recorded with the individual on a regular basis. People were observed to be able to make their own decisions regarding how they spend their day and lifestyle choices and this was confirmed through feedback from questionnaires completed by relatives, people living at the home and in conversation with them. The home supports people to take some positive risks as part of their everyday lives. However this could be further promoted in some areas such as using the kitchen and promoting selfmedication as discussed in the Personal and Healthcare Support section of this report. Currently menus are planned in conjunction with people who use the home for day care, these people have less communication needs and are therefore more able to communicate their wishes, whereas those who live in the home are not. Evidence that confidentiality is not always maintained was noted. The Care plans are kept in the conservatory on an open shelf. This does not protect peoples’ confidentiality and this was discussed with the manager. The manager suggested an alternative secure storage area that would still enable staff to access care plans as necessary and undertook to make this change the following week. It was also noted that peoples’ weekly activities were on display within the home. While this may be acceptable to people living at the home the manager was advised to consult with them to make certain that they were happy with this. Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 People who use 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 opportunities for people who live at this home to engage in activities and keep in contact with friends and family are good. They are free to choose how they live their lives and to engage in activities of their own choosing. The food in the home is good offering both choice and variety. EVIDENCE: People living at the home are supported to take part in a range of activities both inside and outside of the home. These include, educational, social and leisure, physical, and attending day services and college courses. On the day of the visit to the home three people had been out in the minibus and another had been to the local community centre. In discussion with people living at the home they confirmed that they were supported to use local amenities and to access the community. People are supported to pursue their own interests and hobbies. Several people have their own personal computers and have access to the internet. The home also has a communal computer for Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 13 all to use. From viewing several peoples’ bedrooms it was evident that they are supported and free to pursue their own hobbies and interests. People are also supported to go on holiday to various activity centres and to other countries. The opportunity for people to keep in contact with their friends and relatives is good. All relatives contacted said that they could visit the home whenever they wished and that they were made to feel welcome. They also stated that they were kept informed of any important matters affecting their relative. This was further supported by evidence seen in daily records, discussion with the manager, staff and people living at the home. One person commented, “My friends from the church come to visit me during the week, they are made very welcome by the staff who make them a cup of tea and give them cake”. Observations made during the visit showed that people were given freedom of choice, that they are offered encouragement and that staff respect their rights’. The inspectors saw a sample of menus and these demonstrated that people are provided with a nutritious, healthy and varied diet. Choices are available and lot of food is home made. People living at the home said that the food was, “ very good” and that they were offered a choice. Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at this home are supported in some areas of their healthcare needs. However improvements need to be made to the homes’ medication procedures to ensure that people living at the home are better protected. EVIDENCE: Whilst the people who live at this home consider that they are given sufficient support with their personal care needs this could not be fully substantiated due to the lack of detailed information held in care plans. At present the home cannot fully demonstrate that all people receive personal support in the way that they prefer and require. This is especially pertinent to people with communication needs. At present the lack of detail recorded means that these plans could not be used in an emergency by people unfamiliar with the person. Records were available to demonstrate that people have access to a range of services such as GP’s, Dentists, Chiropodists and district nurses. This was supported through conversations with people living at the home. Health care Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 15 records were well maintained and demonstrated that the home liaised with healthcare services and referred people to specialist services as appropriate. The medication administration records were checked for several people during the site visit. From examination of these records it was evident that staff are following correct recording procedures. The home has clear written policy and procedures for the administration of medicines and staff are trained before being able to administer. The manager had arranged to introduce a new monitored dosage system and corresponding pre-printed recording sheets to at the home. A local pharmacist will prepare these. This system was due to take effect from 21st May 2007. This system should afford people greater protection from error than the previous system whereby the manager dispensed the tablets into a weekly cassette system and used handwritten administration sheets. The manager was advised to ask the pharmacist for training in the new system. From examination of the medication recording sheets it was noted that amendments to the sheets such as; increases in dosage had been done by the manager. The manager said that this had been on the advice of the GP. However there was no audit trail to substantiate this and it was agreed that any future changes must be authorised by the person prescribing the medication. Several people had been prescribed ‘as required’ (PRN) medicines and there was not any guidance to inform staff regarding the use of these. At present only the manager and one senior staff member manage this. This presents a problem should someone require PRN during a time when neither person is present or available. Therefore clear written guidelines need to be available. At present no one is self–medicating and risk assessments have not been completed to determine peoples’ ability or wish to manage their own medication. It was noted that the majority of people did not have lockable storage facilities within their bedrooms. This will further encumber the facilitation of selfmedication. It was agreed that these issues would be discussed with everyone living at the home. The current medication storage facilities, which consist of a lockable wooden cupboard in the kitchen, were discussed with the manager. The manager was advised that this did not meet with the Royal Pharmaceutical Society of Great Britain’s guidelines and that she should seek advice. The manager said that she intended to move the storage to an alternative area of the home. Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use 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. Satisfactory systems are in place for people to address any concerns or complaints that they may have. Procedures are in place to offer them protection from harm. EVIDENCE: No concerns regarding the home have been reported to the Commission for Social Care Inspection since the last inspection. A Complaints log is maintained in the home, and from examination, the home had not received any complaints. This was supported by pre-inspection material and feedback from relatives and people living at the home. The home had a complaints procedure prominently on display and this had been made available to people in a format suitable to their needs. Five of the six people living at the home, who completed a questionnaire, stated that they knew whom they could speak to if they were unhappy about anything. Two of the three relatives who completed a comment card responded that they did not know how to make a complaint. The manager said that she would discuss the procedure regularly at house meetings and to review whether relatives needed an update. Staff demonstrated that they were aware of their responsibility should someone wish to make a complaint. The home has systems in place for the protection of the people who live at this home. The home has an adult protection policy and the manager demonstrated that she was aware of correct reporting procedures. In discussion with staff some recalled having training in this area whilst another had not. The home Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 17 has an adult protection video for staff to watch as part of their training in preventing and dealing with suspected abuse and staff reported that they were aware of that there was a written policy although they were unclear of the reporting procedures other than discussing with their manager. The manager agreed to revisit this subject with all staff. Recruitment procedures are followed and this provides safeguards to people who live at the home. Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,28 29 and 30 People who use 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 safe and well-maintained environment. The home is well furnished, homely and comfortable. Good standards of hygiene are maintained. EVIDENCE: During the visit to the home a tour of the premises took place. This included looking at several peoples’ bedrooms and all communal areas of the home. The home is decorated and maintained to a good standard. It is well furnished, homely, clean and comfortable. Communal space consists of a lounge/dining room, a large conservatory and a good size and accessible garden. All bedrooms seen had been personalised with the person’s own belongings and reflected each persons individuality and interests. Some bedrooms had been redecorated since the last inspection and an outside shelter had been erected to enable people to use the garden during different weather conditions. One person commented, “ It is nice living here, I have my own room and it has just been nicely decorated”. Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 19 People were observed to be able to access all communal areas of the home and looked relaxed and at home in their environment. A stair lift had been fitted to enable the most recent person to move into the home to safely access an upstairs bedroom and hoists and aids were fitted throughout the home to meet the needs of those living there. Good standards of hygiene are maintained throughout the home and infection control procedures were being followed. Paper towels and dispensable soap was available in all bathrooms and toilets. Staff are issued with gloves and aprons as necessary. Everyone who returned a questionnaire responded that the home was always fresh and clean. As has previously been discussed it was noted that bedrooms did not contain secure lockable storage facilities. The manager agreed to discuss this with all concerned to ascertain if they wished to have this facility. This will however be necessary should anyone start to look after his or her own medication. Prior to visiting the home it had been remarked by a visitor to the home that the conservatory became too hot in sunny weather. On the day of the visit this was discussed with people living there who agreed with this. Some people use their computers in this area of the home and the lack of shade was noted to cause difficulty in viewing the screens and the television. Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,34,35 and 36 People who use 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 maintains consistent staffing levels for the needs of those living at the home. Staff receive appropriate support and supervision in order to carry out their role. Generally staff receive sufficient training but not in moving and handling. This compromises the safety of people at the home and also puts the staff at risk. People living at the home are protected by the home’s recruitment procedures. EVIDENCE: Staff rotas were examined. These demonstrated that staffing levels remain constant and are maintained at the same level as at previous inspections. The visit to the home confirmed the rota to be a true reflection of actual staffing levels. The home employs domestic staff as well as care staff and this means that care staff can spend more time attending to peoples’ needs. A senior carer is on shift at any given time and a manager is always available out of hours through an on–call system. The home has a number of staff that have worked there for several years. This provides consistency to the people living there. Members of the existing staff team provide cover when a staff Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 21 member is absent. This has enabled the service to avoid the use of agency staff. Staff records were checked for the most recent staff members to be employed at the home. These were for people who have worked at the home for approximately eighteen months. At this point in time it was clear that the home’s recruitment checks were not as robust as they should be. However the manager was aware of this and had since improved procedures. The records of a newly appointed person who had not yet commenced work at the home demonstrated that the home was now following appropriate recruitment procedures, to safeguard people living at the home. Records were also available to demonstrate that new staff followed a suitable induction period. However records such as the date that a staff member commenced working at the home are not maintained and were not accessible. Training courses provided to staff include, food hygiene, epilepsy, medication, first aid and health and safety. At the time of this visit seven of the fifteen care staff held an NVQ level 2 or above. At least one other staff member is currently registered on the course. The home does not ensure that all staff are trained in moving and handling procedures. This effects the majority of people who live at this home who have needs in this area. Whilst most staff are trained in this area it was found that at least one person is without this training. The manager agreed to rectify this and commented that it was sometimes difficult to arrange external training and that she planned to attend a course that will qualify her to deliver this training. Records were available to demonstrate that staff receive regular supervision, appraisals and support from the manager. All staff spoken with said that they felt that the level of support provided to them was good and that they could seek advice from the manager at any time. Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 41 and 42 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has a good knowledge of peoples’ needs and the people living at the home and the staff have confidence in her. However some areas that effect people living at this home such as care planning, medication, moving and handling training, need to be better managed. EVIDENCE: The manager has managed the home for five years and has completed a registered managers award since the last inspection. The manager demonstrated that she had a good knowledge of the needs of people living at the home and it was clear that they and the staff had confidence in her. The home is managed with a senior staff member always on duty. The views of people living at this home are taken into account through regular house meetings. However, people who use the home for day care also attend Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 23 these meetings. Decisions such as menu planning are made at these meetings. The people attending the home for day care have less communication needs than those living at the home and are therefore more able to communicate their wishes, than those who live in the home. The manager is therefore advised to ensure she is demonstrating that the residents who live in the home are consulted on the decisions that are made by others. The home has developed questionnaires for relatives and people living at the home in various formats in order to gain their views on the quality of the service. Evidence would suggest however that despite these being available for quite some time they have yet to be implemented. The manager is proactive in assessing and improving the service and the introduction of systems to ascertain the views of all stakeholders will assist with this process. In general records are well maintained within the home. There is a need to ensure that records such as staff start dates are maintained as discussed in the staffing section of this report and also that records such as care plans are stored confidentially. Health and safety is promoted within the home. Examination of the fire logbook demonstrated that regular and thorough testing of the home’s fire detection and fire-fighting equipment was being carried out. The home reported that all equipment used within the home had been regularly checked and serviced. The home appeared to be safe and is well maintained. It was noted that none of the bedroom doors within the home had self closures on them. Currently some of the people living at the home choose to have their doors open during the day. This must be risk assessed. The manager will need to consult with the local fire authority to check whether this practice is safe and if not action will need to be taken to reduce any identified risks. Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 X 3 X 2 X 2 3 X Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 25 NO Are there any outstanding requirements from the last inspection? 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. 1 Standard YA6 Regulation 15 Requirement All care plans must be reviewed. They must be more detailed and provide specific support instructions and fully address all assessed and identified needs. Written guidance must be produced in respect of any resident prescribed PRN “as required” medication. This must be incorporated into their care plan. All changes made to a person’s medication dose, or frequency must be authorised by the person prescribing the medication. All medicines must be stored safely and appropriately. Staff must receive training such as moving and handling appropriate to the work they are to perform. The registered manager must establish a quality assurance system at appropriate intervals for monitoring the services and care delivered in the home. This must be done in consultation with people living at the home and their relatives/ DS0000011739.V335187.R01.S.doc Timescale for action 17/08/07 2 YA20 13 (2) 17/07/07 3 YA20 13 (2) 24/06/07 4 5 YA20 YA35 13 (2) 18 (1) (c) (i) 24 (1)(2) (3) 17/07/07 17/07/07 6 YA39 17/08/07 Glyn Residential Care Home Version 5.2 Page 26 7 8 9 YA41 YA41 YA42 17(2) Schedule 4 (6) (d) 17(1) (b) 23 (4) representatives to gain their views and opinions. Results of quality assurance monitoring must be made available at any time to the Commission for Social Care Inspection. Records such as the date that staff commence working at the home must be maintained. All records pertaining to people who live at the home must be stored confidentially. Consultation with the Fire Authority must take place to ensure that suitable precautions are in place for the containment of fires. 24/06/07 17/07/07 17/07/07 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 Refer to Standard YA26 Good Practice Recommendations Service users should be supplied with secure lockable storage in their rooms. This needs to be appropriate to their needs. Glyn Residential Care Home DS0000011739.V335187.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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