Inspection on 11/05/05 for Galanos House

This inspection was carried out on 11th May 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Galanos House 06/03/07

Galanos House 20/03/06

Galanos House 05/01/05

Galanos House 08/06/04

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

CARE HOMES FOR OLDER PEOPLE Galanos House Banbury Road Southam Warwickshire CV47 2BL Lead Inspector Terri Owen Unannounced 11 May 2005 & 3 June 2005 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 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. Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Galanos House Address Banbury Road Southam Warwickshire CV47 2BL 01926 812185 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Royal British Legion Ms Jo-Anne Wilson Care home with nursing 60 (40 residential 20 nursing) Category(ies) of Old age - Number 60 registration, with number of places Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 05 January 2005 Brief Description of the Service: The original Royal British Legion Home, Galanos House, was built in the mid 1960’s as a country home for elderly and incapacitated ex-servicemen and women and their dependents (residents must fulfil certain eligibility criteria). A wealthy Greek merchant, Christos Galanos, gave the funds for the building in a bequest. The new home was purpose-built and ready for residents in September 2002. It is registered to provide nursing and personal care to elderly residents over the age of 65. It has 60 rooms, all en-suite and set in approximately 3 acres of grounds, not far from the market town of Southam. The home has a large airy dining room with tables seating 2,3 or 4 residents. There is a lounge, bar and seating area situated on the ground floor. The first floor has a library, lounge, a well-equipped activities room and other smaller seating areas. Residents are encouraged to bring items in with them and can furnish their private room to their own taste if they wish. Ample car parking space is available at the front of the home. Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine inspection, carried out by one inspector that took place over 2 visits. The first visit on 11th May was unannounced. The second visit on 3rd June 2005 was arranged to enable the inspector assess some confidential records. Both visits were made during the daytime. There were fifty-nine residents at the time of the inspection. A tour of the premises was undertaken and the inspector had a meal with residents in the dining room. Records were assessed including staff records, care plans, risk assessments, medication administration records, menus and food records. The inspector also spoke with the manager, deputy manager, four members of staff and three residents. The inspection focused upon care plans and risk assessments, medication systems, the condition of the premises, quality of food, social contact and activities, recruitment practices and staffing levels. What the service does well: What has improved since the last inspection? What they could do better: Care plans and risk assessments need to be further developed to ensure they are comprehensive and contain enough detail for staff to provide continuity of care for residents. Care plans and risk assessments need to be updated on a frequent and regular basis. Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 Page 6 The systems for ordering and controlling stocks of medication need to be improved as overstocking of medications has occurred in some cases with some supplies becoming out of date. Some policies including those for giving homely medicines for minor ailments and occasional use medications need to be updated. 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. Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The above standards were not assessed during this inspection. EVIDENCE: Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9 The standard of care plans and risk assessment is variable in that some lack sufficient detail to manage specific care needs and identified risks. There is no system in place to ensure care plans and risk assessments are regularly reviewed and updated. This may result in care needs not being identified or consistently managed in some cases. The home has good systems and facilities in place to enable those residents who can and wish to, administer their own medication safely. To ensure safe administration and control of medications, policies regarding homely remedies for minor ailments and occasional use medication, and the ordering and stock control of medications need to be updated. EVIDENCE: Three care plans were assessed. In some cases where risks had been identified e.g. pressure damage risk, poor nutritional intake and poor mobility, there was no evidence of a more detailed risk assessment being made and care/management plans being developed. The time interval between reviews of some care plans and risk assessments was 3 months, despite care needs and risks being identified. “Daily Reports” are not being made consistently on a daily basis. Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 Page 10 In one case 19 days had occurred between entries being made. For one resident who was attending an out patient appointment, there was no reason identified for the attendance and no care plan in place regarding this problem. There was little evidence of residents and representatives being involved in the care planning and review process. There are lockable medicine cabinets in every resident’s bedroom. Assessments are undertaken on each resident regarding self-administration of medication to assess whether they may administer their own medication safely. There were no records of receipt of some medications received in February 2005. There was overstocking of some medications and some were found to have passed their expiry date. The staff at the home do not see prescriptions and copies of the prescriptions are not kept. Individual protocols were not in place for each resident for occasional use medications and homely medicines for minor ailments. Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13,15 Residents can maintain their social, cultural, and religious interests and there is a variety of social and recreational activities available to them. They are supported to maintain contact with their family, friends, local community and wider links with the British Legion. Residents can choose from a wide variety of good quality food that is well presented food, nutritionally balanced and available throughout the day and night. EVIDENCE: The home has a minibus and car available to transport residents and an additional minibus is being purchased. Resident’s wishes including their cultural, religious, sexual, social and recreational interests are identified and planned for on an individual and group basis. One to one activities are planned for each resident. There are a range of activities offered including trips out, gardening and cooking clubs, board games, skittles, hand massage and live entertainment. Activity programmes are planned and published on the notice boards. The home employs an Activities Organiser for 35 hours per week and volunteers also assist residents to pursue activities. Televisions are supplied for individual residents and satellite television programmes and internet access is available. Residents said they enjoy a wide range of activities and that they are consulted and involved in planning of activities. Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 Page 12 The home has an open visiting policy for friends and relatives. There is a range of areas in the home that allow privacy for residents if they choose. Relatives and friends meetings are held and they can accompany residents on various trips out. Residents may also invite friends and relatives to take meals with them at the home. Menus are displayed and residents confirmed that they can choose from a wide range of meals. Menus are prepared on a 4-week rotating basis. Fresh ingredients are used for food and convenience foodstuffs are avoided. Residents are offered five portions of fruit and vegetable a day. Special diets are catered for. No more than 5 hours elapses between meals being offered during the day. Tea, coffee and soft drinks are available in the Coffee Shop area and there is a bell placed outside the kitchen used by residents if they wish to request additional food, snack, drinks etc. Meals are served in the dining room that offers a range of seating arrangements. Room service is available. Those residents who need assistance with eating are sensitively supported. Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed during this inspection. EVIDENCE: Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The home is purpose built and set in attractive grounds. It offers residents a safe, spacious, well-maintained environment with a range of specialist equipment that meets their needs. EVIDENCE: All areas of the home are well appointed. There is a maintenance programme in place and the environment, furniture and fittings are maintained to a high standard. CCTV cameras are installed for security and do not intrude into residential areas of the home. The garden is being further developed and residents assisted in the design of this area meeting their wishes and needs. All areas of the home and garden are accessible to wheelchair users. A range of specialist equipment including hoists, baths and showers are also maintained to a high standard. Storage space has become problematic, as many residents have powered assisted wheelchairs resulting in charging units with trailing leads being kept in the clinical room. This area is also used as a consultation room for residents to see their GP. There is also of lack of space to store laundry trolleys. Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 There are a sufficient number of staff on duty at all times with an appropriate range of skill mix to ensure the needs of residents are met. The home operates a thorough staff and volunteer recruitment policy that ensures the protection of residents. EVIDENCE: Residents said there was always enough staff on duty to help them when they needed it. Duty rotas confirmed there was a minimum of 1 nurse on duty throughout the 24-hour period with 2 nurses usually during the day between 8am and 5pm and 1 or 2 nurses between 5pm and 8pm. In total there are 11 nurses and care staff on duty during the day, 8 to 9 staff in the evening from 5pm-8pm and 5 staff overnight. Occasionally agency staff are used to cover some shifts. In addition to nursing and care staff there is the manager, an activity organiser, administration, catering, cleaning, maintenance and garden staff. Assessment of staff records demonstrate the home is seeking all the required information including criminal records and protection of vulnerable adults checks and references prior to staff starting work. Staff contracts are all subject to satisfactory medical and criminal record checks. Volunteers also undergo rigorous checks, including criminal records checks. Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed during this inspection. EVIDENCE: Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 4 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 Page 18 YES 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 7 Regulation 15(1) Requirement The registered manager must ensure comprehensive assessment of residents needs and that care plans include sufficient detail of how care needs are to be met. The registered manager must ensure comprehensive assessment of risks to the health and welfare of residents including pressure damage, nutrition, mobility, moving and handling, falls and their prevention. Where risks are identified, detailed risk management plans must be recorded. The registered manager must ensure regular reviews and updating of care plans and that evidence of updating and review is available for inspection. (Timescale of 28/02/05 not met.) The registered manager must ensure residents and their representatives are involved in the care planning and review process. The registered manager must ensure all occasional use Timescale for action 30/09/05 2. 7 13 (4)(c 30/09/05 3. 7 15(2)(b) 30/09/05 4. 7 15(2)(ad) 30/09/05 5. 9 13(2) 31/08/05 Page 19 Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 6. 9 13(2) 7. 9 17(1)(a)S chedule 3(3)(i) 8. 9 13(2) 9. 9 13(2) 10. 9 13(2) medicines prescribed are administered against a written protocol recording reasons for administration, dose, maximum daily dose and recording requirements The registered manager must ensure all homely medicines for minor ailments purchased without a prescription are administered against a written protocol recording reasons for administration, dose, maximum daily dose and recording requirements. The registered manager must ensure the quantities of all medication received or balances carried over from previous cycles are accurately recorded to enable audits to demonstrate medication is administered as prescribed. The registered manager must ensure all prescriptions are seen prior to dispensing and a system installed to check the dispensed medication and MAR chart against the prescription for accuracy. The registered manager must ensure audits are undertaken to demonstrate medication is administered as prescribed. The registered manager must ensure that all staff follow the policy for receipt of medication. (Timescale of 28/02/05 not met.) 31/08/05 31/08/05 31/08/05 31/08/05 31/08/05 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 Good Practice Recommendations E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 Page 20 Galanos House 1. 2. Standard 7 19 To demonstrate regular assessment and care of residents it is recommended daily entries are made into their care record. Space within the home should be reviewed to maximise storage space. Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB National Enquiry Line: 0845 015 0120 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 Galanos House E53 S35730 Galanos House V226313 110505 Stage 4.doc Version 1.30 Page 22 - 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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