Inspection on 06/03/07 for Galanos House

This inspection was carried out on 6th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Galanos House 20/03/06

Galanos House 11/05/05

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 Galanos House Banbury Road Southam Warwickshire CV47 2BL Lead Inspector Jackie Howe Key Unannounced Inspection 6th March 2007 09:15 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 Galanos House DS0000035730.V331057.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. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Galanos House Address Galanos House Banbury Road Southam Warwickshire CV47 2BL 01926 812185 01926 815596 jawilson@britishlegion.org.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) The Royal British Legion Ms Jo-Anne Wilson Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60) of places Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Galanos House is register for 60 elderly persons - up to 40 places may be used for service users requiring nursing care. Eight service users may be between 54 & 65 years of age with complex care needs / palliative care. 20th March 2006 Date of last inspection Brief Description of the Service: The original Royal British Legion Home, Galanos House, was built in the mid 1960s 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 and 8 younger adults between the ages of 54 and 65. It has 60 rooms, all en-suite and set in approximately 3 acres of grounds, not far from the market town of Southam. Ample car parking space is available at the front of the home. The homes décor, furniture and furnishings are of a high standard. The home has a large airy dining room with tables seating 2, 3 or 4 residents. There is a conservatory, 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. The gardens are landscaped and well maintained, being accessible to all of the current residents. There are a number of seating areas, which are well used in good weather. There are vehicles at the home to transport the residents on trips and for appointments. Residents also benefit from opportunities to go on an annual holiday. Information about the home is given to prospective residents and their families via the ‘Statement of Purpose’ and other information brochures. Range of fees: from £470 residential and £700 nursing per week depending on assessment. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 5 Additional charges are made for chiropody and personal items. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of the inspection year 2006/07 and was unannounced. It was undertaken over one day. The inspection focused on the outcome for residents of life in the home. The registered manager was present throughout the day. The inspector was able to tour the home, and spend time speaking with a number of residents, visitors to the home and staff. The manager supplied a completed ‘Provider Information Questionnaire’ (PIQ.) and a number of ‘comments cards’ were received from both residents and their relatives. Information from these has been included in the report. The inspector ate lunch with the residents and was able to observe care practices, and how staff interacted with residents in the home. During the inspection the care of three residents was examined in detail, by reading their care plans and other documentation, observing care offered to them and checking that staff have the necessary skills to care for them. This is part of a process known as ‘case tracking’ where evidence is matched to outcomes for residents. Records including staff files, policies and procedures, health and safety / environmental checks and risk assessments were also read. The inspector would like to thank the residents, manager and staff for their hospitality and co-operation during the inspection. What the service does well: The home provides a bright, cheerful, and well-maintained environment, and much has been done to ensure that the home, despite its size, has retained some homely touches. The home offers a service to residents that is friendly and caring and aims to meet the social and physical care of those using the home, both as a resident and to the relatives of those admitted to the home. Comments cards received from relatives confirmed this: ‘ The care that my father receives is outstanding. The warm, friendly and encouraging atmosphere has helped my father to establish a new life free from anxiety.’ Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 7 ‘ The home is warm and friendly whenever I visit ’. The home offers residents real opportunities to join in activities and live a lifestyle that meets their individual needs and aspirations. ‘ There are so many activities laid on that I am never inactive, save by my own request’. Food provision is very good with plenty of choice available and special diets made available. ‘ I have to have a soft diet, but the catering staff always try to change the menu if not suitable to something I like’. Staffing levels are suitable to the needs of the residents. Training opportunities are made available to equip staff with the skills they need to undertake their role. Residents and their families find staff to be very helpful and kind. ‘ The staff are unfailingly helpful, caring and fun’. The home is run by a competent management team, who have experience in the care sector. Residents and their families are given opportunities to make their comments known via questionnaires and in attending meetings, and their opinions are sought in making decisions about life in the home. Complaints are taken seriously, and comments and concerns raised are recorded and dealt with. What has improved since the last inspection? What they could do better: The home is currently reviewing its systems for identifying the needs of residents via their care planning. Both systems were reviewed during the inspection, but the new care plan seen had not been fully completed. Care plans using the old system read during the inspection, identified some areas for improvement. There were gaps in identifying some care needs, in identifying risks and giving guidance to staff so that care is being given in a consistent manner. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 8 Systems for the safe handling of medication are in need of some review. A recent audit undertaken by the pharmacist has identified some areas for improvement. The home does not currently have a protocol in place for the administration of PRN medication i.e. medication to be given ‘as required’. This is of particular concern for medications that are being used as a sedative, and where a consistency of approach and other intervention is required. Currently the care manager does not undertake a regular audit to identify where there may be error, or incorrect practice. These issues were discussed during the inspection, and the manager and care manager demonstrated that an audit is something they would be keen to introduce, and are committed to addressing the areas identified for improvement. 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. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 9 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 Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 10 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): Standards 1 and 3 Quality in this outcome area is good. Service users are presented with information with which to make an informed decision. Pre admission assessments are undertaken to assess needs, and to allow the home’s staff to demonstrate how they can meet those needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has in place a ‘Statement of Purpose’ and a ‘Service Users Guide’. These are provided by the home to ensure that all residents coming to the home are provided with information with which to make an informed decision as the whether or not the home can meet their needs. The Statement of Purpose, has been recently been reviewed and a copy has been received by the commission. The users guide is currently under review. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 11 Comments received and residents spoken with during the inspection, confirmed that they had access to this information, and were given an opportunity to look around the home, prior to admission, and that this helped them to make a choice. ‘ I filled in all the relevant forms, had an interview with the matron, and looked around the home. The residents guide showed that the home would satisfy my needs’. As well as being provided with information about the home, prospective residents are assessed to see that their care and social needs can be met. These pre admission assessments are required to look at a number of key areas of need, including dependency, health and social care needs, including manual handling and specific medical needs as well as potential areas of risk. All prospective residents to the home are assessed usually by the care manager, and offered where appropriate an opportunity to visit the home. Assessments read at the inspection were found to meet the standards required, but there was evidence to show that evidence found on assessment was not always transferred into care plans. All new residents to the home are provided with a contract, which sets out the fees payable, and terms and conditions of living in the home. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 12 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): Standards 7, 8, 9 and 10 Quality in this outcome area is adequate. Residents’ health and social needs as documented in care plans demonstrate areas, particularly with regard to specialist need and risk assessment that require improvement and clarification to eliminate potential risk to residents. Procedures for safe administration of medication are satisfactory although some improvements are required. Residents are treated respectfully. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is currently piloting a new care planning process, and examples of both old and new systems were read during the inspection. The example of the new care plan seen was incomplete and therefore not able to be fully assessed at the inspection. The care plan being piloted is a large complex document, which will take time and training for staff to complete in detail. Staff spoken with said that as yet they had not yet had sufficient time Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 13 to introduce them properly, but were positive that when complete, they would be a good comprehensive document. Three of the examples of the old style care plan read were mainly good, but some key areas of need had not been identified and care not implemented by staff. One example of this was a resident who had been admitted with a nutritional assessment showing ‘little appetite’, and recent weight loss. There was no recording of exactly how much weight had been lost, but some indication that this could be more than 2 stone. Directions to staff in the care plan were to ‘monitor weight’, and to ‘encourage to eat’, but no detail of how this should take place, i.e. how often should he be weighed, and what actions should be taken as a result of loss. Records show that the resident was not weighed on admission, and was not actually weighed for 3 weeks. There was also little to show that eating habits and intake had been monitored by staff, as daily records only refer to him being ‘up dressed and down for breakfast’. Care plans read did not give details of how staff should manage challenging behaviours, and that psychological and mental health support needs were not recorded, although daily record entries described definite need. There was also insufficient information to demonstrate what actions staff should take in a consistent manner in response to challenging needs and where this should involve the administration of ‘as required’ medications. Care planning was discussed with the care manager and manager during the inspection and the comments taken seriously as a need for improvement in the home. The home is currently looking to provide more specialist dementia care. The new care plans proposed, would not be appropriate for assessment and care of people with a dementia. Care plans indicate that residents and their families are consulted in their personal care needs, and residents are encouraged to be as independent as possible. More could be documented to show personal care tasks are being delivered in a way, that residents prefer and are person centred in their approach. Risk assessments in some areas of care are inadequate and do not give clear indication of the action staff should undertake to minimise risk, or demonstrate where residents could be involved in positive risk taking. Health care needs are monitored and well met in this home, and residents in the home have access to a dentist, optician, chiropodist and an occupational therapist works regularly and assesses residents. The home has also achieved the gold standard in palliative care. The home has excellent access to Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 14 equipment to aid mobility, and to minimise the risk of the development of pressure areas. The local GP surgery offers a very personal service to the home visiting weekly for a ‘surgery’ The manager following a recent pharmacy audit is reviewing the medication policy. All residents in the home have a small locked box in their own rooms for their medication, which is mainly supplied in blister packs. Medication is administered according to instructions on the Medication Administration Record (MAR). Photographs are kept with the MAR sheets to minimise the risk of wrongful administration. Currently all medication in the home is administered by the nursing staff, but the manager is introducing training for care staff so that they can administer medication in the residential part of the home. Records checked show that there were no omissions in the administration of medication, and reasons for non-administration are recorded. The home had a refrigerator, so that all medications that are required to be stored at low temperature can be done so safely. Staff must ensure that the date of opening is recorded on all medications that are required to be disposed of after a certain time period. The care manager does not currently undertake a regular recorded audit on medication administration and correct practice. This is recommended to ensure competency and to identify training needs for staff. The home has systems in place for those residents wishing to administer their own medication. A secure cupboard is available for the storage of controlled drugs. Examination of the controlled drugs confirmed that they are stored and administered within the legal framework relating to such medication. Throughout the inspection staff were observed to treat residents with courtesy and privacy is respected. Residents spoken with said that they were satisfied with their care, and felt that they were treated respectfully. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 15 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): All of the above standards were assessed at this inspection. Quality in this outcome area is excellent. Residents enjoy a lifestyle, which satisfies their social and recreational needs. They are given the opportunity to join in a wide range of activities and are therefore able to choose an activity appropriate to their age and interests. Meals are well cooked and presented with plenty of choice and served in pleasant surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Galanos House demonstrates a commitment to providing a life style for residents that is varied, offers plenty of choice, and is appropriate to the differing needs, interests and capabilities of the people who live there. On the day of the inspection residents were using all areas of the home, including their own rooms and were seen to be involved in either some form of organised activity, or talking with others, either fellow residents, relatives or staff and volunteers or quietly reading and listening to music. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 16 There is a large library on the top floor, where there is not only a selection of books, but also the home provides a number of computers, which are connected to the internet. During the inspection, the residents were seen to be making good use of these and a computing class was being held. One of the younger adults in the home spoke positively about the computers and classes available, and how this had helped him to keep in regular contact via email to his family. He was also delighted to have been given an opportunity to develop a new skill. Other organised activity on the day of the inspection included a reminiscence session and a musical concert. There is a monthly activity programme displayed on the wall, but there is also additional daily information written on a white board in the dining room. Included in the March programme are: Craft sessions, Irish dance night, Skittles, Film nights, Bingo, Quizzes and games including ‘play your cards right’ and ‘call my bluff’, music and movement and reminiscence. During the inspection, it was noticed that residents were regularly reminded about what was available, and that they knew where the activity was being held. Residents spoken with were very positive about their lifestyle and the opportunities available. They particularly enjoy the holidays that are taken near Blackpool, and joining in some of the groups available. They also spoke enthusiastically about joining the choir, and entertaining the home at Christmas time. The home has two minibuses and a car available to them, and residents confirmed that they went out to local pubs, to see the lights in local towns at Christmas time and out to local restaurants. During the inspection visitors were seen coming and going in the home. Relatives and visitors were described by the manager as being ‘part of the home’, and there is a separate part of the dining room available, designed like a coffee shop with drinks machines, where relatives can join residents for a meal. The bar is available on a number of evenings, and during the day on a Sunday and is run by a volunteer to the home. One gentleman spoken with said how much he particularly enjoyed being able to maintain his old established routine of having a pint in the pub prior to Sunday lunch. Meal provision in the home is very good. The menu is varied, well balanced and offers plenty of choice. The inspector ate lunch with the residents in the main dining room. The menu on the day of the inspection was; roast beef, Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 17 roast and mashed potatoes, with a selection of vegetables and Yorkshire pudding and gravy, and for desert lemon sponge pudding and custard. Residents were offered drinks to accompany the meal, with some residents enjoying a glass of wine. The meal was served hot and was very tasty. Residents spoken with said that the food was ‘superb’ and that they felt that they were offered plenty of food and plenty of choice. They particularly enjoy the ‘themed’ meals that are put on, for example the Burns supper, valentine’s meal, and the Chinese food for Chinese New Year where they were entertained by a lion dance. Residents are involved in menu planning, and one resident who takes part in this group showed the inspector the work currently being undertaken to review the menu for the warmer months. He was very pleased that the proposed menu had been given to him in large print as he has difficulty with his eyesight. The dining room though large is a pleasant environment. Tables are laid attractively with tablecloths, napkins and condiments available. Staff served the meal courteously to residents, and those requiring assistance were offered it sensitively. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 18 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): Standards 16 and 18 Quality in this outcome area is good. The home has good policies and procedures in place to deal effectively with complaints, and to offer protection from abuse. People who use the home are able to express concerns and are confident that their views are listened to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an established complaints procedure in place, which is known and understood by people who use the home. Residents spoken with said that they knew how to complain should they wish to do so and felt confident that their concerns would be listened to and dealt with appropriately. One resident said that he would always go and see the manager, as her door is ‘always open and she will sort something out’. The home keeps records of complaints made, but also each head of department keeps a record of all comments and concerns made during more informal conversations, and the outcomes of the results of these comments. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 19 The commission has not received any complaints about this service. The manager has clear procedures in place as to Safeguarding Adults, and has a copy of the Warwickshire Multi agency policy for responding to allegations of abuse, and also a copy of the department of Health ‘ No Secrets’ document. The manager is aware of what procedure to follow when making a referral to the local authority for investigation, and a recent allegation made was handled appropriately. Staff have received training in the Protection of Vulnerable Adults (POVA). Staff in the home are currently working through a booklet entitled ‘Recognising and responding to abuse and neglect’ which has been devised by Warwickshire workforce development service and Warwickshire Quality Partnership. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 20 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): Standards 19, 23, 25 and 26. Quality in this outcome area is good. Residents are provided with an environment, which is clean, well maintained and very comfortable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the home was undertaken with the manager. No offensive odours were noticed and the home was found to be clean and tidy. Galanos House is a purpose built modern home, approximately 4 years old. The home is divided into four separate units, and is on two floors. Each unit is named after areas in Warwickshire, and has pictures and photographs displayed on the walls, of these areas. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 21 Personal rooms all have en-suite facilities and are well presented, furnished and decorated, and are bright and cheerful, but are very similar in decoration and furnishings, giving the home a slight hotel type feeling. Some residents have chosen to personalise their rooms, and married couples occupying two rooms, have chosen to use one room as a bedroom and one as a lounge/sitting room. Rooms are large enough to allow the use of specialist equipment and lifting aids. One of the younger residents in the home, said how much he would like to personalise his room with his own choice of paint colour and curtains and bedding, to make it feel ‘more like my own home’. Discussions held with the manager confirmed that the home would be pleased to accommodate this. There is a selection of communal rooms and spaces including a new conservatory with access to the outside and these were noticed to be used well during the day. The dining room houses a very large projector screen for film viewing. Bathrooms are well decorated with patterned tiles to avoid a clinical feel, although it was noted that laundry trolleys and wheelchairs are stored in these when not in use. A lack of storage space for items such as wheelchairs, hoists, shower chairs and laundry bags could create a health and safety issue, which requires addressing. Bathrooms and toilets are equipped with aids to help mobility and independence. There are large garden and seating areas around the home, with patio areas in which to sit, and items of interest such as bird tables a large pond with fish and a water feature. Residents spoken with were positive about the home’s environment, and using the gardens. The home has a large laundry, with 2 dryers and 2 washing machines, which are suitable to wash clothes at high temperature if required. There are appropriate hand washing facilities for staff, and good clean and dirty procedures. A tour of the kitchen showed an adherence to good food hygiene standards, staff were noted to wear protective clothing, and there are good staff facilities. The kitchen is clean large and well maintained with plenty of storage and freezer space available, which were found clean, tidy and well maintained. Stocks in the kitchen were plentiful, and stored appropriately. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 22 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): All of the above standards were assessed at this inspection. Quality in this outcome area is good. Residents are supported by staff that are well trained and competent in their role. Recruitment practices are robust. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection, there appeared to be sufficient staff to meet the needs of the residents in the home. Staff were unrushed, and had time to spend talking, and interacting with people. There is sufficient ancillary support from cleaners, and from caterers to support the care and nursing staff, and the home also employs administration, activity, gardening and maintenance staff. Additionally the home employs a ‘resident coordinator’ who is responsible for making sure that residents are able to attend appointments, provides escort to hospital and arranges some outings such as shopping trips. There is a clear management structure within the team with staff understanding their roles and responsibilities. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 23 Staffing rotas checked show that staff are employed as per the agreed workforce model and that known absences are always covered, usually by relief staff or current staff working overtime. Agency use is minimal, but staff are not required to work hours that do not allow for sufficient rest periods. The manager said, and records confirm, that turnover in the home is low. Residents spoken with were very complimentary about the staff and this was also supported by comments received prior to the inspection. Comments included: ‘ They do it with such tender care, I’ve never seen one flustered, they’re just like friends’. ‘They do it for you before you think of it for yourself’. Training opportunities made available for staff to ensure that they have the required skills to care for the residents in the home are good. The manager has a training plan in place for the year, with some of the key mandatory training courses repeated during the year, to ensure that staff have opportunities to attend. Staff files read showed that a thorough induction is completed, and training has been attended. Staff files also confirm that recruitment checks undertaken are thorough. There was evidence to show that offers of employment are not confirmed until police checks are undertaken, and references are always taken. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 24 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): Standards 31, 32, 33, 35 and 38. Quality in this outcome area is good. The manager is competent and of good character. Residents benefit from a home, which is well managed, where their views are taken seriously and their health, safety and welfare is safeguarded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is managed by a person of good integrity and an experienced health care professional. She has had a number of years experience working with the client group and as well as being a qualified nurse, has achieved the Registered Managers Award. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 25 On the day of the inspection it was noted that there is a good relationship within the management team and staff in the home, and the manager is known by all the residents who said that they felt confident to go to her with any concerns. She has an ‘open door’ approach, and spends time in the home speaking to residents and their families and listening to their points of view. Residents are encouraged and supported in making their views known, and their opinions are sought in life style issues such as menu planning, and activities and entertainment. Residents sit on the ‘House Amenity Committee’, where decisions about how to spend funds available to the home are made. The home has a suggestions box which residents are encouraged to use. Quality assurance is taken very seriously, and the manager holds regular meetings with senior staff ensuring that they are informed about all the feedback and comments she receives about the service and ensuring that ideas they may have, are considered. Quality assurance audits take place regularly, and residents and relatives are given an annual questionnaire to complete. Spot checks are regularly undertaken. Procedures for the receipt and safe keeping of residents’ monies are good. The home gives all aspects of health and safety for its staff and service users due consideration and thorough checks are made. Fire safety lectures and drills are undertaken at regular intervals, including at the evening to ensure that staff working late and evening shifts are able to attend. Weekly tests of fire alarms are undertaken. Required checks of lifts, lifting aids, electrical wiring, portable appliances, water temperatures, gas installation and fire equipment have been undertaken. A tour of the home showed that at times storage of equipment such as wheel chairs not currently in use, could cause a safety issue for residents, and storage in the home could be improved. The manager said that she was aware of this, and was currently reviewing where more storage space could be made available. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x 3 x 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 x 3 x x 3 Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 27 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. 1. Standard OP7 Regulation 15 Requirement The registered manager must ensure that care plans reflect all aspects of the personal and social needs of the residents and that staff are sufficiently guided in respect of their welfare. The registered manager must ensure that all care plans include risk assessments and guidelines for staff in how to minimise risk. The registered manager must ensure that action identified in the recent pharmacy audit is undertaken. To include: A protocol must be in place in regard to the administering of PRN medication to the resident referred to in the report. The date of opening must be recorded on medications including eye drops, so that staff are clear when they must be discarded. Timescale for action 31/05/07 2. OP7 13 31/05/07 3. OP9 13 31/05/07 Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 28 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP9 OP38 Good Practice Recommendations The manager should ensure that a regular recorded audit is undertaken on the procedures for the storage and administration of medication. Storage of wheel chairs and other equipment should be reviewed to minimise risk to residents, staff and visitors. Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Galanos House DS0000035730.V331057.R01.S.doc Version 5.2 Page 30 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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