Inspection on 21/06/05 for Galtee More Nursing Home

This inspection was carried out on 21st June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Galtee More Nursing Home 22/09/08

Galtee More Nursing Home 10/04/08

Galtee More Nursing Home 16/04/07

Galtee More Nursing Home 07/12/05

Galtee More Nursing Home 21/04/05

Galtee More Nursing Home 13/01/05

Galtee More Nursing Home 18/08/04

Galtee More Nursing Home 24/03/04

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

CARE HOMES FOR OLDER PEOPLE Galtee More Nursing Home 164 Doncaster Road Barnsley South Yorkshire S70 1UD Lead Inspector Sue Stephens Unannounced 21 June 2005 08:15am - 16:30pm 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. Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Galtee More Nursing Home Address 164 Doncaster Road Barnsley South Yorkshire S70 1UD 01226 733977 01226 282555 None Dr Gulzar Khan 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) Vacant N Care home with nursing 28 Category(ies) of OP Old age (28) registration, with number of places Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons accommodated shall be aged 60 years and above. The registered manager must receive formal supervision from a 1st level nurse or a GP. There must be a 1st level nurse in charge in the home at all times. The managers hours must be supernumerary, ie she must not be rostered to provide direct care to service users. Date of last inspection 13 January 2005 Brief Description of the Service: Galtee More is a 28 bed home for older people, providing both nursing and personal care. It is situated in a residential area on the outskirts of Barnsley town centre with good access to public services and on a main bus route. Within a short walk from the home there are a variety of shops, chemist, opticians, hairdresser, post office, newsagent, health centre, local pubs, clubs and churches. The home has disabled access and a passenger lift to all levels. There are eighteen single and five double rooms, two lounges and a dining room. There are garden areas and car parking is available at the side of the building. Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 8 ¼ hours, between 08:15am and 16:30pm. A partial inspection of the premises was carried out. Consultation with residents, staff, the owner and the part time advisor took place. Samples of records, including three residents’ records were checked. Over half of the residents were consulted, either individually or in small groups; most gave very positive views of the care they received. Qualified staff and care staff were observed carrying out their duties, and breakfast was observed in the dining area. The residents, owner, staff and manager are thanked for the welcome and their assistance during this inspection. What the service does well: What has improved since the last inspection? A copy of full needs assessments were now kept in the residents file. Resident’s consent to medication had been recorded and oxygen signs had been put in place. The advisor to the home confirmed most staff had now received adult protection training. Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 6 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. Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI 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 Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI 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) 3 and 4 The home was not identifying and meeting all assessed needs; this could put resident’s health and welfare at risk. EVIDENCE: Full needs assessments had been carried out before residents were admitted, these included nursing and personal care needs. Plans of care were not based on the assessed needs, and the homes own assessment was not sufficient to identify all nursing and care needs. Reviewed assessments carried out by NHS professionals had not been followed up by the home for some residents, this had resulted in some nursing care needs not been delivered or monitored sufficiently. Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI 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) 7,8,9 and 10. Residents were confident with staff and felt well cared for. Care plans were not sufficient in setting out health and personal care needs; this could put resident’s welfare, health and continuity of care at risk. Some medication administration practices, and the lack of medication induction for new staff, did not fully safeguard resident’s health and safety. Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 10 EVIDENCE: Residents said they felt well cared for and supported by staff, and had access to health care services. Three plans were checked, and one plan was checked in detail for nursing and clinical guidelines. Individual care plans were in place and contained reasonable information of photos, family and professional contacts, and daily records. The plans were not suitably based on assessed needs, they did not outline clearly the action staff were to take, and did not include relevant clinical guidelines. Plans of care and risk assessments had not been reviewed on a monthly basis to reflect changing needs. It was not identified whether plans of care were nursing or non-nursing tasks. A procedure was in place for dealing with medicines, and only qualified nursing staff administered medication. In the main the medication trolley was clean and tidy, however, on one bottle, medicine had been spilt over the prescription label, making it difficult to read the information; and the controlled drugs cabinet had been used to store personal possessions. A new recruited nursing staff had been designated to give medication before a sufficient induction and introduction to the homes medication systems had been carried out. Three medication records were checked; medication was not administered as directed on the prescription on one record and sensitivity to medication had not been checked on another. Residents spoke highly of the staff team and said the staff treated them with good dignity and respect; comments made included: “They always listen and never turn away”, “you can ask for anything and they will always oblige”. Staff were helpful and positive, and spoke to residents respectfully. It was also noted that residents were clean and well presented. (See standard for further information about resident’s dignity, privacy and respect). Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI 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) 15 Residents enjoyed nutritious meals and mealtimes were sociable relaxed events. Unsuitable seating did not promote the resident’s health and comfort. EVIDENCE: Breakfast time was observed. Cooked breakfast was offered and residents chose from a variety of cereals, toast and fruit. Most residents said they had been given a cup of tea in bed before rising. The dining areas were well set with crockery and condiments and staff were positive and helpful; there was a happy rapport between residents and staff. Residents said they were always offered good food and had choices they liked. Residents needing assistance with meals were treated with dignity and the arrangements were discreet, however one resident was in a wheelchair that did not support their posture and did not encourage comfortable, independent eating and drinking. Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 12 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) 16 Residents were confident they could make complaints and the home has acted within complaints procedures where a complaint has been registered. EVIDENCE: Residents said they could raise concerns and they were confidant staff would listen to them. Some residents said they had found nothing to complain about because staff looked after them so well. Staff consulted said they knew what to do if someone made a complaint and the complaints procedure was available at the home. Complaints were recorded and followed up by the homes advisor. A complaint had been registered with the commission about the home, the commission was liaising with the home to investigate and resolve the complaint. Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 13 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) 19,20,22,23, and 24. Residents said they were satisfied with the homes environment. The general maintenance and fire safety procedures did not safeguard residents comfort, wellbeing and safety. Shared rooms were not managed in a way that promoted comfort, dignity, choice and respect for residents. Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 14 EVIDENCE: Residents said the home was comfortable and warm; they had comfy chairs to sit in and found their beds comfortable and warm. They said they could choose where to spend their time, some preferring the lounge or conservatory areas or in their own rooms. Unemptied ashtrays were left in the entrance lobby, furniture and other items were stored under the stairwell, furniture and empty boxes on the 3rd floor were untidy and not stored safely, fire doors close to the dining areas were propped open, and the new staff member had been left in charge without receiving suitable fire instruction. Some areas around the home were in need of routine maintenance and redecoration, for example some skirting boards were scratched and damaged and some fire doors were painted in thin paint allowing the previous paint to show through, this did not give the home a well-maintained look. The garden contained rubbish that had not been disposed of. The carpet in the entrance hall was stained and worn and the entrance space was cluttered and untidy. See standard 15 for information about suitable aids and adaptations. Most bedrooms were decorated and personalised, however some had not been well maintained with bright and fresh décor. One bedroom carpet was worn, stained, and dirty. Most wall lights provided in bedrooms were without a shade and some of the fittings were not secure. Residents who preferred not to share a room had not been given clear information about what the home could do to support them, including involving residents in choices when a room became available. Screening between beds in shared rooms was maintained in a poor and undignified manner, the curtains were un-ironed and ill fitted and did not run on the tracks freely. Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI 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 and 30. Sufficient staff was available to meet residents needs. Insufficient recruitment and induction procedures could put residents safety and welfare at risk. EVIDENCE: Residents said they felt there were enough staff available when they needed them; and the homes advisor confirmed staffing levels were well maintained and staff were good at covering during sick leave to ensure residents receive continuity of care. Thorough recruitment checks had not been completed for one new staff member who had been left in charge; and appropriate induction had not been arranged. Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI 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) 31, 32,36, and 37. Because there was no manager to provide consistent leadership and ensure policies and procedures were carried out effectively, residents best interests were not fully supported. Resident’s rights and best interests were not fully safeguarded because record systems were not adequately maintained. Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 17 EVIDENCE: A registered manager was not employed at the home, a part time advisor was available, but did not fulfil all managerial responsibilities. This has led to a lack of consistent management, direction and accountability for the staff team. Evidence of this is shown in the previous standards. Although difficulties were identified around managing the home effectively and following good practice procedures, residents have spoken highly of all the staff and expressed their satisfaction with how they are cared for. One resident described the home as “one happy family”, with several residents agreeing with him. Staff received insufficient supervision and support, and did not receive clear guidelines on consistent working practises. Records relating to residents, and for the efficient running of the home, were not all maintained in an accurate and up to date order. See previous standards relating to care plans, medication, recruitment and induction training. Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 18 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 1 1 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 2 2 x 2 2 2 x x STAFFING Standard No Score 27 3 28 x 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 1 2 x x x 1 1 x Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 19 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 3 Regulation 14 Requirement The homes own assessment tool must be improved in line with the National Minimum Standards. Plans of care must be put in place following NHS assessments. The home must put systems in place to ensure residents assessed and changing needs are met. All nursing staff must be given guidance on identifying assessed needs and ensuring plans are in place to meet these. Care plans must be based on assessed needs. Care plans must be developed in line with the National Minimum Standards and include relevent clinical guidelines and risk assessments. The plans must be reviewed monthly and reflect changing needs. Timescale for action 30.07.05 2. 4 14 Schedule 3 30.07.05 3. 7 15 Schedule 3 30.07.05 Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 20 4. 5. 8 9 13 13 Nursing and non nursing tasks 30.07.05 must be identified in the care plans. Administration of medicines must 30.07.05 be in line with the Royal Pharmacuetical Society of Great Britain guidelines. Prescription lables must be kept clean. Items other than controlled drugs must be removed from the controlled drugs cabinet. Medication must be administered as prescribed. Medication must not be given until clarification is sought, from a GP or pharmacist, where prescription details are not clear or consistent. IMMEDIATE REQUIREMENT New staff must not administer medication until they have received an appropriate induction and the homes policies and procedures on medication. Immediate from 21.06.05 6. 15 16 An assessment must be carried 30.07.05 out to establish adequate seating for the resident whose posture was not correctly supported in the wheelchair at mealtimes. IMMEDIATE REQUIREMENTS All ashtrays must be emptied immediatley after use. Stairwell must be kept clear at all times. Storage must be kept to a minimum and stored safetly allowing access and away from Immediate from 21.06.05 7. 19 23 Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 21 fire exits and routes. Fire doors must not be propped open. 8. 19 23 A routine of maintenance and renewal of fabric and furnishings must be carried out. Fresh paint must be applied to areas that are worn, damaged or have not been suitably maintained. Garden rubbish must be safetly disposed of. The entrance hall and bedroom carpet must be replaced with a new suitable carpet. The entrance lobby must be kept clean and tidy at all times. 9. 20 23 The entrance hall carpet must be replaced with a new suitable carpet. (previous requirement 10.03.05) The entrance lobby must be kept clean and tidy at all times. 10. 11. 22 24 23 23 See requirement for standard15. Residents sharing double rooms must be offered a single room when one comes available. The screens between beds must be replaced with suitable screens that provide privacy and dignity to the resident. 30.07.05 30.07.05 30.07.05 30.07.05 Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 22 12. 24 23 The bedroom carpet must be replaced with a new suitable carpet. Residents must be consulted about the provisions of their rooms, this must be recorded and action taken to meet residents needs. All recruitment checks must be completed before new staff commence work. IMMEDIATE REQUIREMENTS All new staff must be instructed on fire safety procedures before starting their first duty Staff must not be left in charge until they have received appropriate induction, including fire safety and carried out a fire drill. New staff must receive induction based on Skills for Care (TOPSS) targets. Immediate action must be taken to appoint a manager with sufficient knowledge skills and expertise to manage the home. (previous requirement 07.04.05) The manager must be employed with sufficient hours to carry out the role effectively and be supernummery to direct care. Suitable leadership and management of the home must be put in place whilst manager recruitment processes are completed. This person must be supernummery and receive support and supervision. 30.07.05 13. 14. 29 30 19 18 21.06.05 Immediate from 21.06.05 15. 31 8 04.07.05 16. 32 10 04.07.05 Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 23 17. 18. 36 37 18 17 All staff must receive suitable training support and supervision to effectively carry out their role. All records must be maintained in line with National Minimum Standards and Care Home Regulations. 30.07.05 30.07.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 3 Good Practice Recommendations The home is reponsible for following up assessments when these have been carried out by external assessors. If the home is unsuccessful in obtaining the assessment this must be recorded in the residents care plan. Staff should be informed of the role of the person nominated to take on leadership and direction responsibilities. 2. 32 Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Ground floor, Unit 3 Waterside Court Bold Street Sheffield, S9 2LR 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 Galtee More Nursing Home J55 S6480 Galtee More V230593 210605 UI Stage 4.doc Version 1.30 Page 25 - 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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