Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Galtee More Nursing Home 164 Doncaster Road Barnsley South Yorkshire S70 1UD The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mike ONeil
Date: 2 2 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home
Name of care home: Address: Galtee More Nursing Home 164 Doncaster Road Barnsley South Yorkshire S70 1UD 01226733977 Telephone number: Fax number: Email address: Provider web address: None Name of registered provider(s): Name of registered manager (if applicable) Dr Gulzar Khan Type of registration: Number of places registered: care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Persons accommodated shall be aged 60 years and above. Date of last inspection Brief description of the care home Galtee More is a 28-bed home for older people; it provides both nursing and personal care. The home is in a residential area on the outskirts of Barnsley town centre, where there is good access to public services. There is a bus route, a variety of shops, health centre, post office, pubs, and church near by. 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 is a garden and car parking is available at the side of the building. 0 Over 65 28 Care Homes for Older People Page 4 of 25 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This is what was used to write this report. Information about the home kept by the Commission for Social Care Inspection. Information asked for before the inspection, this is called an Annual Quality Assurance Assessment. Information contained in a service improvement plan that was provided by the provider and manager to the CSCI following the last Key inspection. This was carried out in April 2008. Care Homes for Older People
Page 5 of 25 Information from surveys that were returned to us by 3 relatives and 1 staff. An unannounced visit to the home. This was carried out by Michael ONeil, regulation inspector on 22nd September 2008 and included talking to 6 staff and Susan Dooler, home manager about their work and the training they have completed. And checking some of the records, policies and procedures the home has to keep. Susan Dooler is not registered with the CSCI as manager but is currently undertaking the process to register. Some time was spent observing staff supporting people and talking with 11 people and 2 visiting relatives. We wish to thank the people living in the home, staff, and relatives for their time, friendliness and co-operation throughout the inspection process. What the care home does well: What has improved since the last inspection? Several issues of concern were raised during the CSCI inspection in April 2008 relating to Health and Safety Issues and the general environment of Galtee More. The management and staff took these issues seriously and all have now been addressed. Fixed and portable moving hoists have been repaired and serviced. A new tumble dryer has been purchased for the laundry room. A new machine to iron the bed sheets had Care Homes for Older People Page 7 of 25 been purchased. Hot water is available in all parts of the home. Extensive work has now been completed on the heating/water system and all water temperatures checked were within safe limits. Records were provided to show that the water temperatures were now being regularly monitored. These measures mean the risk of people being scalded has been reduced. New commodes have been purchased. This will minimise the risk of cross infection. Improvements had been made to the homes quality assurance system since the last inspection. Clear procedures have been developed which has improved the communication channels between the staff and management of the home. A new raised patio has been built at the rear of the home. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were individually assessed prior to admission to ensure their needs could and would be met. Evidence: Care plans showed that people within the service had been assessed before moving into the home. Risk assessments and a plan of care reflected any specialist interventions. The manager and staff liaised with professionals, the person and their families to find out about peoples needs. The manager visited people and undertook assessments, prior to admission. Care Homes for Older People Page 10 of 25 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health is monitored and arrangements for dealing with health issues were met with support from health professionals. People were treated with respect and said they were very happy with the care they received. Medication policies and procedures were well managed ensuring the safe administration of medication. Evidence: Three peoples care plans were checked. The peoples care plans checked were good in that they contained details about the persons biography, personality and their preferences and choices. The plans were being regularly reviewed and the changes in peoples health were being observed and recorded. Risk assessments were included within the documentation and included moving and handling, nutritional, skin integrity, and other risk factors. The care plans identified that a range of health professionals visited the home to assist in maintaining peoples health care needs. Overall the standard of the care plans and the recordings made by staff were good. The care plans
Care Homes for Older People Page 11 of 25 Evidence: were strongly based on a medical model and more detail does need to be included relating to the social care needs of people. People looked clean, well dressed and had received a good level of personal care. People said The staff are lovely, all of them Staff take time to talk and listen to me Its a lovely home. Relatives said The care and support is excellent First class care home Staff are brilliant Im kept informed about what is going on and whenever I visit the staff are always helpful, nothing is too much trouble. Issues highlighted at the last CSCI inspection, linked to the environment, that may have had an affect on peoples dignity had all been addressed. Staff were aware of the need to treat people with dignity and respect and were observed interacting in a friendly and pleasant way. Medicines were securely stored in locked trolleys within locked rooms. Medicine Administration Records (MAR) checked were completed with staffs signatures. Care Homes for Older People Page 12 of 25 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People had a choice of lifestyle within the home and were able to maintain contact with family and friends ensuring that they continued to be involved in community life. People were able to make choices about daily living and be involved in some social activities. Meals served at the home were of a good quality and offered choice to ensure people receive a balanced diet. Evidence: People said they were able to get up and go to bed when they chose, and were seen to walk freely around the home. Relatives said they were able to visit at any time and were made to feel very welcome. We saw that everyone coming to the home was offered hospitality and staff took time to make sure friends and family were made to feel comfortable whilst visiting. People and relatives said that there were some activities planned. An Autumn Fayre had also just been held at the home. We saw that some people welcomed the opportunity to undertake simple activities and talk to staff or other people in the
Care Homes for Older People Page 13 of 25 Evidence: home. There was a friendly atmosphere in the home and staff spent time talking to people and their families. Relatives and people commented on the friendliness of Galtee More and said, We are just like one big family. The mealtime experience for people in the home had improved for all and was very positive. Tables were set nicely. Staff were supporting people with their meal in a polite and discreet way. Some people had their meals in their own room because they said preferred to eat there. People said We always get a good meal The food is very good. The cook was aware of peoples special dietary needs. Choices of meals were advertised on a board in the dining room. Care Homes for Older People Page 14 of 25 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints procedures were in place and people and their relatives felt confident that any concerns they voiced would be listened to. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home, so helping to ensure that people were protected from abuse. Evidence: People and their representatives had been provided with a copy of the homes complaints procedure, which was also on display in the entrance hall. This contained details of who to speak to at the home and who to contact outside of the home to make a complaint should they wish to do so. People said that they felt very comfortable in going to the manager knowing that any concerns they may have would be addressed without delay. Regarding safeguarding adults, the safeguarding policies and procedures were available to the staff. Staff had undertaken Safeguarding Adults training, and the manager was able to evidence this by producing the training records. Care Homes for Older People Page 15 of 25 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was clean, pleasant and hygienic although some areas of the home are in need of redecorating and refurbishing. Evidence: The home was clean and tidy and no unpleasant odours were noticeable. People, and relatives said the home was always kept very clean. Lounge and dining areas were domestically furnished to a satisfactory standard. People said they were very comfortable at the home. They had a variety of furniture and touches such as ornaments and pictures that gave their rooms a homely feel. Some areas of the home are in need of refurbishment and redecoration. In particular the paintwork in three bedrooms is damaged and the rooms need redecorating. Also the carpets in some bedrooms and the ground floor corridor are marked and need replacing. Several issues of concern were raised during the CSCI inspection in April 2008 relating to Health and Safety Issues and the general environment of Galtee More. The management and staff took these issues seriously and all have now been addressed. Fixed and portable moving hoists have been repaired and serviced. A new tumble dryer has been purchased for the laundry room and was due for delivery on the day of
Care Homes for Older People Page 16 of 25 Evidence: this visit. We spoke to the retailers who said that there had been a delay in the delivery time, which was an error on their part. All bathrooms are now functional. A new machine to iron the bed sheets had been purchased last month. Hot water is available in all parts of the home. The majority of the home is however bright and cheerful. Touches have been added to make Galtee More feel more homely. A new raised patio has been built at the rear of the home. People said they had enjoyed sitting outside in this area during the warmer weather. Care Homes for Older People Page 17 of 25 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff were employed in sufficient numbers and recruitment procedures promoted the protection of people. People receive care from a well-trained staff team. Evidence: People spoke highly of the staff team and said staff always listened and acted on what they said. People said that staff were always or usually available when needed. Staff and the manager confirmed that staffing levels were adequate. Three staff files were checked at this visit. The files contained a range of information including two references and a declaration of health and identification. The staff had undertaken a criminal record bureau check (CRB), at the enhanced level. This confirmed thorough recruitment practices were in place, which was sufficient to safeguard people. Staff said that they really enjoyed working at the home and got a lot of job satisfaction. We found that the staff were very enthusiastic to improve the service further. Staff were able to talk about the various training courses that they had
Care Homes for Older People Page 18 of 25 Evidence: attended. Development and training records were checked these records showed when staff had completed mandatory training and refresher training. Care Homes for Older People Page 19 of 25 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedures and ethos of the home ensure that the home is run in the best interests of people who use the service. The homes procedures promote the health, safety and welfare of people who use the service and the staff. Evidence: The manager, Susan, has many years experience within the nursing and caring profession and had recently obtained the Registered Managers Award. She is committed to ensuring that people staying in the home were consistently well cared for, safe and happy. The manager is not yet registered with us. The CSCI registration team have written to Susan and she is now in the process of registering. Staff, people and relatives spoke highly of the manager and said she was very approachable.
Care Homes for Older People Page 20 of 25 Evidence: The home had a good quality assurance system. There was evidence of internal auditing of the homes environment, services and records. Improvements had been made to the system since the last inspection. Clear procedures have been developed which has improved the communication channels between the staff and management of the home. Staff meetings were held and minutes of these meetings were seen. The registered provider visited the home several times a week. People said they saw the provider and spoke to him on a regular basis. Monthly reports were now being produced by the provider. People who use the service and their families met with the management of the home. These quality assurance systems will help to ensure that the service is operating in the best interest of the people who live there. A sample of monies that was looked after on behalf of people living at the home was checked. Records were kept and money tallied with the records. Concerns were raised and requirements were issued during the CSCI inspection in April 2008 due to the excessively high water temperatures and other health and safety issues in the home. These previous requirements were checked and all had been met. Extensive work has now been completed on the heating/water system and all water temperatures checked were within safe limits. Records were provided to show that the water temperatures were now being regularly monitored. These measures mean the risk of people being scalded has been reduced. The lock on the sluice door has been repaired. This means unauthorised people cannot now enter and put themselves at risk from contamination. New commodes have been purchased. This will minimise the risk of cross infection. Fixed and portable moving hoists have been repaired and serviced. We saw all people were safely moved around the home in wheelchairs, which had, footplates fitted. Evidence was seen that the manager had encouraged people, and their families to understand safe wheelchair use. The fire risk assessment was in place at the home. No issues requiring attention were
Care Homes for Older People Page 21 of 25 Evidence: highlighted in the assessment. South Yorkshire Fire and Rescue Service had visited the home in May 2008. No issues requiring attention were highlighted in the report. Staff said they had received recent fire safety and other health and safety training .A sample of records showed that staff were receiving this statutory training. At the time of the visit fire exits were clear and hazardous products were safely stored in the home. This will promote the safety and welfare of the people. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations
These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 7 19 19 The care plan should provide more detail the action, which staff need to take to meet the social needs of the person. Work should continue with the rolling programme of redecoration. Carpets should be replaced when they become worn and marked. (Corridor and bedrooms) Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!