Inspection on 07/12/05 for Galtee More Nursing Home

This inspection was carried out on 7th December 2005.

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

The inspector 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 21/06/05

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 Mrs Sue Stephens Unannounced Inspection 7th December 2005 11:30 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 Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 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. Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Galtee More Nursing Home Address 164 Doncaster Road Barnsley South Yorkshire S70 1UD 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) 01226 733977 01226 245486 Dr Gulzar Khan Vacant Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons accommodated shall be aged 60 years and above. The managers hours must be supernumerary, ie she must not be rostered to provide direct care to service users. There must be a 1st level nurse in charge in the home at all times. The registered manager must receive formal supervision from a 1st level nurse or a GP. 21st June 2005 Date of last inspection Brief Description of the Service: Galtee More is a 28-bed home for older people; and provides both nursing and personal care. The home 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 DS0000006480.V268620.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 4 ½ hours between 11:45 am and 4:15pm. The inspection included observations of care practices, consultation with residents, visitors, staff and the manager. Samples of the homes records, including three staff files, were checked. The inspector would like to thank the residents, visitors, staff and manager for the welcome and assistance they gave during this inspection A full time manager had been recruited and will apply for registration following a successful three-month probation period. The manager was reviewing the homes policies and procedures, and management systems. The manager had been in post just over a month when this inspection took place. On the previous inspection the home was given immediate requirements to improve their assessments, care plans, fire safety, recruitment and induction. An additional visit was carried out on 10 August 2005 to check the homes progress and offer guidance. The home was also required to take action to recruit a manager; the home had been without a full time registered manager for some time and routine management systems were not being carried out. A nurse was nominated to oversee each resident’s assessments and care plans. The nurse’s role was to make sure each resident’s assessed needs were identified, drawn up into care plans and reviewed monthly. Fire hazards, which included unemptied ashtrays, storage under stairwells, unsafe storage of unused items and furniture, and fire doors propped open, had in the main improved. Some staff had received fire training. The maintenance person was given advice about fire drills and fire checks on the additional visit. The local fire authority was contacted by the home for further advice. On the additional visit the inspector was told that no further staff would be recruited until a new manager was recruited. There has been good progress made following the additional visit, however the new manager must remain focused on making sure all residents’ assessments and care plans are improved. And improving the fire safety and recruitment systems must be kept a priority to make sure residents safety and welfare is protected. What the service does well: Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 6 Residents and visiting relatives spoke very highly about the staff and the care at the home. They said they felt well looked after and were comfortable and warm. Visitors said they felt welcomed and the staff were friendly and kind. Residents had good access to health care, and were treated with dignity and respect. Residents and visitors said they felt confident they could raise concerns and the home would respond positively. Residents were satisfied with their daily routines and the leisure activities provided. Staff were provided in sufficient numbers and over 50 were trained in care at a National Vocational Level 2 or better. What has improved since the last inspection? What they could do better: Better progress could be made to review and update all residents’ assessments and care plans. Medication reviews need to be requested from GPs and consultants. Staff should be better informed about adult protection. Routine maintenance needs to be improved. Staff need to access regular training specific to the residents’ needs and on safe working practices. Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 7 Robust recruitment processes need to be in place, which include criminal record bureau checks before new staff start work. The provider needs to carry out recorded monthly visits. The home needs to inform the commission in writing of events which happen at the home. The home needs a safer way to keep valuables, and monies need auditing. Residents and staff need to be protected with a clear policy about gifts. Health and safety monitoring, maintenance, and training needs to improve. 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 DS0000006480.V268620.R01.S.doc Version 5.0 Page 8 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 Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 1,3 and 4 The information about the home is out of date, and therefore cannot keep residents and potential residents fully informed. Residents felt their needs were well met and their families supported this. The needs assessments need to be up to date and regularly reviewed to make sure residents are properly and safely cared for. EVIDENCE: There was a Statement of Purpose, which gave information about the home. Some of the information was out of date and it was not provided in an easy to read version. The manager was aware of this and said she would be reviewing and updating the information. Some resident’s needs assessments had been reviewed following the previous requirements. The nurse responsible for this was still in the process of reviewing all residents needs. Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 10 Residents said they were very happy and they were pleased with how the staff cared for them. Residents families also said they thought their relatives were well looked after and cared for. Comments made about the care at the home included: “I have nothing but praise”, “they are a first class team”, “Staff are very good; they are all very good”. One family member, with her relative stated, “I think we have chose the best, its lovely here, we are very happy”. Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 7,8,9 and 10 Residents are treated with dignity and respect, however staff need to keep focussed on improving and updating the care plans to make sure residents get the appropriate care they need. Regular medication reviews would better safeguard resident’s health and welfare. EVIDENCE: Some resident’s care plans had been reviewed following the previous requirements. The nurse responsible for this was still in the process of reviewing all care plans. Residents consulted said they felt their heath needs were met. They had access to G.P, dentist, optician and chiropody and were given support to attend hospital appointments. A pharmacist had recently audited the homes medication systems. In the main the homes medication systems were safe and had improved following the previous requirements. Regular medication reviews had not been requested for some residents. Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 12 The home did not have a contract for the disposal of medication. Residents and the family members consulted said staff treat people at the home with dignity and respect. The inspector observed staff being polite, friendly and attentive to the residents. Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 12 and 13 Residents can maintain contact with their family and friends. The activities and leisure opportunities at the home met the expectations of the residents. EVIDENCE: Residents who were sitting in the lounge said they were satisfied with the daily events at the home and felt there was enough activity and entertainment. Recently residents had had a Thornton’s chocolate party, and other events included Christmas shopping at Meadow Hall. The home arranged transport with the local Dial-a-Ride scheme for residents who wished to go on outings. The visitors said staff always made them very welcome and they could visit their relatives at times that suited them both. Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 16 and 18 Residents and their families could raise concerns and complaints about the home and action would be taken to address these. Residents would be better safeguarded if staff were informed of the contents of adult protection procedures and had access to the local authority training. EVIDENCE: The new manager had reviewed how the home handles complaints. The manager had carried out an investigation following a complaint made about the home. During this time the manager kept the complainant and the commission informed. The manager provided a written response, which included where the home had identified the need to improve practices; for example an increase in laundry hours. The inspector consulted two residents and two family members about how the home deals with complaints. The residents said they were very happy at the home and felt they did not need to complain; however they felt that staff would take positive action if they did. The family members said they were happy with the home, one person stated they had raised minor concerns and staff at the home had been responsive. Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 15 National and local authority adult protection procedures were available for staff. At the point of inspection these had not been introduced to each individual staff member, to help them be more aware of the contents. Two staff members said they had received adult protection training, but had not had access to the local authority training. Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 16 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 the following standard(s): 19 An audit of the homes environment and a plan of routine maintenance needs to be put in place to make sure the environment is safe, comfortable and pleasant for the residents. EVIDENCE: The manager was in the process of recruiting a maintenance person to oversee the routine maintenance of the home. At this time a record of routine renewal and refurbishment was not available. The manager confirmed this would be part of the maintenance role. New carpets had been fitted in the entrance hall and small lounge. A skip had been hired to remove unwanted furniture and garden rubbish. The entrance to the home was much improved, for example clutter, litter and ashtrays had been removed. This made the entrance of the home feel more pleasant and welcoming. Designated smoking areas had now been provided. Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 17 The staff toilet had a bin that contained a lot of cigarette ends and ash. The manager was asked to remove this because it presented a fire risk. Residents said they were satisfied with the lounges and dining room and they said their rooms were comfortable and warm. Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28, and 29 Sufficient staff numbers were provided, this enabled residents care needs to be met. To make sure residents are looked after safely and appropriately, the staff team need to access specific and suitable training. The failure to provide robust employment checks could put resident’s welfare and safety at risk. EVIDENCE: One month of rotas was checked. These demonstrated that staffing levels were in the main adequate and systems were in place to provide cover. The residents and family members said they felt there were enough staff to make sure residents were well looked after. Staff training was insufficient; the manager was reviewing this and was in the process of finding training that was suitable for the homes needs. Over 50 of staff were trained in a National Vocational Qualification at level 2 in care, or better. Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 19 New staff did not have Criminal Record Bureau checks carried out by the home. The new staff did have CRBs but these had been brought from previous employment. This is against CRB guidelines. An immediate requirement was issued and the manager took action on the day to arrange for new CRBs to be done. Recruitment records did not contain the following for new staff. • Full employment history • Declaration about criminal offences • Declaration of health. Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37 and 38 Improvements to the management systems were being made. The homes safe working practices must to be urgently improved to make sure residents; staff and visitors safety is protected. EVIDENCE: The manager was reviewing the working systems at the home. Staff said the manager had been approachable, supportive and had started to implement changes. The staff consulted said they felt this was very positive. The manager had not applied for registration at the time of inspection. This was because the manager was working a three-month probation period. Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 21 Quality assurance systems were not in place. The manager was aware of this and was working with the provider to begin to put some systems in place, for example provider visits, improved complaints procedures and maintenance. The commission had not been notified about events at the home, for example falls resulting in hospital admission. Three service users finance records were checked. The manager had carried out an audit and started a new accounts system. In the past, receipts had not been obtained where items had been bought for residents, and one resident had been charged for taxi fares to hospital. The manager had consulted with the family member about the taxi fares and had informed staff that receipts must be produced for all expenditure. Recent purchases were checked and these did have receipts. One receipt did not state what the purchase was. Monies held tallied with the account records. The provider did not audit the residents’ accounts. The place where monies were held was not secure enough. The home did not have a clear policy about staff receiving gifts from residents. Gifts received were not recorded. This could put both residents and staff at risk. The monitoring of safe working practices was insufficient. An immediate requirement was issued because there was no evidence that gas, electric, water and equipment safety checks had been routinely carried out. The manager reported back to the commission within one week of the inspection that action had been taken and safety organisations had been contacted to carry out the checks. Fire training and checks were insufficient. The manager was in the process of recruiting a maintenance person to carry out routine health and safety checks and general maintenance at the home. Staff training in safe working practices was not up to date. The manager was consulting with a college to provide the training. Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 22 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 2 X 2 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X X STAFFING Standard No Score 27 3 28 3 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 2 X 2 1 Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 23 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 OP1 Regulation 5 Requirement The service users guide and statement of purpose must be updated to include the changes at the home. The documents must be made available in an easy to read format for residents. All residents must have their needs regularly reviewed, this must include an assessment on falls. Time must be provided for nursing staff to continue reviewing assessed needs. All care plans must be based on assessed needs. The care plans must be developed in line with the National Minimum Standards and include relevant clinical guidelines and risk assessments. The plans must be reviewed monthly and reflect changing needs Time must be provided for Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 24 Timescale for action 31/03/06 2 OP3 14 31/03/06 3 OP7 15 Sch 3 31/03/06 4 5 OP8 OP9 13 13 nursing staff to continue reviewing and updating care plans. Nursing and non-nursing tasks must be identified in the care plans. A medication review referral must be made for all residents at least annually. A contract must be arranged for the disposal of medicines for the nursing care section of the home. Cigarette ends and ash must be safely disposed of. A routine check of maintenance and renewal of fabric and furnishings must be carried out. Staff must be provided with training specific to the needs of the residents. Immediate requirement All recruitment checks must be completed before new staff start work. Portable criminal record bureau checks are not accepted; all staff must have a CRB check done through the home. The CRB applications must be submitted by the timescale for action date. Immediate requirement The commission must be formally notified of all events in the home that effect resident wellbeing. The registered provider must carry out monthly visits to the home. The visit must include: • Consultation with residents • Consultation with staff 31/03/06 31/03/06 6 7 8 9 OP19 OP19 OP28 OP29 23 23 18 19 07/12/05 31/12/05 31/03/06 09/12/05 10 OP33 37 09/12/05 11 OP33 26 31/12/05 Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 25 • • Check on the environment Review of the homes documentation. The report must be provided to the commission on a monthly basis. 12 OP35 13 and 16 A secure safe must be provided to store valuables. Receipts must state what the purchase was. The provider must make sure that residents’ finances are audited on a regular basis. A policy must be put in place about staff receiving gifts. Residents, relatives and staff must be informed about the homes gifts policy. The policy must be included in the homes statement of purpose. All records must be maintained 31/03/06 in line with National Minimum Standards and Care Home Regulations. Immediate requirement 16/12/05 The following safety checks must be carried out immediately and the certificates shown to the commission: • Gas • Electrical –5 year check • Portable appliance testing • Legionnaires • Hoists and Equipment 15 OP38 13 and 18 All staff must participate in a fire drill and receive fire training at least once a year. 31/12/05 31/12/05 13 OP37 17 14 OP38 13 and 23 Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 26 A system must be put in place to cover all fire checks. All staff must receive safe working practice training and this must be kept up to date. 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 OP18 Good Practice Recommendations All staff should access the Local Authority adult protection training All staff should have guidance on the adult protection procedures Galtee More Nursing Home DS0000006480.V268620.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Sheffield Area Office 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 DS0000006480.V268620.R01.S.doc Version 5.0 Page 28 - 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!