Inspection on 18/07/05 for Glanmor

This inspection was carried out on 18th July 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

Glanmor 05/07/07

Glanmor 02/08/06

Glanmor 05/01/06

Glanmor 01/03/05

Glanmor 07/10/04

Glanmor 17/03/04

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

CARE HOME ADULTS 18-65 Glanmor Bath Road Chippenham Wiltshire SN15 2AD Lead Inspector Alyson Fairweather Unannounced 18th July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Glanmor Address Bath Road Chippenham Wiltshire SN15 2AD 01249 651336 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) ABLE (Action for a Better Life) Mrs Maricka Hamblin Care Home 7 Category(ies) of MD Mental Disorder registration, with number of places Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 1st March 2005 Brief Description of the Service: Glanmor is a detached house converted from two semi- detached homes. It is situated within walking distance of Chippenham town centre and provides a service for residents who have or are recovering from mental illness. The home has a close support network with a local community psychiatric team. Glanmor is managed by ABLE (Action for a Better Life) and Sarsen Housing Association owns the property. There is a a large secluded garden surrounding the home, with a paved patio area, and a car park at the rear. Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one afternoon in July. The registered manager was called away and the inspection was conducted by one of the support workers, who is to be commended for her professional approach to the process. Three staff members and four residents were spoken to during the inspection. Staff showed the inspector round the premises, and a number of records were inspected, including care plans, health and safety records and medication systems. What the service does well: What has improved since the last inspection? 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. Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Prospective residents have their needs, hopes and goals assessed and recorded before they move in to the home so that staff know how best to support them. EVIDENCE: Considerable information from the referring mental health team is sent to the home when a new resident is planning to move in. Information is also received from medical teams and from various other professionals. Residents talk to staff at the home about their hopes for the future and what they would like to do with their daily routine before they move in, during the trial visits. The referring mental health teams provide a copy of the most recent Care Programme Approach (CPA) plan, which gives details of how the potential resident can best be supported with their mental health needs. Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 Care staff were not aware of the contents of care plans, and they were not reviewed on a regular basis, which means that staff cannot support residents in the way they should. EVIDENCE: The care plans of two residents were examined. Each of these contained a daily diary, and contained evidence of how staff were working with the residents. However, none of the care plans had been dated or signed by staff or residents, and one history sheet had not been completed. One resident had not had a CPA meeting for several years, although the new manager had recently arranged for this to take place. The details of this meeting were found to be on file, although the resident’s keyworker said she was unaware of its content and the fact that it had been placed on file, in spite of her responsibilities detailed in the CPA. There was no evidence of any other care plan review since 2004. The manager must therefore ensure that all care plans are reviewed regularly, and that they are signed and dated. All staff with responsibility for care planning must have training in how to do this effectively. Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 , 13, 15 and 17 Social and leisure activities are varied and tailored to individual need, with residents choosing what they wish to do. Residents can have as much or as little contact with family and friends, and are encouraged and supported by staff. They are offered a healthy diet, with their preferences taken into account. EVIDENCE: Records showed a range of daytime activities. Some people attended day services, and some were taking IT courses. Activities are discussed at residents’ meetings, and people go shopping, out for meals, visit cafes, the cinema and church. Staff were aware of local facilities and how to help residents access them. One resident spoken to was enjoying an afternoon film on television, and videos and computer games were available. One staff member said she enjoyed playing crib with a resident. Residents can entertain family or friends either in the privacy of their own bedrooms or in the communal areas available. Staff encourage and support Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 10 links between residents and their families, although the frequency of contact varies depending on individual circumstances. The menu supplied in the home is varied and nutritious, and residents decide on a daily basis what the main meal will be. There was a good supply of fresh fruit and vegetables, and juices and yoghurts were also available. Staff have records of the food likes and dislikes of all service users, and healthy eating options are encouraged. Vegetarian options are available, although the dishes offered each day should be recorded. One resident who goes to stay at a friend’s house on a regular basis is able to take his own food with him. There is a small residents’ kitchen where people can make a coffee or a light snack, and main meals are prepared in the bigger kitchen. The dining room is light and airy and comfortably furnished, so people can enjoy mealtimes together. Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20 Healthcare needs of residents are written in care plans so that they can receive support in the way they need and prefer. Medication recording procedures are sound and ensure that residents are safe. EVIDENCE: People receive support from staff to maintain their health care needs and there was evidence of further support from GP’s and community mental health teams. The care plans recorded input from community psychiatric nurses, psychiatrists, GP’s, optician and dentist. People who have diabetes have routine blood sugar monitoring. One resident spoken to was extremely anxious about a dentist appointment he was attending, so was able to have some PRN medication, and was very happy that a staff member had agreed to accompany him. Medication records examined were in good order. The home has a policy in place for all medication, including homely remedies, and all staff have medication training. When the medication of one resident was checked, the amount which should have been in the bottle was exactly correct. When PRN medication was given, it was seen to be recorded both in the communication book and in the diary sheet. There was, however, no specific protocol for the use of residents’ PRN medication, and the manager has been asked to ensure that this is done. Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The system of regular house meetings, and the formal and informal complaints mechanisms in place, mean that residents’ views are listened to and acted on. EVIDENCE: Weekly resident meetings are held, and people are encouraged to voice any concerns they may have. There is also a complaints book and a suggestions book available for residents. The home has a formal complaints procedure which outlines the steps to take if there are any complaints. This also gives details of how service users and families can contact the Commission for Social Care Inspection (CSCI). No complaints had been received either by the home or the CSCI. Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The care which residents and staff take to maintain the home means that residents live in a homely, comfortable safe environment, which is clean and hygienic. EVIDENCE: Glanmor is a detached house converted from two semi- detached homes. It is a comfortably furnished home with large airy rooms. Residents’ bedrooms were homely and each contained individual personal items. Residents who have small bedrooms have the benefit of another room which can be used as a sitting room, and one was watching an afternoon film in his sitting room. There is a smoking room available, and the main lounge is non-smoking. There is a large secluded garden to the rear of the house, with a patio area and a car park. Residents are encouraged to help with household tasks, although a cleaner is also employed. Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Residents’ individual and joint needs are met by staff who have had induction and some specialist training, and are undertaking NVQ. EVIDENCE: All staff have standard induction training which includes Health and Safety, First Aid, Food Hygiene and Safe Handling of Medication. Staff have also had training in managing diabetes. Training about to be started includes Disability Equality Awareness and Mental Health Awareness. There is a staff file in place which contains records of training and any certificates received. Two members of staff have completed NVQ Level 2 with two more currently undertaking this, and one staff member is doing NVQ Level 3. One staff member asked about the management of aggression was clear as to the procedures to be followed, and was aware of the lone worker policy. The home also operates an on-call procedure, which involves either the manager of Glanmor or the manager of the sister home in Melksham. Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The training, policies and procedures in place promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: All staff have had food hygiene training and food temperatures are recorded on a daily basis. The fire bell and emergency lighting is tested weekly and the emergency lights are tested monthly. There are regular fire drills, and records are kept of when these take place, although it would be useful to record the names of those who participate and those who refuse to do so. Fire extinguishers are checked annually, with the last service taking place in December 2004. The downstairs lavatory off the laundry room had a cloth hand towel in place, and consideration should be given to replacing this with paper towels. One area of concern to staff was the downstairs lavatory attached to the main kitchen. This was seen by them to be a potential source of cross infection, as it Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 16 has been used by residents with gastric upsets on occasion. The registered manager has been therefore been asked to complete a risk assessment relating to the use of the lavatory adjacent to the kitchen and to seek advice from the EHO regarding its future use. Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Glanmor Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 18 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 6 6 Regulation 15 (2) (b) 15 (2) (a) (c) (d) 18 (1) (c) (i) 13 (2) 13 (3) Requirement All care plans must be reviewed on a regular basis. All care plans must be dated and signed by staff and residents or the reasons for not doing so must be recorded. All staff must receive training in care planning. A medication protocol must be in place for all those residents receiving PRN medication. The manager must compile a risk assessment relating to the use of the lavatory adjacent to the kitchen and seek advice from the EHO regarding its future use. Timescale for action 18/09/05 18/09/05 3. 4. 5. 6 20 42 18/10/05 18/09/05 18/10/05 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. 2. 3. Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Refer to Standard 17 42 42 Good Practice Recommendations All vegetarian options should be recorded on the menu. The initials of all those who participate and those who refuse to participate in fire drills should be recorded. Paper hand towels should be available in the downstairs lavatory near the laundry. Version 1.40 Page 19 Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 20 Commission for Social Care Inspection Bath Road Chippenham Wiltshire, SN15 2BB 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 Glanmor D51_D01_S28637_Glanmor_V200950_180705_Stage4.doc Version 1.40 Page 21 - 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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