Inspection on 05/01/06 for Glanmor

This inspection was carried out on 5th January 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Glanmor 05/07/07

Glanmor 02/08/06

Glanmor 18/07/05

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 Inspection 5th January 2006 1:00 Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 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 Glanmor DS0000028637.V266765.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 Adults 18-65. 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. Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Glanmor Address Bath Road Chippenham Wiltshire SN15 2AD 01249 651336 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) ABLE (Action for a Better Life) Maricka Elke Hamblin Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 2005 Brief Description of the Service: Glanmor is a large, detached house converted from two semi- detached homes. It is situated within walking distance of Chippenham town centre and provides a service for seven residents who have or are recovering from mental illness. The home has a close support network with the local community psychiatric team. Glanmor is managed by ABLE (Action for a Better Life) and Sarsen Housing Association owns the property. There is a large secluded garden surrounding the home, with a paved patio area, and a car park at the rear. Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one afternoon in early January 2006. Four residents, the manager and several care staff were present and spoken to. Written comments about the home have been received from five residents, four families and from a social worker who has a client living in Glanmor. The inspector walked round the premises and examined several records, including risk assessments, health and safety, the complaints procedure and staff training. What the service does well: What has improved since the last inspection? A great deal of work had been done on residents’ care plans. They contained information about people’s likes and dislikes and how their needs could best be met, as well as detailed information about their physical and mental health, their activities, their family contacts and any personal care needs. These care plans are reviewed on a regular basis and signed by the keyworker and the resident. One family member who wrote to the inspector said that her niece felt “very happy and secure” living in Glanmor. Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 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. Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 8 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 the following standard(s): 2 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 DS0000028637.V266765.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 6, 7 and 9 Residents know that their needs and goals are reflected in their care plans, and they are encouraged and assisted to make their own decisions. Poor record keeping relating to risk assessments make it difficult to know how residents are supported when taking risks. EVIDENCE: All staff have recently had care planning training, and care plans examined were in the process of being updated. Residents’ care plans contained a daily diary and evidence of how staff were working with the residents. Each care plan contained information on people’s social activities, their diet and physical and mental health, and their daily routines. Each plan was indexed and numbered, although some of the numbers conflicted where new care plans had been introduced and not indexed. Some care plans also appeared to contain the same information, and it has been recommended that each care plan is clearly linked to the one heading. Residents are supported to make decisions about their own lives with guidance from the staff. They are encouraged to manage their own finances wherever possible, although some have family involvement and other support. Glanmor Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 10 has recently been encouraging residents to use the local bank more, and this has had a positive effect on their independence. They have also started to use individual money boxes for their own use, instead of staff having to hand out money to them each time. Where restrictions are in place, for example to limit self harm or harm to others, this is clearly recorded and guidelines are drawn up for staff to follow. There were few risk assessments in place, and several of those which were had not been reviewed for some time. In discussion with the manager, it was clear that she was aware of the ways in which residents could be at risk, and that staff were taking measures to avoid these. However, all identified risks must be recorded, along with the plan of how to minimise the risk. The manager has been asked to ensure that this is done. Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 16 and 17 Residents’ rights are respected and responsibilities recognised in their daily lives. Residents are offered a healthy diet and enjoy their meals and mealtimes. EVIDENCE: Residents can choose when to be alone or in company, and when not to join an activity. They have unrestricted access to the home and grounds, and can come and go as they please. Several residents had gone out to day services on the day of the inspection, but some were at home. Staff enter residents’ bedrooms only with the individual’s permission, and were seen to knock on the bedroom door and wait for response. Residents’ responsibility for housekeeping tasks, such as doing their laundry or tidying their room is specified in their care plan. No resident has an advocacy worker, although one does have a befriender. One resident who had been out all day was seen to open his own mail when he came home. 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 Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 12 fruit and vegetables, and juices and yoghurts were also available. Staff have records of the food likes and dislikes of all residents, and healthy eating options are encouraged. Vegetarian options are available at all meals, and one new staff member who is also vegetarian, was making a supper of Spaghetti Bolognese and salad on the day of the inspection. One resident who is vegetarian was assisting in the kitchen. 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 DS0000028637.V266765.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 20 Medication recording procedures are sound, although failure to have protocols for PRN medication could mean that residents are at risk. EVIDENCE: 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 PRN medication was given, it was seen to be recorded both in the communication book and in the diary sheet. However, at the last inspection the manager had been asked to ensure that each resident who used PRN medication had a specific protocol for when it should be used. This had still not been done. The manager was reminded of the seriousness of failing to meet legal requirements, and again asked to ensure that a medication protocol for all PRN medication is in place. The records showed that one resident who looks after their own medication had taken the wrong tablet on one occasion. No notification of this incident had been sent to the Commission for Social Care (CSCI) and the manager has been asked to ensure that this is done in future. A copy of the CSCI guidance will be sent to the home. Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 23 The policies and procedures the home has in place try to ensure that residents are safeguarded from abuse and harm. EVIDENCE: The home has copies of the “No Secrets” document, as well as the organisational policy and procedure on responding to allegations of abuse. All staff have had training in Working with are encouraged to report any incidences of poor practice. A “Whistle Blowing” procedure is also available for all staff. All staff have Criminal Records Bureau (CRB) checks and are checked against the Protection of Vulnerable Adults (POVA) register. The manager was unaware of whether the home had a copy of the Wiltshire & Swindon Vulnerable Adults procedures, and it has been recommended that she obtains a copy. One recent incident had been referred to the Vulnerable Adults team by the home, and the matter dealt with appropriately. Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 15 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 the following 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. There is a smoking room available, and the main lounge is nonsmoking. 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. There have been instances recently where leaks from pipes and tanks have occurred, although staff have dealt with this promptly and are in negotiation with the housing agency about how to prevent this happening again. Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 16 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 34 Residents are supported by competent and qualified staff, and by the home’s recruitment policy and practices. EVIDENCE: Staff training has included Food Hygiene, Infection Control, Safe Handling of Medication, and Disability Equality. Four members of staff are studying NVQ Level 2, with one about to start, and one has almost completed NVQ Level 3. The staff team has had training in certain aspects of mental illness, for example Obsessive Compulsive Disorder, but would benefit from more of this type of specialist training. One staff member spoken to was keen to learn more about the medications taken by residents, and said that in the past, ABLE had given them information sheets. The manager has been asked to investigate whether this would be possible again, as part of staff knowledge of psychiatric medication. There is a staff file in place which contains records of training and any certificates received. However, it has been recommended that a training plan should be in place which clearly outlines when training updates are needed by staff. All prospective staff are invited to visit the home prior to being interviewed, in order to get a feel of the home and to enable staff to receive feedback from residents. The person is then interviewed and two references are obtained. Staff sign a declaration of criminal convictions prior to the completion of a CRB and POVA check. All staff receive a copy of the code of conduct and terms and Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 17 conditions, and have a three-month probationary period. One new staff member spoken to confirmed that these checks had been done for her, and that she had had induction training. Examination of her staff file showed this to be the case. Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 18 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39 Residents benefit from a well run home, although poor reporting of monthly visits by the organisation means that it is difficult to establish that residents’ views underpin all self monitoring and development in the home. EVIDENCE: The manager has been registered with the Commission for Social Care within the last year. She has almost completed her Registered Managers Award and will then go on to do an NVQ Level 4 in Care. She has had experience of working with people with mental ill health and with older people. One staff member spoken to said how supported she felt by the manager in particular, and by colleagues in general. There are regular meetings which discuss service provision, including staff meetings, and psychiatric reviews about individual residents. Residents meetings were said to be poorly attended, but individual’s views were sought by staff. An annual questionnaire is issued to residents and families, seeking their views on the service and asking how it might be improved. This is due to be issued again in April. Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 19 As part of their responsibility towards the home, the organisation has an obligation to visit on a monthly basis and report on these visits to the Commission for Social Care. Staff reported that they do receive regular visits by senior managers of the organisation. However, the reports of these visits have not always been sent to the CSCI, and the manager has been asked to ensure that this is done. Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 20 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 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Glanmor Score X X 1 x Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X X x DS0000028637.V266765.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? YES 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 YA9 Regulation 13 (4) (c) Requirement Timescale for action 05/03/06 2. YA20 13 (2) The registered person must ensure that all residents have their identified risks recorded, along with the plan of how to minimise the risk. These must be reviewed on a regular basis. 05/03/06 The registered person must ensure that a medication protocol is in place for all those residents receiving PRN medication, outlining the circumstances where it may be used. Comment: This is the second time this requirement has been made. The registered person must ensure that all staff are aware of their obligation to report incidents to the CSCI. The registered person must ensure regular monthly visits to the home and must provide a copy of the report of these visits to the CSCI. 3. YA20 37 05/12/05 4 YA39 26 05/01/06 Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 22 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. 4. Refer to Standard YA6 YA23 YA32 YA32 Good Practice Recommendations The registered person should ensure that each care plan is clearly linked to the one heading and highlighted in the index. The registered person should obtain a copy of the Wiltshire & Swindon Vulnerable Adults procedures. The registered person should have a training plan in place which clearly outlines when training updates are needed by staff. The registered person should introduce more specialist mental health training for staff. Glanmor DS0000028637.V266765.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham 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 DS0000028637.V266765.R01.S.doc Version 5.0 Page 24 - 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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