Inspection on 16/05/05 for Glasson House

This inspection was carried out on 16th May 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

Glasson House 05/09/06

Glasson House 30/01/06

Glasson House 08/12/04

Glasson House 13/05/04

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

CARE HOME ADULTS 18-65 GLASSON HOUSE 93 Belmont Avenue Cockfosters Barnet, Hertfordshire EN4 8JS Lead Inspector David Hastings Announced 16 May 2005 at 09:30 am 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. GLASSON HOUSE Version 1.10 Page 3 SERVICE INFORMATION Name of service Glasson House Address 93 Belmont Avenue, Cockfosters, Barnet, Hertfordshire EN4 9JS 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) 020 8449 7808 020 8364 9257 Martin Bourke of De Bohun Care Ltd Vacant Post PC Care Home Only 5 Category(ies) of MD Mental Disorder registration, with number of places GLASSON HOUSE Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 8 December 2004 Brief Description of the Service: Glasson House is a care home providing personal care and accommodation for five adults with mental disorders, excluding learning disabilities or dementia. De Bohun Care Ltd., which has another service nearby for people with mental health problems, runs the home. The home is set in a quiet residential road and benefits from good shopping and transport facilities, which are only about seven to ten minutes walk away. Each service user has a single bedroom, which meets the required minimum standard of bedroom size. The home provides three bathrooms with toilets and a separate toilet on the first floor. The kitchen and the dining room are on the ground floor. The staff support the service users with their medication, personal care, social and recreational activities, and with cooking. GLASSON HOUSE Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on 16th May 2005 and lasted five hours. The inspector was assisted by the manager and registered provider who were open and helpful throughout the inspection. The inspector spoke with all of the service users during the inspection and the feedback was positive regarding the management and staff at the home. A tour of the premises took place and care records were inspected. One comment card was received by the CSCI from a relative, five comment cards were received from service users including two poems and three comment cards were received from doctors and other care professionals. Comments from health care professionals were generally positive regarding the service. What the service does well: What has improved since the last inspection? What they could do better: Seven new requirements have been issued relating to the registration of the manager, more detailed records of what service users eat, staff training in adult protection, more detailed records in relation to service users’ meetings and three issues relating to health and safety monitoring. GLASSON HOUSE Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. GLASSON HOUSE Version 1.10 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 Standards Statutory Requirements Identified During the Inspection GLASSON HOUSE Version 1.10 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 standard(s) 2 The home has a good admission policy and service users know that their needs will be fully assessed before they move into the home. EVIDENCE: The home’s admission policy states that potential service users are assessed by the home and invited for a series of visits and overnight stays. Evidence of assessments were seen on service users files. These included assessments carried out by social workers and other health care professionals. GLASSON HOUSE Version 1.10 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 standard(s) 6,7 and 9 Detailed, written plans of care are provided for all individual service users. Service users are involved in these plans and are able to make decisions about how this care is to be provided. Service users are supported to take risks as part of an independent lifestyle within a risk assessment framework. EVIDENCE: There was evidence from the five care plans examined that they were drawn up from the assessments of the service users. The inspector also saw evidence in the files that the social workers, health professionals, staff from the home and the service users have been involved in reviewing care plans. Care plans were detailed and contained information on how staff were to encourage service users to achieve individual goals. There was evidence from care plans that service users’ rights are respected and they are able to make decisions about their care. Service users confirmed that they were able to go out to local shops and services independently. Throughout the inspection staff were observed to be encouraging service users to express their needs and choices. . The acting manager was able to describe how service users’ views and suggestions have been incorporated into the running of the home. GLASSON HOUSE Version 1.10 Page 10 The service users’ risk assessments, which were seen in files, were up-to-date and detailed. The assessments reflected the individual assessed needs of each service user. The risk assessments seen also contained specific triggers to identify possible relapses of service user’s mental health. GLASSON HOUSE Version 1.10 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 standard(s) 12, 13, 15, 16 and 17. Service users are actively encouraged and supported to take part in varied activities both inside and outside the home. Service users rights are respected. The home encourages service users to maintain appropriate relationships with family and friends. The home provides a varied menu that has been chosen by the service users. EVIDENCE: The home currently assists three service users with their benefits. No service users are currently employed or are undertaking training. The inspector saw minutes from the service users’ meetings in which suggestions were made regarding activities. The home employs an activities coordinator for twelve hours a week. Service users that the inspector spoke with said they enjoyed the activities available to them. Records are being maintained of activities undertaken. One service user attends a day centre three times a week and said she enjoyed going. Service users confirmed that they went out as a group once a week to local restaurants. Another service user gave a detailed account of all the activities that take place at the home. GLASSON HOUSE Version 1.10 Page 12 Three service users are registered with dial-a-ride. Although not all service users have visitors some service users go out of the home to visit family and friends. The inspector was informed that all service users have keys to their bedrooms. Some service users go out of the home when they want and within a risk management framework. Some service users that the inspector spoke with said they could go out to the local shops and that they enjoyed this activity. The service users spoken to said that the food provided at the home was varied. They said that they were happy with the food and they could make snacks whenever they wanted. The fridge, freezer and the kitchen are locked only at night. Discussion with the manager and records showed that the home catered for people with special dietary needs such as diabetes. Three service users have fridges in their rooms for snacks and drinks. A service user told the inspector that they choose the menu at meetings. Lunch was relaxed and sociable and service users assisted with domestic tasks. Records of food eaten by service users did not give enough detail to evidence that service users receive a balanced diet. Staff must record what service users have eaten including what vegetables and fruit were available. A requirement relating to this has been issued in the relevant section of this report. GLASSON HOUSE Version 1.10 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 standard(s) 18, 19 and 20 Staff at the home provide a good level of care and support to service users. Service users physical and emotional health needs are being met by the home. Service users receive the medication that has been prescribed for them at the right times by appropriately trained staff. EVIDENCE: None of the current service users require direct personal care. Care plans examined indicated that staff supervise and support service users to be as independent as possible. Service users told the inspector that the staff at the home are “very caring”. The service users interviewed said that they chose their clothes and hairstyles. They said that the staff always knocked on doors and waited for permission before entering bedrooms. The home has an equal opportunities policy. All the service users are registered with a General Practitioner, a psychiatrist and a community psychiatry nurse (CPN). The acting manager said opticians and chiropodists visited the home. All service users are registered with the local dentist. The inspector saw evidence that service users health care needs were being met from individual medical appointments on individual service user’s files. GLASSON HOUSE Version 1.10 Page 14 The home has a satisfactory medication policy. Medication is administered to the service users. The medication administration sheets, which were inspected, were found to be in order. Medication is stored appropriately. Staff that administer medication have had appropriate training and certificates were seen on staff files examined. GLASSON HOUSE Version 1.10 Page 15 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 and 23 The home has a good complaints policy and procedure and service users are aware of how to make a complaint. Service users are protected from abuse by a clear adult protection procedure, which all staff at the home are aware of and understand. EVIDENCE: No complaints have been recorded since the last inspection. Service users that the inspector spoke with said they had no complaints about the home and new what to do if they had any. The acting manager has revised the complaints format with the assistance of a service user at the home. The revised system now has a detailed chronology from the date the complaint is received through to the date of the full report and includes an annual review of the policy. This revised policy has been discussed at the most recent service users’ meeting. Evidence was seen that minor issues are discussed at the service user’s meetings and acted upon. The home has a policy on Violence and Abuse. The acting manager said the staff have read this policy. The staff spoken to confirmed this. The home uses the Adult Protection procedure of Barnet’s Adult Protection Unit. The acting manager has also drawn up advice for staff on how to implement this policy. The inspector examined a satisfactory whistle blowing policy. Staff at the home would benefit from adult protection awareness training to underpin their knowledge of the home’s policy. A requirement relating to staff training in adult protection has been issued in the relevant section of this report. GLASSON HOUSE Version 1.10 Page 16 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, 28 and 30 Service users live in a comfortable and homely environment. Staff ensure that the home is clean and hygienic. Where risks to service users safety has been identified, appropriate assessments have been carried out to minimise these risks. EVIDENCE: The home is located in a quiet residential area and is very close to the shops, bus terminals and the Piccadilly line of the London Underground system. All the rooms are large and spacious and meet the required minimum standards. The home has a smoking policy, and bedrooms, the kitchen and the dining room are non-smoking areas. In reality some service users do smoke in their rooms and appropriate risk assessments were seen. The premises were bright, airy, clean and free from offensive odours on the day of the inspection. Records are maintained of all repairs and maintainance issues at the home. The inspector also saw that service users discuss maintainance issues in service user meetings. GLASSON HOUSE Version 1.10 Page 17 The home has a large kitchen, a lounge, dining room and a front and back garden. A large room on the second floor, which was being used as the second office, has been converted to a sleeping in room. All communal areas were decorated to a good standard. A requirement issued at the last inspection that the missing kitchen cupboards must be replaced has been complied with. The kitchen has been refitted with stainless steel worktops and all service users’ rooms have been redecorated. Service users were involved in choosing the colour scheme for their rooms. Although the washing machine is domestic it is sufficient for the needs of current service users at the home. No service users currently need continence management. The acting manager informed the inspector that if service users continence needs change the washing facilities would be reviewed. The home has a satisfactory infection control policy. Certificates were seen of staff training in infection control. GLASSON HOUSE Version 1.10 Page 18 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) 34 and 35 Service users are protected by a thorough recruitment procedure ensuring staff are not employed with out satisfactory references and police checks. The management of Glasson House actively encourage staff training and service users benefit from an appropriately trained staff group. EVIDENCE: The home has a satisfactory recruitment procedure. Two written references, proof of identity and CRB disclosures were seen in the staff files examined. Staff are also given contracts. The home has a probationary period of three months for new staff. The acting manager informed the inspector that individual training needs are identified in supervision and records seen confirmed this. All staff have individual training records in their file. Two staff have completed NVQ level 2. A number of staff are undertaking a foundation training course with an outside organisation in order to underpin their knowledge of mental health issues. GLASSON HOUSE Version 1.10 Page 19 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) 37, 39 and 42 The manager ensures that the home is well run and staff are appropriately supported. Service users have a say in how well the home is meeting its aims and objectives. Generally there are good systems in place to monitor health and safety compliance. EVIDENCE: Although the acting manager is qualified and has the experience needed to run the home, she has not applied for registration with the CSCI. This is an issue, which needs to be addressed, and a requirement has been made in the relevant section of this report. Throughout the inspection the manager was observed supporting staff appropriately and staff interviewed were positive about her management approach. The manager sends out an annual questionnaire to service users, friends and family as well as professional agencies. Minutes of service users meetings were seen and included suggestions for improvements for the home. It was not clear what action was taken to address these issues identified by the service users. GLASSON HOUSE Version 1.10 Page 20 A requirement that minutes of service users’ meetings include the action to be taken as a result of suggestions from service users has been issued in the relevant section of this report. Evidence was seen that fire drills and emergency light checks have been carried out regularly. However smoke detectors need to be checked on a more regular basis as service users are known to smoke in their rooms. A requirement relating to this has been issued in the relevant section of this report. Certificates were seen to confirm that the staff had attended a training programme in the control of infection. Portable electrical tests were carried out in September 2004 and gas safety certificate was dated 21st June 2004. A Legionnaires check had been carried out on 16th November 2004. The electrical installation certificate was dated 13th September 2004. The accident book and fire log were both satisfactory. No service users require assistance with moving and handling however the manager is planning to provide this training for all staff. Two issues relating to health and safety were identified during this inspection. The water temperatures in wash hand basins are thermostatically controlled. However the home must maintain a record of temperature checks to ensure the thermostats are functioning correctly. One radiator in the kitchen area was very hot and did not have a cover. Some of the service users at the home may be at risk from this. A requirement has been made that any radiators that may present a risk to service users must be fitted with guards. A requirement issued at the last inspection relating to first aid training for staff has now been complied with. All staff have undertaken emergency first aid training and the manager will be ensuring that all staff undertake the first aid qualification. 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. Where there is no score against a standard it has not been looked at during this inspection. 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) GLASSON HOUSE Version 1.10 Page 21 “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 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 2 Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x 2 x x 2 x GLASSON HOUSE Version 1.10 Page 22 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. Standard 17 Regulation 16(2)(i) Requirement The registered provider must ensure that all meals taken by service users are recorded in sufficient detail to evidence that service users get a balanced diet. The registered providor must ensure that all staff undertake abuse awareness training. The registered providor must ensure that the manager applies for registration with the CSCI. The registered providor must ensure that minutes of service users meetings contain written information on how comments and suggestions are to be actioned by the home. The registered providor must ensure that smoke detectors are tested on a regular basis and not less than every quarter. The registered providor must ensure that water temperatures of hand basins are tested on a regular basis to ensure they are within safe limits. The registered providor must ensure that the radiator in the kitchen is fitted with a guard and that other radiators in the home Version 1.10 Timescale for action 01/07/05 2. 3. 4. 23 37 39 13(6) 8(1)(2) 24(3) 01/10/05 01/08/05 01/07/05 5. 42 13(4) 01/07/05 6. 42 13(4) 01/07/05 7. 42 13(4) 01/09/05 GLASSON HOUSE Page 23 are risk assessed and covered if needed. 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 Good Practice Recommendations No recommendations have been issued at this inspection. GLASSON HOUSE Version 1.10 Page 24 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London N14 6HA 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 GLASSON HOUSE Version 1.10 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!