Inspection on 30/01/08 for Glastonbury Care Home

This inspection was carried out on 30th January 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Glastonbury Care Home 04/12/08

Glastonbury Care Home 06/06/08

Glastonbury Care Home 11/07/07

Glastonbury Care Home 30/08/06

Glastonbury Care Home 23/02/06

Glastonbury Care Home 23/08/05

Glastonbury Care Home 23/03/05

Glastonbury Care Home 22/09/04

Glastonbury Care Home 29/03/04

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

CARE HOMES FOR OLDER PEOPLE Glastonbury Care Home Pike Close Sedgemoor Way Glastonbury Somerset BA6 9PZ Lead Inspector Gloria Ashwell Key Unannounced Inspection 10:00 18th March 2008 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 Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 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. Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glastonbury Care Home Address Pike Close Sedgemoor Way Glastonbury Somerset BA6 9PZ 01458 836800 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) Brunelcare ****Post Vacant**** Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32), Physical disability (32) of places Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Elderly persons of either sex, not less than 60 years, who require general nursing care Up to four persons of either sex, between the age of 55-60 years, who require general nursing care Registered for a total of 32 places in categories OP and PD That the clinical manager for the upper floor has a minimum of 30 hours managerial time. Random inspection: 7 November 2007 Date of last inspection Brief Description of the Service: The Glastonbury Care Home was first registered in July 2000 and is a purpose built Care Home. It is a two-storey building, set in accessible gardens on the outskirts of the town of Glastonbury. Numerous car parking spaces are available in the grounds, close to the building. At present it is managed as two separate homes, one on each floor, and within each floor there are two units. The ground floor accommodates service users requiring personal care (formally residential care’), one unit for those with mental health needs. The first floor is for those who require general nursing care. All rooms are single occupancy and have en-suite facilities. The Registered Manager of the ground floor is now also in charge of the nursing care service (first floor) and intends to apply to the Commission to become the Registered Manager of the entire service, i.e. both the ground and first floors. This report relates to the General Nursing units (first floor) only. A separate report is available for the Personal Care areas (ground floor). The fee range quoted in the service user guide at the time of inspection was from £593 per person per week; fees are determined by assessment of the persons needs. Additional amounts are charged for chiropody services, hairdressing, daily papers /magazines. Up to date fee information may be obtained from the service. Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 5 Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk A report entitled Care Homes in the UK - A Market Study is available on web link http:/www.oft.gov.uk/NR/rdonlyres/5362CA9D-764D-4636-A4B1A65A7AFD347B/0/oft780.pdf Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was a statutory inspection required in accordance with the Care Standards Act 2000. The previous key inspection took place on 11 and 12 July 2007, and on 7 November 2007 a random inspection took place to review the arrangements for the storage documentation and administration of medication. Another visit was conducted on 30 November 2007, at the request of the home manager, to discuss additional concerns that had been identified by the management team. The first visit of this inspection was unannounced; the inspector arrived at 10.00 on 18 March 2008, toured the premises and spoke to residents, visitors, staff and the manager and examined a sample of documents relevant to requirements issued in the report of the previous inspection. By arrangement with the manager the inspector revisited the home at 10.00 on 28 March 2008 and with the acting manager discussed and examined further documents regarding care provision and management of the home. The duration of the inspection (both visits combined) was 7 ¼ hours. The inspector spoke to the manager, care and household staff and most of the residents accommodated at the time both individually and in small groups in the communal areas, and observed staff interaction with residents and the carrying out of routine tasks. During the inspection, particular residents were ‘case tracked’; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same resident were examined and the resident spoken with. The care records of five people who live at the home were examined in detail. During this inspection compliance with all key standards of the National Minimum Standards was assessed. What the service does well: Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 7 Glastonbury Care Home provides a comfortable environment for older people with nursing needs. Residents are cared for by registered nurses supported by care staff. The home ensures that prospective residents have the information they need to enable them to make an informed choice about moving to the home. Before being admitted to the home the needs of each person are fully assessed to ensure the home can properly care for them. Staff are kind and respectful to residents. The company values its staff and provides a good range of training to them including induction to all new staff to ensure that they are confident in their role and feel well supported. 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. The summary of this inspection report can be made available in other formats on request. Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 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 Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (The home does not provide intermediate care so Standard 6 does not apply) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them. EVIDENCE: The files for two residents who had recently moved into the home were inspected. Both contained evidence of pre-admission assessments carried out by the manager who had visited each person at their previous address. The records Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 10 contained sufficient details about the needs and circumstances of each person to enable a plan to be made and thereby provide staff with enough information about how to meet their needs. A resident confirmed that prior to admission the manager had visited and the person thereby had felt confident about moving to Glastonbury Care Home. In advance of making the decision to enter the home the relative of the other resident had visited the care home to view the premises and meet residents and staff. Following pre-admission assessment of the prospective residents needs and circumstances the home writes to them confirming agreement and ability to accommodate and care for them. Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. In general residents receive the care they need but for some aspects staff do not have sufficient guidance and supervision to enable them to properly meet the needs of each resident. Residents receive the medicines they have been prescribed but aspects of medicine handling and associated record keeping must be improved to ensure the protection of residents from the harm and ill health that incorrect administration might cause. EVIDENCE: Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 12 Care records of 5 residents were examined and found to be of generally good standard, having been recently re-written in accordance with a new care planning system. The care plans were evaluated on a monthly basis and are in the process of being agreed by residents or their representatives. However, a number of residents use bedrails to protect them from risks of falling from bed; for some of these people there were no risk assessments for the bedrails, and for others the records were out of date and inaccurate. Accordingly there was little if any evidence of the reason/s for use of the bedrails, the agreement of the resident for the fixing of bedrails and of identification of possible risks associated with their use; since the last key inspection two residents had experienced accidents involving beds and bed rails. The failure to provide reliable and thorough plans of care for these residents placed them at risk of poor and inappropriate care because their needs and circumstances had not been reliably assessed and thereby were not recorded in the care plans, and may not be known to staff. Due to the seriousness of these particular concerns, which may have a direct bearing on the safety of residents, a requirement was issued during the inspection and is contained in this report. Most residents are weighed each month; the record of one resident’s weight indicated significant fluctuations but no reference to this was recorded and the acting manager said the condition of the person had not noticeably altered. It is therefore likely that some inaccuracy of weighing or recording has taken place (e.g. using different scales, or at different times of day). It is required that for each resident the home record an accurate and comprehensive care plan ensuring provision of sufficient information to staff enabling them to properly care for and safeguard every resident. The homes uses a monitored dosage system for the administration of prescribed medicines, which is carried out by registered nurses. The dispensing pharmacy provides pre-printed medication administration records (MARs) but on occasion it is necessary for staff of the home to handwrite additions or alterations in accordance with instructions of the prescriber. Medicines were found to be securely stored but the acting manager was unsure if the installation of the Controlled Drugs cabinet is fully compliant with current standards; it was agreed that she will further investigate this circumstance and if necessary bring it to the attention of the provider organisation to ensure the necessary improvements can be made. In general, records provided evidence that medicines have been administered as prescribed but for one person prescribed to receive Tramadol four times a Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 13 day the record indicated it was given only once and when not given was recorded as “R” meaning it had been refused by the resident, or as “O” but without definition of the reason for omission. Another person is prescribed Haloperidol; the MAR had an unsigned and undated handwritten instruction “can be given covertly: see care plan” but the care plan and other records provided no relevant information and there was no evidence that the home has followed established guidance in consideration of administration of medicines covertly e.g. concealed in foodstuffs. These two matters were referred to in the report of the random inspection which took place during November 2007, but the necessary improvements have not been made and therefore the requirements are repeated in this report; an Immediate Requirement regarding the covert administration was made during the inspection. In the presence of staff residents appeared relaxed, confident and at ease; staff interactions with residents were of a friendly and considerate manner and the atmosphere throughout the home was calm and unhurried. Residents are treated with respect and their privacy and dignity is promoted and maintained. Residents and their relatives believe they are properly cared for; one resident said “They do their best for me …they’re all very nice…”. Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Recreational and social activities focus mostly on the more able residents; the limited time available to the activity organiser means that many residents spend a number of hours each week without opportunities to engage in recreational and social activities. In consequence many are likely to become bored, apathetic and unhappy. Improvements are underway to provide all residents with food and drink of their preference and at the times they prefer but more must be done to ensure that those who require assistance to eat promptly and reliably receive it. EVIDENCE: An Activity Organiser is employed for 24 hours each week and arranges a variety of one-to-one and small group activities; during the first day of this inspection she was accompanying a resident to local shops to make personal purchases. The work of the Activity Organiser is supplemented by the involvement of a team of volunteers including two persons who in addition to Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 15 on occasion working in a voluntary capacity are also in the paid employ of the home. Between the two dates of this inspection a number of residents participated in an excursion to a nearby Rural Life Museum; excursions take place on a regular basis. However, many of the residents have frail health and are unable to go out or to engage in group activities. For these people there seem to be many unfilled hours, when they are left to sit unattended; staff were observed to be carrying out activities such as laying meal tables, close to these residents but without engaging them in the activity or in conversation. At one time a mobile hoist was seen to have been left in the main lounge in front of a switched on television which some residents were trying to watch; the inspector drew this to the attention of a care worker who moved the hoist to a more suitable position. One resident said she had hardly been out of her room for some months because it is a complex task requiring at least 2 staff and a hoist to assist her to move about; records showed that she had been offered involvement in recreational and social activities but had declined. It is recommended that more be done to attempt to provide each resident with suitable and accessible recreational activities. Residents are able to attend church services if they wish and representatives of all faiths are made welcome, as are the personal visitors of residents. There are no restrictions to visiting times. There are two lounges combined with dining areas; the largest of these two rooms has recently had a shelf unit installed to partly separate the lounge and dining areas. Most residents eat meals in the dining rooms, others receive them in their bedrooms. Shortly before each meal each resident is offered a choice of menu; however, the meal is not always quite as described e.g. on the first day of this inspection a resident selected ‘cold meat salad’ from the available options – the meal that was served was cold meat with mashed potatoes and green beans. A tray with this meal was placed on the bed of a resident with severely impaired vision and as the nurse was leaving the room asked for her spectacles, but her request went unheard. The inspector sought the nurse and brought this to her attention; the nurse found the spectacles and said she had not known the resident needed spectacles. The resident then attempted to feed herself but the tray was tilted sharply towards her. Again, the inspector informed the nurse who provided a ‘cushioned tray’ enabling the plate to be level. It was then apparent that the resident was unable to cut the meat or Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 16 feed herself using cutlery so the nurse stayed with her to assist. It is recommended that staff are trained to check that meals served are to a resident’s satisfaction before leaving the area. However, for a resident who did not like any of the midday meals on the menu that day, a special meal of tripe and onions was cooked; this was greatly enjoyed by the particular resident. Also, a ‘Light Bite’ (snack) menu has been recently introduced to ensure that residents are aware of the availability of these foods and beverages, which can be provided to them at any time. Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure provides information on the procedure to follow to persons wishing to make a complaint; all complaints are recorded and investigated and the home has implemented and adhered to its policies and procedures for safeguarding adults. EVIDENCE: Residents and their representatives have access to the complaints procedure which is included in the service user guide to the home displayed at the entrance with a copy provided to each residents’ relative/representative. Residents know how to complain and feel confident that if they had concerns or complaints they will be listened to and taken seriously. The home keeps records of all complaints received and investigated. Since the last inspection two complaints against the home have been investigated by the home investigated; and a third was investigated with the involvement of the Commission. Two were found to be partly substantiated; the third was not substantiated. The home has developed and implemented written policies and procedures for the protection of residents from abuse or neglect and provides all staff with Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 18 training in the understanding of abuse and their role in protecting residents from abuse in its many forms, including neglect. To ensure the rights of all residents are properly protected staff receive training in the Mental Capacity Act. Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This is a well-appointed and comfortable home with a continuous programme of improvements. On the dates of inspection the home was clean, pleasant and hygienic and there was evidence indicating that this is the usual standard of provision. EVIDENCE: The home has a warm and homely atmosphere; it is comfortably furnished and well decorated. Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 20 Aids and adaptations are available throughout the home e.g. grab rails, raised toilet seats. Residents with particular needs have their own personal equipment to assist with their independence. Adjustable beds are in place for those who need them; the acting manager said that she hopes to obtain some beds of the ‘profiling’ style which enhance the comfort and safety of very dependent residents. Residents are encouraged to personalise their rooms with furniture and general belongings as they wish and in agreement with the home. There is a passenger lift in the home providing level access to all floors. There are ‘staff call bells’ throughout the home; residents said they do not experience undue delay in receiving a response when they use the call bells. On the days of this inspection the home was clean and there were no unpleasant odours. The laundry was clean and tidy and properly equipped; all laundry is carried out at the home. Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and maintenance of the good condition of the premises. Recruitment practices ensure the protection of residents from potentially unsuitable staff. Staff receive appropriate training and are competent to carry out their jobs. EVIDENCE: At all times the home is in the overall charge of an experienced nurse. Staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. The records of 2 recently employed staff members were examined and found to contain essential information including an interview assessment, health Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 22 details, two written references, evidence of identity and ‘Criminal Records Bureau check’ and induction training. There is an enthusiastic approach to staff training; there is an annual programme of training in relevant subjects to ensure that all staff have sufficient knowledge and understanding to properly care for the residents. Care staff spoken with during the inspection said they think the standard of training available to them is very good and they are encouraged to undertake training in subjects that interest them. Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is properly managed but more must be done to ensure it operates in the best interests of service users and protects them from risks of harm. EVIDENCE: The Registered Manager of the ground floor is now also in charge of the nursing care service (first floor) and intends to apply to the Commission to become the Registered Manager of the entire service, i.e. both the ground and first floors. Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 24 The manager is supported by a Clinical Lead Nurse and between them maintain a regular presence in the home; both are well respected and liked by staff and service users. The home has processes for quality assurance; satisfaction surveys are periodically issued and the home has developed and implemented aspects of internal audit but is recommended to extend the system to ensure there is an annual development plan for the home, based on a systematic cycle of planning – action - review, reflecting aims and outcomes for service users. Records are kept of all accidents and for most there is evidence of subsequent investigation, review of the care plan and periodic audit to identify any trends e.g. time, place, person, activity. However, some residents have experienced accidents involving beds and rails, including at least one occasion when a resident became trapped between a faulty rail and the wall. During this inspection the bed was checked and found to have the rail both loose and incorrectly positioned, thereby placing the resident at risk of harm and injury. Some other beds were also observed to have incorrectly positioned rails. An Immediate Requirement was issued for reliable recorded evidence that all bed rails in use are safe for the purpose. The home manages the finances of most residents with regard to the safekeeping of monies for personal expenditure; a sample of documents were examined and found to clearly show income and expenditure. Staff trained in First Aid and health care are on duty in the home at all times. Records of equipment servicing and maintenance are kept; the inspector examined a sample and noted that engineers have identified some concerns regarding the passenger lift. The home is recommended to establish if the described shortcomings present a risk to safety of service users and if so, to take the necessary actions to remove these risks. The home has a written assessment of the ‘Health & Safety’ of the premises and working practices and keeps records of fire safety checks and tests, including drills and staff training. Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 25 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 X X 3 X X N/A 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 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 26 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 OP7 Regulation 15 Requirement It is required: that the plans of care are developed and reviewed with the service user and or their representative that the plans give clear guidance to the care staff on the needs of the individual. A person centred approach should be adopted. This requirement is outstanding from the last inspections. Previous timescales 29/11/06 and 29/01/08 2. OP9 13(2) 15 (1) It is required that the rationale 01/03/08 for any medication given covertly is done so in line with good practise guidelines and that this is documented fully, including rationale, in the plan of care. This requirement is outstanding from the last inspection. Previous timescale 27/12/2007 It is required that the controlled DS0000003259.V358243.R02.S.doc Timescale for action 01/05/08 3. OP9 13 (2) 01/06/08 Page 27 Glastonbury Care Home Version 5.2 drug cupboard is fixed to the wall in line with the safe custody regulations This requirement is outstanding from the last inspection. Previous timescale 27/12/2007 4. OP38 13 (4) (6) The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. This means that there must be reliable recorded evidence that all bed rails in use are safe for the purpose. 30/03/08 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 OP12 OP15 OP33 OP38 Good Practice Recommendations More should be done to attempt to provide each resident with suitable and accessible recreational activities. Staff should check that meals are served are to each resident’s satisfaction before leaving the area, to ensure that residents are able to eat the meals provided. There should be an annual development plan for the home, based on a systematic cycle of planning – action review, reflecting aims and outcomes for service users. The home should establish if the described shortcomings of a passenger lift present a risk to safety of service users and if so, take the necessary actions to remove these risks. Glastonbury Care Home DS0000003259.V358243.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0117 930 7110 Fax: 0117 930 7112 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. 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