Inspection on 10/10/05 for Glebe House

This inspection was carried out on 10th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Glebe House 26/01/06

Glebe House 18/05/04

Glebe House 04/02/04

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

CARE HOME ADULTS 18-65 Glebe House Glebe Road Rainham Essex RM13 9LH Lead Inspector Harbinder Ghir Unannounced Inspection 10 October 2005 10:00 Glebe House DS0000015591.V257372.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 Glebe House DS0000015591.V257372.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. Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Glebe House Address Glebe Road Rainham Essex RM13 9LH 01708 554 711 01708 526 469 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) The Avenues Trust Limited Brian James Smith Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (12) Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. No service users under 40 years of age. Date of last inspection 11th February 2005 Brief Description of the Service: Glebe House is a care home with nursing care. The home provides accommodation for up to 12 people of either gender with enduring mental health problems. All residents are over the age of 40. The Registered Provider is The Avenues Trust. The home is purpose built and consists of two storeys with lift access to the first floor. All the rooms are single with en-suite. There is a large wellmaintained garden. The home is situated in a residential area of Rainham and is close to local community facilities. The home is easily accessible by public transport and by car via the A13 and M25. The home also has its own transport. ` Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Harbinder Ghir, Regulatory Inspector, undertook this unannounced inspection on the 10th October 2005 and was at the premises from 11.00 am to 3.00pm. The visit included talking with residents and staff. Some judgements about quality of life within the home were taken from direct conversation with staff and observation. In addition a tour of the premises was undertaken and some records were looked at. All beds in the home are contracted to Havering Primary Care Trust and the home follows clear admissions criteria defined by the trust. Residents admitted to the home suffer with enduring mental health problems. They are physically independent and are able to make their needs and wishes known. During the inspection one resident consented to speaking to the inspector, who was verbally able to communicate her views. What the service does well: Residents benefited from a well-organised staff team who are motivated and committed to meeting their needs. The home has a strong focus on independence, and developing personal, social and emotional skills is fundamental to the service provided. Residents are supported to make active choices and decisions throughout their daily living and their quality of life is enhanced by the opportunity to participate in a range of activities. Residents benefited from good sized and comfortable communal and personal accommodation providing furnishings and fittings to a good standard; the premises included two lounges, a dining and kitchen area and a wellmaintained communal garden. Care plans were clear, consistent and comprehensive and are devised with the consultation of residents. There is a comprehensive training programme for staff and staff training needs are consistently updated. Staff are supervised regularly. Recruitment procedures are robust ensuring the protection and welfare of residents. Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 6 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. Glebe House DS0000015591.V257372.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 Glebe House DS0000015591.V257372.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): 1,2,3,4,5 The home’s Statement of Purpose and Service User Guide are good. They provide service users, prospective service users and their representatives with all the information they need to make a decision about moving into the home. Service users’ needs are fully assessed prior to admission. Service users have access to specialist services if they need them. EVIDENCE: The Statement of Purpose and Service User Guide were seen, which provided detailed information about the service. The Service User Guide was also presented on a CD format available in two parts, which is the complaints procedure and the Avenues Annual Report. Providing further information in pictorial formats making the documents appropriate to the communication needs of residents where required. A copy of the Service User Guide is given to all residents prior to admission and is readily available within the home as is the last inspection report. Residents receive a written contract of terms and conditions, which is very comprehensive. Residents or their representatives signed contracts. The home follows the admission criteria defined by Havering Primary Care Trust. All referrals to the home are made via the multi-disciplinary panel and include input from the referrer, the CPA and prospective resident. The registered manger also completes comprehensive pre-admission assessments using the organisations own assessment tool. Risk assessments Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 9 and the last Care Programme Approach review documents are also included in the assessment. The registered manager confirmed that trial visits to the home are encouraged and are an opportunity for potential residents and their family to identify how appropriate the home is for them in meeting their needs. Residents are offered day visits and can stay at the home for up to a month on a trial basis. Residents can access specialist services, which are tailored to meet their individual needs. Staff have the skills to deliver the agreed services and can communicate with residents within the limitations of residents’ abilities. This was observed throughout the inspection. Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 10 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, 8, 9, 10 There is a clear and consistent care planning system in place, which provides staff with the information they need to meet the needs of residents. Residents are supported to make active choices and decisions throughout their daily living and areas of risk are assessed. Information about service users is kept confidential. EVIDENCE: Care plans inspected were divided into sub sections, which were easy to read and follow. Care plans seen were divided into sections covering daily routines, all aspects of personal and social needs in addition to healthcare needs, incorporating the Care Programme Approach. Residents are involved as far as possible in setting up the care plan and are encouraged to attend their care plan reviews. Each service user has a designated key worker. The care plans set out specialist requirements and how they are met. Care plan files seen demonstrated that residents are enabled to take risks within a comprehensive risk management framework. Risk management strategies are recorded in individual care records of all residents and held on file. Risk assessments were in place for individual areas of identified risk and Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 11 steps had been taken to reduce risk where possible, clear guidance was given to staff. For one resident documentation was seen included risk areas associated to one resident wanting to smoke in their room and ways of managing those risks. Care plans and risk assessments were up to date, reviewed regularly by the home and by multi-disciplinary professionals. Reviews are held six monthly. The individual daily records for residents included involvement in the daily running of the home as far as their abilities allow. Some residents contributed to the running of the home by participating in domestic duties, such as cleaning their rooms and going out shopping to Tesco’s. Individual records examined were accurate, secure and confidential and staff were aware of how to handle confidential information. Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 12 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): 11, 12, 13, 14, 15, 16, 17 Residents are provided with the support to maintain their independence and in areas of personal development according to their needs and wishes. Residents are engaged in community life; enjoy a range of leisure activities and a varied and nutritional diet. EVIDENCE: Care plans showed that the development of personal, social and emotional skills are fundamental to the service provided. Staff support residents to develop practical life skills for example by supporting them with managing their finances. Residents are offered opportunities to develop their skills and are encouraged to integrate into the community. Some residents attend the local centre run by Mind. Group trips and outings are available for those who share the same interests. Regular theatre trips and holidays are arranged by the home. This year the residents went to a Butlins resort. Other in-house entertainment consists of bingo, watching videos, going to the local shops and pub. Residents Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 13 are also supported and encouraged to pursue their own interests and hobbies. One resident enjoys watching football and therefore staff support him to go to football matches. Residents are also provided with a support worker, a service commissioned by Havering Social Services, to provide one to one support and assist residents to integrate into the community to ensure residents feel part of community life. It was observed that daily routines are flexible and promote the independence of residents. Residents were observed to come and go as they choose. One resident spoken to informed that they can go to bed and get up what ever time they like. Residents hold the key to their rooms and personalise their rooms as they wish. Residents’ family and friends can visit anytime of the day. Residents are encouraged to go out with their families and develop personal relationships. Due to the complex level of mental health problems residents are admitted with they are not able to prepare meals independently. Therefore staff support residents to prepare snacks where residents are able to. The home also employs a cook to provide all meals, which are varied and healthy. Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 14 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): 18, 19, 21 Personal, physical and emotional healthcare is provided to meet residents’ needs and wishes. Residents’ wishes in the event of death are established and are handled with respect and as the individual would wish. EVIDENCE: All residents have a detailed plan of their daily routine including what support is needed in relation to personal hygiene. Personal support takes account of individual preferences and residents’ choice of dress and appearance is respected. All residents have a designated key worker to promote their privacy and dignity. Residents are supported by staff to attend appointments with health care professionals. Care records showed that residents’ health is monitored and prompt referrals are made. Personal support takes account of individual preferences and is provided in private. The wishes of residents in relation to dying and death are established and are documented in the care plan file. The home has a comprehensive policy and procedure on dying and death. Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 15 Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 16 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): 22, 23 The home provides a satisfactory complaints system and residents feel that their views are listened to and acted upon. Policies, procedures and staff training were provided that protected residents from abuse. EVIDENCE: The home has a comprehensive complaints policy and procedure, including written information, an audiocassette and a CD. The complaints procedure is included in the Statement of Purpose and Service User Guide and meets all the requirements of The Care Homes Regulations Act 2001. One resident spoken to informed that staff listen to their concerns and act upon them. The home also holds regular residents’ meetings. Records seen demonstrated that all concerns and complaints raised by residents were listened to and actioned. Policies and procedures regarding the abuse of vulnerable adults were provided. Records seen identified all staff received training on adult abuse and this was also incorporated into the induction programme. Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 17 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, 25, 26, 27, 28, 29, 30 Residents’ benefited from living in a safe, well-maintained and clean environment. Décor, furnishings and fittings were of a good standard and provide a homely and pleasant living environment. EVIDENCE: The premises were comfortable, bright, airy, clean and free from offensive odours. Furnishings and fittings in communal areas were of good quality, domestic and unobtrusive. The home provides a lounge on each floor. The first floor lounge is a designated smoking area. The ground floor has a large dining and kitchen area. There is a communal assisted bathroom and shower room, and additional toilets. The grounds around the home were well maintained and equipped. One resident’s room was seen during the inspection. The room was comfortable with adequate furnishings and was personalised by the resident. Emergency call points were in place and all specialist equipment for those Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 18 residents in need was in place. All rooms were lockable and can be overridden by staff in an emergency. Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 19 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): 31, 32, 33, 34, 35, 36 Staff were aware of their and other’s job roles and responsibilities, providing clarity of roles to residents. There is a good match of qualified staff offering consistency within the home. Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their quality of life. Recruitment processes are robust and ensure the protection of people living at the home. The staff group receive adequate training to meet the needs of residents. Staff receive supervision on a regular basis. EVIDENCE: The GSCC Code of Conduct is covered in the induction-training programme. Staff receive a comprehensive induction programme and attend comprehensive mandatory training organised by the home. Discussions with staff indicated that they were aware of their roles, responsibilities and skill limitations and demonstrated that they were aware of when to involve someone else with more specific expertise for the benefit of residents. Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 20 Staff were observed to respect residents and were accessible and approachable. Staff demonstrated that they have the necessary skills and knowledge to meet individual needs of residents. It was evident from the activities in the home that the staff were highly motivated and committed to the service user group. The staff team consists of permanent and agency staff. The home has six qualified nurses and one nurse is always on duty to meet the nursing needs of residents. Agency staff are used to cover one vacant post, sickness and annual leave. The staff duty rota was seen; this showed that staff were working appropriate hours and the home was adequately staffed. During the inspection it was observed that adequate numbers of staff were on duty. There are three members of staff per shift including a qualified nurse during the day and two awake members of staff on duty at night. Two members of staff informed that they felt that they had adequate numbers of staff on duty and the home provided enough cover. Staff morale is very high. Two members of staff were spoken to who informed that they enjoyed working at the home. On inspecting the homes recruitment procedure, three staff files were viewed during the inspection. All three files were complete with all relevant checks made required by the regulations. The home employs a successful applicant once a Criminal Bureau and POVA check has been completed and received by the home. Training is organised for all staff on an on-going basis. A comprehensive Inhouse and external training programme was seen, with courses available to all staff. A member of staff spoken with informed that her training needs have been met by the home and has found all training useful. Whilst working at the home she has had the opportunity to complete her NVQ level 2 training. The home has a 50 and above ratio of NVQ trained staff. Staff training files viewed were up to date to reflect the training staff had attended and completed. Staff records seen identified members of staff were being supervised regularly. One member of staff had been supervised four times this year. A supervision programme for all members of staff was in place. The manager informed that they are trying to supervise all staff on a monthly basis. Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 21 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, 38, 39, 41 Residents benefit from an experienced manager who recognises their needs and manages the home well. The manager has a clear vision for the home, which he has effectively communicated to residents, relatives and staff. Residents are safeguarded by the home’s record keeping policies. The systems for Service User consultation are good with evidence that Service User views are sought and acted on. EVIDENCE: The manager has many years experience of working with this service user group and has completed a management qualification. He holds a certificate in Health Services Management. The registered manager communicates a clear sense of direction, leadership and an openness. Staff said they felt well supported and the manager was approachable. One resident spoken to informed that the manager was very approachable. Lines of accountability within the home and with external management is clearly understood. Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 22 The quality assurance system includes seeking the views of residents by the home holding monthly meetings. The minutes included ways in which issues raised will be actioned by the management team. Records of quality assurance surveys were also seen, which are sent out yearly to residents. The results of surveys are published and discussed with staff and residents in residents’ meetings. Stakeholder evaluation surveys are also given to Stakeholders on a yearly basis. Reports regarding monthly visits in accordance with Regulation 26 visits have been received by CSCI, which are comprehensive and consider the quality of the service for which they are responsible. During the inspection all residents care plans were kept in a secured place when not in use. Documentation seen was completed appropriately. Residents could access their records if they wished. Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 23 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 4 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Glebe House Score 3 3 X 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 X 3 X x DS0000015591.V257372.R01.S.doc Version 5.0 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Glebe House DS0000015591.V257372.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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. 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