Inspection on 02/06/05 for Glebe House Nursing Home

This inspection was carried out on 2nd June 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 Nursing Home 28/03/07

Glebe House Nursing Home 09/12/05

Glebe House Nursing Home 10/08/04

Glebe House Nursing Home 14/04/04

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

CARE HOMES FOR OLDER PEOPLE Glebe House (Chaldon) Church Lane Chaldon Surrey CR3 5AL Lead Inspector Mary Williamson Announced 02/06/05 10:00am 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 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. Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Glebe House (Chaldon) Address Church Lane Chaldon Surrey CR3 5AL 01883 344434 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) Glebe Care Ltd Sarah Vincent CRH N 40 Category(ies) of Physical Disability - PD - 6 registration, with number Physical Disability - over 65 - PD(E) - 40 of places Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10/08/04 Brief Description of the Service: Glebe House is a well established care home providing nursing care for forty older people. The home is currently being extended to provide an extra six beds for people who are terminally ill. Accommodation is provided in single and shared rooms spread over three floors. There is a shaft lift and chair lift to provide access to all areas of the home. There is ample communal space to include a large lounge, dining room, and a conservatory, which provides ramp access to a mature well maintained garden. Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and the first in The Commission for Social Care Inspection programme year 2005/2006. Mary Williamson, who is the lead inspector for the service, undertook the inspection. The registered manager who is also The Provider Mrs. S. Vincent was present throughout the inspection. For the purpose of this report the service users in Glebe House wish to be referred to as residents. There were thirty- three residents in the home on the day of the inspection. Some rooms were empty due to the current building work taking place. The inspector had the opportunity to meet all the residents and talk with some in greater detail. The manager and her husband arranged a buffet lunch for relatives and some residents to provide them with the opportunity of meeting the inspector and each other. Twelve relatives and the GP attended who all had positive feedback and favourable comments about the home. It also facilitated the opportunity to promote The Commission fro Social Care Inspection and it’s role. A tour of the premises was undertaken and records relating to the care of the residents and the management of the home were examined. The home was functioning well and all residents were well cared for and relaxed. Staff were interacting in a caring and respectful manner with the residents. The inspector would like to thank the residents, staff, and relatives for their helpful and positive contribution to the inspection and Mr. and Mrs. Vincent for their hospitality. What the service does well: Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 6 The home provides good quality nursing care to residents as outlined in welldocumented care plans. The interaction between the residents and the staff was warm, professional, and respectful. Both communal and individual accommodation is decorated to a good standard, well maintained and comfortable. The catering arrangements provide residents with a varied diet, which is nutritious and appetising. The home is well managed and the staffing levels are sufficient to meet the individual and collective needs of the residents. The manager is committed to the ongoing training and development of her staff team. The social and recreational arrangements provide a varied programme of events on a monthly basis. What has improved since the last inspection? What they could do better: The service is doing everything possible to keep disruption to minimum while the building work is taking place. Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 7 Areas of the home have been identified for refurbishment, which will be undertaken once the building work has been completed. The call bell in an individual bedroom is out of order and is in the process of being repaired once the engineer receives the replacement part. 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 (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, and 5. Prospective residents and their families are provided with the relevant information necessary to make an informed choice about the home. Trial visits are encouraged following a full needs assessment. Individual contracts outline the terms and conditions of occupancy. EVIDENCE: The home has a statement of purpose and service user guide in place providing prospective residents and their families or designated representative with the information necessary to make an informed choice about living in the home. The manager undertakes a pre admission needs assessment to establish if the home can meet the needs of the prospective resident. A selection of these assessments were sampled and were very informative. The manager stated that trial visits are encouraged whenever possible which may be for a meal or coffee. Some relatives explained that due to capacity Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 10 they had to make a choice on behalf of the prospective resident. They stated that the information provided on the initial visit was the deciding factor when choosing the home. Contracts of terms and conditions of occupancy are in place and outline all the relevant charges and care to be provided. Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, and 10. Individual care plans are in place, which outline the care to be provided. Appropriate arrangements are in place to ensure that all care needs are being met. The home’s policies and procedures for dealing with the administration of medication are satisfactory. Resident’s privacy and dignity is protected and they are treated with respect. EVIDENCE: All residents have an individual care plan in place outlining the care provided. These plans are written with input from the resident, relatives, information gathered from the pre admission needs assessment and any relevant medical and social reports available on admission to the home. These care plans are reviewed regularly or as needs change. Risk assessments are also included in care plans for example moving and handling, risk of developing pressure sores, nutrition, and the prevention of falls. Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 12 Residents have access to appropriate health care services. A GP from the nearby surgery visits the home every Thursday or more frequently if required. The inspector had the opportunity to meet with the GP during lunch who gave positive feedback about the care being provided. There are also frequent visits from the dentist optician and chiropodist. Physiotherapy is inclusive of fees and provided weekly. The physiotherapist also undertakes the initial manual handling assessment. Some residents were being nursed in bed, and there were two who had a pressure sore. The home provides a wide range of pressure relieving equipment to promote and aid good nursing practice. The home has a policy in place for dealing with the administration of medication. All qualified staff receive regular updating, and training relating to medication. Recording charts are well maintained and all medication is stored appropriately. Staff were observed to interact with residents in a positive and respectful way during the inspection. They were seen to address residents politely and explain their actions when giving care. The staff were observed to knock on bedroom and bathroom doors prior to entry. The home has a policy in place with regard to privacy and dignity of residents and staff have training in these procedures during induction training. Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, and 15. There was evidence to suggest that resident’s social and recreational needs are being met. Residents are able to maintain contact with family and friends. Residents diet was appetising and appealing. EVIDENCE: The home displays a monthly programme of events on the notice board in the main hall. This includes gentle exercise, music and movement, sing along, and PAT dog. Various therapists provide these activities. Some residents have a daily newspaper. Birthdays are celebrated with parties and one resident was able to explain how she celebrated her 100th birthday, which was organised by the provider and attended by family and friends. Residents spiritual needs are also supported with various clergy made welcome in the home. Relatives and friends informed the inspector that they could visit at any reasonable time. They are consulted in the care planning process and Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 14 informed of changing care and emotional needs. Relatives also spoke of the supportive and inclusive atmosphere in the home. The catering arrangements in the home are very good. The manager and the cook plan the menus with input from the residents. A current menu for the week was displayed on the main notice board. Lunch was appetising, nutritious and wholesome. Some residents joined relatives for a buffet lunch. Special diets are catered for and the dietician is also available if required. Sensitive support is available for residents who require help with feeding. Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 15 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,and 17. Residents and their relatives are confident that their complaints will be listened to and acted upon. Systems are in place to protect residents from abuse. EVIDENCE: The home has a complaints procedure in place and this is available to all residents and their families on admission to the home. Relatives were aware of this procedure and felt confident that if they had to make a complaint that this would be treated seriously and acted upon. There is an abuse awareness policy in place and all staff have training in this procedure during induction training. Staff also supported this during conversation with them. Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 24 and 26. Residents live in a safe and well-maintained environment. The indoor and outdoor communal facilities meet the resident’s needs. There are sufficient bathrooms and toilets, which have been adapted to meet mobility needs. The standard of decoration and cleanliness is of a high standard. EVIDENCE: The home is currently undergoing building work to increase the number of bedrooms by six. The providers are doing everything possible to keep disruption to a minimum. Empty rooms are available for residents away from the building work if they become effected by noise or any inconvenience. The home is well maintained and decorated to a good standard. Accommodation is offered in single and shared rooms and arranged over three Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 17 floors. Resident’s bedrooms have been personalised to reflect individual personalities. Personal items of furniture can be brought into the home. The communal areas of the home include a large lounge, a Victorian conservatory, which overlooks a mature well- maintained garden with ramp access. The dining room is situated on the lower ground floor near the kitchen area. There are sufficient bathrooms and toilets situated throughout the home some of which have been adapted to meet the mobility needs of the residents. The home employs a physiotherapist and also has access to an occupational therapist for specialist input. Several adaptations have been made in the home to promote mobility. Grab rails are fitted in convenient areas; toilets have raised seats and safety arms. Bathrooms have also been adapted it include a new shower room on the ground floor and an Arjo high –low bath on the first floor. Wheelchairs, walking frames, and hoists, are in use and there is also a call bell system in place. One service user stated that her bell did not work but the manager produced evidence that this was in the process of being repaired. Resident’s bedrooms were seen and these are well furnished and decorated to a good standard. Bedrooms are personalised to reflect individual personalities and residents can bring items of their own furniture with them on admission to the home. The home is clean and tidy and free from offensive odour. There is a control of infection policy in place and all staff have training in this during induction training. Arrangements are in place for the weekly collection of clinical waste. There has recently been a new sluice installed on the first floor. The laundry for the home is done on site and a new laundry is part of the building project. Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 27, and 30. Evidence gathered during the inspection indicated that the skill mix of staff meets the assessed needs if the residents. The recruitment procedure is robust and satisfactory. Staff are enthusiastic and competent in caring for the residents in their care. EVIDENCE: The staff duty rota was examined and confirmed that the skill mix of staff, and the number of staff on duty during the inspection were adequate to meet the assessed needs of the residents. The recruitment procedure is robust and safeguards the residents. Three staff employment files were seen and all the required documentation was in place. Access to staff training is provided on and off site. All staff undertake a sixweek induction training followed by foundation training. NVQ level 2 and level 3 is ongoing and staff stated that they found the training provided was worthwhile. There are currently two adaptation nurses from overseas on a placement in the home. There is evidence that qualified staff are supported to further their training with one staff nurse undertaking I/V training, and two doing continence assessment training. Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 19 A training company from Portsmouth provided the NVQ training and both the manager and one staff nurse are registered assessors. Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 37, and 38 Evidence gathered during the inspection indicates that the home is well managed in the best interests of the residents. The standard of record keeping is good. The health, welfare, and safety of the residents are protected and promoted. EVIDENCE: The registered manager is also the provider. She is a qualified nurse with an RGN qualification and several years experience in the provision of care to older people. Her leadership skills and experience promotes an open and inclusive atmosphere in the home. This was evident during lunch when the rapport Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 21 between the residents, relatives, staff and the manager was observed to be supportive positive and inclusive. The standard of record keeping in the home is good. Records sampled included care plans, per admission needs assessments, risk assessments, medication recording charts, the staff duty rota, employment recruitment files, and menus. These are all well maintained and promote the best interest of the service users. There is a wide range of policies and procedures relating to health and safety available in the home. These were seen throughout the day. Risk assessments are in place for safe working practice. Staff have been trained in manual handling, first aid, food hygiene and fire safety. The manager is committed to the ongoing development of the staff team in health and safety issues. The fire safety records were seen and are well maintained. Accident records are also well maintained. Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 22 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 4 3 x x x x 3 3 Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 23 N/A 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 Regulation Requirement There are no requirements as an outcome of this inspection. 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. 1. Refer to Standard Good Practice Recommendations Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Glebe House (Chaldon) H58-H09 s13324 Glebe House Chaldon v219238 020605 stage 4.doc Version 1.30 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. 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