Inspection on 27/03/09 for Glebe House Retirement Home

This inspection was carried out on 27th March 2009.

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

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 Retirement Home 27/02/07

Glebe House Retirement Home 09/02/06

Glebe House Retirement Home 27/07/05

Glebe House Retirement Home 09/11/04

Glebe House Retirement Home 26/08/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Glebe House Retirement Home Rectory Lane Hollesley Woodbridge Suffolk IP12 3JS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: John Goodship     Date: 2 7 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Glebe House Retirement Home Rectory Lane Hollesley Woodbridge Suffolk IP12 3JS 01394410298 01394411557 sallysquirrell@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Sally Ann Squirrell,Mr Nigel David Squirrell care home 19 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following categories of service: Care Home Only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling into any other category - Code OP The maximum number of service users who can be accommodated is: 19 Date of last inspection Brief description of the care home Glebe House is located on the edge of the village of Hollesley, in a former rectory within seven acres of mature grounds. The accommodation is of a high standard and all bedrooms have en-suite bathrooms. The communal areas consist of a lounge, dining room and conservatory and the areas are all well furnished with pleasant views 0 Over 65 19 Care Homes for Older People Page 4 of 24 Brief description of the care home over the garden. Bedrooms are located on the ground, first and second floors and there is a lift and a chair lift. Fees at the time of this inspection ranged from £540.00 to £650.00 per week. The home is owned by Mr and Mrs Squirrel who are both actively involved in the management of the home. The home has traditionally cared for residents who are relatively independent and at the time of the inspection provided one member of waking night staff. Mr and Mrs Squirrel reside in an adjacent property and provide on call services at night should the need arise. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was the first key inspection for two years as the home had been rated as a two star home providing good outcomes for its residents. An annual service review based on surveys and information held by the Commission was issued in 2008. Our visit was unannounced and took place on a weekday. It lasted five hours. We concentrated on assessing the outcomes for residents against the national minimum standards. We toured the home, spoke to the owner, and the assistant manager, who was in charge on the day, and interviewed two staff. We also spoke to two residents in detail as well as talking to several residents as we toured the home. We examined a sample of care plans, staff records, health and safety records and certificates. Before the visit, we sent out survey forms to a sample of residents, relatives, staff and local health professionals. We received back ten completed forms from residents, four Care Homes for Older People Page 6 of 24 from staff, three from relatives and three from health professionals. The manager had also completed an Annual Quality Assurance Assessment for us. Information from all these sources have been used to compile this report, as well as our observations during our visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents can be assured that they will have sufficient information to decide if the home is right for them, and the home will ensure that it can meet their needs. Evidence: The AQAA told us that the home provided new residents with a colour brochure which included the statement of purpose, aims and objectives, philosophy of care, room tariff and the activities programme. This brochure was being updated at the time of our visit, but previous inspections, comments from our surveys, and questionnaires which the home issues, showed that people had received comprehensive information about the home so that they could decide if it was the right place for them or their relative. One person told us that the home was recommended to me by the local rector who knew it well. Another said that I visited the home before moving in. We saw Care Homes for Older People Page 10 of 24 Evidence: contracts in residents files which confirmed that new residents were offered a months trial to ensure that they were happy to live there. We noted from residents files that, if possible, prospective residents were invited to spend a day at the home when a full assessment of their needs would be carried out to ensure the home could meet those needs. There was an admission checklist for staff to complete to ensure that all relevant information about the person had been covered. Although the home does not offer intermediate care, it does offer short stays for respite care. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assured that their needs will be identified, monitored and reviewed. They can expect to be protected by the homes procedures for dealing with medicines. Evidence: We examined the care plans for two residents. These documented their health and social care needs, and set out the actions to be taken by staff to meet the needs. Residents preferences for their care were recorded, including how they wished to be addressed, and whether they wished to self-medicate. We noted that the plans were reviewed at least monthly, as well as a daily record completed at the end of each shift. Any changes to the care plan were highlighted in red for ease of reference by staff. All the residents who completed our survey said that they received the medical support they needed. All the relatives except one agreed that medical and care needs were met. Staff told us that the home received good support from the local GP practice. The district nurse was visiting the home during our inspection, to attend to the daily insulin requirements of a resident and to treat a sore on their ankle. A GP told us that the home always responded appropriately if there had been any concerns Care Homes for Older People Page 12 of 24 Evidence: about a residents care. Another health professional told us that the home had improved its moving and handling practices, although residents were generally reasonably fit and mobile. A third professional confirmed that individuals health care needs were met and it sought advice appropriately. I feel that Glebe House is an extrememly well run care home and the level of care is high. The manager is extremely efficient always seeking nursing advice and input when required. We noted from one care plan that a residents weight had been causing concern following a period in hospital for surgery. The home had referred the case to the dietitian, who had visited three times. Their dietary recommendations had been followed and the person had gained half a kilo. Their dietary intake was still being recorded and monitored. Another resident had been exhibiting changes in their behaviour recently which caused the home concern. Their suitability for the home was re-assessed, and on the day of our visit, relatives were moving this person to a care home with nursing. The family were appreciative that the home had adjusted the staffing rota to allow a carer to be with this resident at all times. We saw a letter from a family saying seeing the dedicated care you all have provided has been a great comfort. The homes brochure said that transport was provided to and from hospital and other health appointments. During our visit, a resident was taken to the dentist in the homes car, with a driver and a carer. Because of the rural location of the home, this reduced the travelling time and, according to staff, reduced any anxiety the resident might have about the appointment. Two residents took responsibility for the storage and administration of their own medication. We were shown how the medication was issued to each person, and stored in a lockable drawer. We observed the medication procedures at lunchtime, and sampled the medication administration record (MAR) sheets, and checked the stock of a sample of drugs. Everything was administered and properly recorded in line with the homes policy and procedures. The assistant manager told us that they checked the MAR sheets each Monday to ensure that residents had received their prescribed medication. We saw records of staff training in medication administration given by the pharmacy supplier. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to be offered opportunities for activities and entertainment, and for accessing the local community. They can expect to receive a varied and well balanced diet. Evidence: Seven residents told us in their survey that there were always or usually activities arranged by the home that they could take part in. Three said this happened only sometimes. One relative thought there should be some exercising to music. A banjo player had proved very popular recently and would be booked again. Four residents attend a club locally, and one resident was able to drive themselves about. A member of staff had taken on responsibility for organising activities but at the time of our visit they were on maternity leave. A religious service was held occasionally. Two members of staff would have liked there to be more in-house activities and trips out for residents. They currently arranged one a month. A hairdresser attended regularly and was there on the day of our visit. They were clearly very popular and were friendly and sensitive to the residents wishes. Nine out of ten residents who replied to our survey told us that staff listened and responded to what they said. Preferences were seen in care plans, and some of them Care Homes for Older People Page 14 of 24 Evidence: joined in activities in the local community. The dining room was able to seat all the residents although one was out of the home and the other was having their meal in their room that day. The staff told us that about four or five residents chose to have breakfast in their rooms. The lunch menu was posted in the hall. On the day of our visit, the choice was poached cod or breaded haddock, with new potatoes and fresh vegetables, followed by peach clafoutis. The atmosphere in the dining room during the meal was very pleasant and relaxed, with tablecloths and napkins provided. Nine out of the ten residents who replied to our survey told us that they liked the meals. One said the cook is very cheerful. There is a good variety of food, and they always produce a lovely cake on birthdays. We noted that there was a selection of fresh vegetables in store. The home had been inspected by the Environmental Health Officer of the local authority in September 2008. We saw that the home was required to replace the seal in the door of a fridge, and to clean some areas under equipment. This had been done. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assured that they are protected by the homes procedures and staff training. Evidence: The AQAA told us that the home had not received a complaint in the previous year. The home had a complaints procedure which was laid out in the introductory information. All the residents told us that they knew who to speak to if they were not happy, and all but one said they knew how to make a complaint. One said the manager is always available to listen and help in any way she can. New staff were subject to enhanced Criminal Record Bureau (CRB) checks. These were seen in their files. The whistleblowing procedure was on display in the office for staff to read. Staff received training on issues of the abuse of vulnerable adults during their formal induction, as part of their NVQ courses, and on in-house training sessions. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to live in a comfortable, clean and well maintained environment. Evidence: The home was located in an old rectory, set in pleasant gardens. Residents told us about the wildlife they could see there, visible from the lounge and the conservatory. All the bedrooms were single rooms with ensuite facilities. Some of the bathrooms had been fitted with equipment to allow residents to bath in their own ensuite. Otherwise there was one communal bathroom. There was a lift and stairlifts for access to all floors. A resident told us there is always a fresh clean smell wherever you go. All the residents who replied to our survey said the home was always or usually fresh and clean. The home employs a housekeeper and two domestic staff who make the beds, clean the home and do the laundry. The AQAA told us that more benches had been supplied around the grounds, sun umbrellas provided on the terrace and a fish tank placed in the hall. The owner pointed out that the joins in the carpets in the hall and dining room were splitting and they were due to be replaced. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assured that they will be supported by trained staff who have been recruited properly. Evidence: The rota showed that there were three care staff on duty during the day with either the manager or assistant manager. One carer was on duty at night with the manager on call. The staffing levels appeared to be appropriate for the needs of the residents. The home cared for a number of relatively independent and mobile residents as well as the occasional resident who needed bed care or whose needs required more time. The home had shown it could provide this with a resident who needed support all the time. Staff told us that there was always or usually sufficient staff on duty to meet peoples needs. The AQAA told us that the home had increased its pool of staff to cover holidays and sickness, so that no agency staff needed to be used. Nearly all staff had achieved NVQ 2 and above including the housekeeper. Others were in the process of completing their course.We saw the records of staff training. These were confirmed by the staff we spoke to. We observed two members of staff using appropriate techniques for supporting a resident who was confused and upset. Staff were able to describe to us how they would handle other scenarios. This showed that Care Homes for Older People Page 18 of 24 Evidence: staff applied their training for the benefit of residents. We examined two staff files. They held all the required application forms, references, POVA First checks, CRB certificates and training certificates. They showed that new staff followed the Common Induction Standards programme. One person told us we do shadowing shifts at the start. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to live in a well run home, and be protected by the homes safety procedures. Evidence: The manager was also one of the owners, and was registered with the Commission in 2002. She was supported by an assistant manager who also held NVQ Level 4. Residents spoke highly of the two owners and the assistant manager. One resident told us I have lived at Glebe House for 4 years and am very happy here. A very well run home with a relaxed and homely feel at all times. The home held staff meetings and resident meetings monthly. 14 residents attended the last meeting whose minutes we saw. The menus were discussed. One person thought there was too much stodge but others were happy with the choice. The home also sent a questionnaire to new residents to check if they had received sufficient information and had been welcomed and settled in properly. The home also sent out annual questionnaires to residents and relatives to ask for their views on the home. Care Homes for Older People Page 20 of 24 Evidence: The results of the most recent one had not yet been analysed. As part of the quality assurance programme, the assistant manager checked weekly that the MAR sheets had been filled in properly. The home had records to show that its equipment was serviced regularly, and that fire equipment and procedures were tested regularly. The homes liability insurance certificate was displayed and was in date. The certificate of registration was not correct at the time of our visit due to a misunderstanding about the registered number of places. There were nineteen residents on the day of our visit, but the home was registered for seventeen. The home was due to be visited by a registration officer of the CQC shortly after our visit to discuss the owners application to increase their registration to nineteen. We checked the cash held for one resident. The amount tallied with the receipts and cash book. The staff told us that no-one at the home was an appointed person over a residents finances. Staff told us that that they received regular supervision sessions and we saw the records of these in the staff files. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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