CARE HOMES FOR OLDER PEOPLE
Gledhow Christian Care 145 & 147 Brackenwood Drive Leeds Yorkshire LS8 1SF Lead Inspector
Gillian Sangster Announced 16 August 2005 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. Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Gledhow Christian Care Address 145 & 147 Brackenwood Drive Leeds LS8 1SF 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) 0113 2888805 0113 2888816 Trinity Care Ltd Mr Iver Klingenberg Care home with nursing 50 Category(ies) of Old age (50) registration, with number of places Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None. Date of last inspection 22/02/05 Brief Description of the Service: Gledhow Christian Care Home is a purpose built property. The home is located ina residential area close to local amenities and public transport routes. There are car parking facilities. There are gardens surrounding the home that are accessible to the residents. The accommodation is on two floors with a passenger lift connecting the two. There are fifty en suite bedrooms. There are several lounge and dining rooms located throughout the home. there are sufficient communal bathrooms and toilets. Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection was carried out by one inspector between 9.45am and 5.40pm. Time was spent talking to twenty residents, six visitors and six staff. I also looked at records including duty rotas, residents’ care records, assessments, complaints, staff recruitment files, accident reports and menus. Some bedrooms and other areas of the home were checked. I had lunch with the residents. The registered manager was present at the inspection and feedback at the end of the visit. The home provided detailed information in the pre-inspection questionnaire. Comment cards were sent out to the home for relatives and residents to complete before the inspection. Only one card was returned. This was from a relative, which said “I am always impressed by the quality of care provided”. Another relative contacted me before the inspection. Her relative had recently died in the home and she wanted to pass on her comments. She said her relative always looked well cared for and no matter what time she visited staff always had time for her. She said that the staff were very caring and gave very individualised care, doing everything they could to make her relative comfortable particularly during the last few days when she was very ill. There were no requirements from the last inspection. Recommendations from this inspection are included at the end of the report. What the service does well:
Feedback from residents and visitors was very positive. Residents said that they felt well cared for and that staff respected the choices they made. Residents said that there was a lot to do in the home if you wanted to join in. Several people said how much they enjoyed the prayer and praise sessions and spoke warmly of Ken, the pastor. Residents said that the staff were very good and caring and many described them as friends. Comments included “nothing could be made any better”, “everything is as good as it could be” and “it’s a wonderful place, I feel safe and that’s very important”. Visitors said they were pleased with the care given to their relatives and felt that they were kept informed. Staff and visitors said that the laundry service was very good. Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 Page 6 The home is clean, comfortable and decorated and furnished to a good standard. Bedrooms are personalised and residents said that they liked their rooms. Residents described the food as “excellent” and “very good”. Menus offer a wide choice of meals and mealtimes are pleasant and sociable. Staff show a good understanding of good care practice and would have no hesitation in reporting bad practice. There are good systems in place for dealing with complaints and any allegations of abuse. Accident report is well recorded and regular audits are carried out to spot any trends. What has improved since the last inspection? What they could do better:
The care plans could be improved by making them more individualised. They need to contain sufficient detail to show what action staff need to take to meet the residents’ needs. For example rather than saying “bath twice a week or as appropriate”, care plans should be more specific about what the resident wants such as “likes to have a shower on Sunday morning, needs one staff to help, etc ”. Nursing assessments for nutrition, risk of pressure sores, continence, etc are well recorded and reviewed regularly. However the outcome of the assessment should be included in the care plan. For example if someone has a high Waterlow score this indicates that they are at high risk of developing a pressure ulcer and the care plan should show what action staff are taking to manage this risk. Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 Page 7 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. Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 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 Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 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, 3 and 5. Good written information is available to make sure that people can make an informed choice about moving into the home. All residents are assessed before moving in to make sure that their needs can be met. Residents are offered trial visits so that they see if the home is suitable before moving in. EVIDENCE: The manager said that any people making enquiries are sent a copy of the home’s brochure, which includes the service user guide. The home has a statement of purpose and service user guide, which provide detailed information about the service and facilities provided in the home. Both these documents were well presented and have recently been updated. There is detailed information about the home freely available to residents and visitors in the reception area. The manager said he or the deputy manager assess all residents before they move in to make sure that the home can meet their needs. Detailed assessments were seen in the care records. All residents are offered the opportunity for a trial visit but the manager said that few people take up this
Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 Page 10 offer. Most residents I spoke with said that they had either looked round themselves or had been happy for relatives to do so on their behalf. Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 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 and 9. Care planning is good but could be improved by making the information more individualised, including the action taken in response to assessments. Arrangements are in place for residents to access health care services as required. Residents are treated with respect and their privacy is maintained. EVIDENCE: Care records for four residents were inspected. Care plans were detailed covering all aspects of the resident’s needs but some improvements could be made. Some sections were very generalised using phrases such as “toilet regularly” and “ offer drink of choice”, rather than giving specific detail such as “needs to be taken to the toilet every two hours” or “likes a cup of tea in the morning”. Some individual preferences had been recorded in the initial assessments such as preferred rising and retiring times yet this information had not been transferred into the care plan. Care plans are reviewed monthly. Staff said that they now have access to the care records and the information given at handover reports is much more detailed. There are detailed assessments covering nutrition, risk of pressure ulcers, falling, moving and handling and continence. However the outcome of the
Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 Page 12 assessment is not always included in the care plan. For example one resident had a high Waterlow score indicating there was a high risk of developing pressure ulcers, yet there was nothing in the care plan to show what action staff were taking to manage the risk. Arrangements are in place for residents to access health care services as required. Care records for one resident who had a pressure ulcer showed the involvement of the tissue viability nurse. There were clear records showing how the wound had been treated and had now healed. Appropriate pressure relieving equipment including a specialist mattress and cushion had been provided. Another resident who had lost weight had been seen by the dietician who had recommended enriched and fortified foods. Residents said that they felt well cared for and praised the staff describing them as “very good” and “excellent”. Several of the residents described the staff as their friends. One resident said “I feel safe here and that’s very important. When I’ve not been well staff have really helped me”. Staff were relaxed, caring and professional in their dealings with the residents. It was noted that staff knocked on bedroom doors and waited for a response before entering and any personal care was carried out in private. One resident said “this is my room , it’s private, and I’m able to lock my door and do as I please.” Staff were discreet and sensitive when asking residents if they needed assistance. Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 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) 13, 14 and 15. Residents are encouraged and supported to maintain contact with family and friends. Residents are encouraged by staff to exercise choice and control over their lives. Residents enjoy the food. EVIDENCE: I met with six visitors during the inspection. All said that they felt that their relatives were well cared for. They said they could visit when they wanted, were always made to feel welcome and were kept informed of any changes. Staff were described as very good. Residents said that they are able to choose how they spend their days including what time they get up and go to bed and whether or not they join in with activities. One resident was having a lie and had decided to spend the morning in bed having her breakfast and doing the crossword. Some residents said that they preferred to spend time in their own rooms entertaining themselves and said staff respected this choice. Other residents told me about different activities going on in the home, including prayer and praise, which they looked forward to. I had lunch with the residents, which was a pleasant and sociable experience. The meal was served from a heated trolley and was covered when brought to the table. The food was nicely presented and appetising. Cold drinks were
Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 Page 14 available on the table and a cup of tea was served after the meal. The residents I sat with said that they enjoyed the meal. The staff were attentive and residents were able to enjoy the meal at their own pace. Those who needed help with their meals were given the time they needed. Menus are devised on a four week rota and offer a good choice of foods. The menus highlight meals that are suitable for diabetics, soft diets or can be liquidised. Residents were unanimous in their praise of the food. Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 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 18. Complaints are listened to and dealt with appropriately. Systems are in place to make sure that residents are protected from abuse. EVIDENCE: The home has a detailed complaints procedure and maintains a record of all complaints received. There was detailed evidence to show how the complaint had been dealt with and the response to the complainant. The home has not received any complaints since December 2004. The home has detailed procedures for staff on what action to take if abuse is suspected or reported. This includes contacting the local adult protection team. Staff have received training on identifying different types of abuse and what action to take. Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 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, 23, 24 and 26. The home provides a comfortable environment that is decorated and furnished to a good standard. Bedrooms are personalised. There is a good laundry service and all areas of the home are kept clean. EVIDENCE: The home is purpose built offering level access throughout the building and into the gardens. The home is well maintained and decorated and furnished to a good standard. Residents’ rooms are light and airy. The residents said how much they liked their rooms and having all their belongings around them. Rooms were personalised and provide comfortable accommodation. Residents have keys to their rooms and said that they enjoyed having that privacy. The home is kept clean. Several residents and a visitor praised the laundry service and in particular the laundry lady who was described as “lovely” and “always cheerful”. One visitor said “ I know people who have relatives in other
Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 Page 17 homes and their clothes go missing or they get other people’s clothes. That doesn’t happen here”. Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 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, 29 and 30. Staffing levels are sufficient to meet the residents’ needs. Recruitment procedures make sure that staff are suitable before they start work in the home. Staff receive on going training and development to maintain their competence. EVIDENCE: Duty rotas are maintained for all staff. The manager advised that the staff team is stable and no agency staff have been used. The home has a bank of staff that can be called upon if there is staff sickness or holidays. No concerns were raised about staffing levels. Two staff recruitment files were looked at and showed that all the necessary checks had been completed. Protection of Vulnerable Adults (POVA) and Criminal Record Bureau (CRB) checks are completed before staff start work. It is recommended that the outcome of the CRB and the date it was received back is recorded on the staff file. The home has an annual training plan. This includes mandatory training in fire safety and moving and handling as well as clinical updates such as wound care, care of the dying and continence management. Four of the care staff have completed NVQ level 2 and a further twenty staff are studying for this qualification. Training in the last twelve months has included dementia care, medicine administration, challenging behaviour, abuse and wound management.
Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 Page 19 Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 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, 36 and 38. The home is well organised and the manager provides supportive leadership. The management approach is open and inclusive. Staff are supervised. The health and safety of residents is promoted and protected. EVIDENCE: The manager is a qualified nurse with several years experience of care home management. He has worked hard to make improvements in the home and provides strong and supportive leadership. Staff said that they felt supported and enjoyed working in the home. Staff said that morale had improved in the home as all staff are now working together as a team and communication has improved at all levels. Staff said the manager had an open door policy and listened to their views. Regular meetings are held with staff. Relatives and residents meetings are held also to keep them informed and involved in the running of the home.
Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 Page 21 Staff confirmed that they receive regular supervision and said that they found this helpful. The pre-inspection questionnaire showed that maintenance and service checks are up-to-date. All staff receive mandatory training and updates as necessary. Accident reports are well recorded and monthly audits are carried out to look at any trends. Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 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 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x 3 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 3 3 x x x 3 x 3 Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 Page 23 No. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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. 1. 2. 3. Refer to Standard op7 op7 op29 Good Practice Recommendations Care plans should included sufficient detail so that staff know the action they need to take to meet the residents individual needs and preferences. Care plans should include the action required as a result of any assessments undertaken. The date the CRB check is received back and the outcome should be recorded on the individual staff file. Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley LS13 1HP 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 Gledhow Christian Care J52 S1341 Geldhow Christian Care V182927 16.8.05 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
