CARE HOMES FOR OLDER PEOPLE
Glen Marie Rest Home 2/4 Harrow Place New South Promenade Blackpool Lancashire FY4 1RP Lead Inspector
Mr Kevan Royston Unannounced Inspection 13th September 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Glen Marie Rest Home Address 2/4 Harrow Place New South Promenade Blackpool Lancashire FY4 1RP 01253 406869 01253 346308 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) Mrs Cynthia Winifred Gallagher Mr John Daniel Gallagher Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42), Physical disability (2) of places Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The service is registered to accommodate a maximum of 42 service users to include up to 42 service users in the category OP (older persons, 65 and over) up to 2 service users in the category PD (adults with physical disability) 26/11/05. Date of last inspection Brief Description of the Service: The Glen Marie is registered for 42 people over 65. The home is situated in the South promenade area of Blackpool with sea views and close to tram and local bus routes. South Shore shopping centre is approximately half a mile away. The premises are on three floors with lift access to all floors. The bedrooms have en- suite facilities with sufficient bath and toilet facilities available on all floors. There is a large lounge area with a stage and bar. A small second lounge with a dining room leading off is situated on the ground floor. Aids and adaptations are available where required. The front of the building provides wheel chair access with seating for residents. There is a statement of Purpose/Service user Guide, which is given to all prospective residents. This written information explains the care service that is offered, who the owners and staff are and what the resident can expect if he or she decides to live at the home. The fees for the home range from £293-£340. Additional charges are for hairdressing and chiropody, which varies due to personal choice. Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 13/09/06 over a period of six hours. The Inspector spoke to the Registered manager, five staff, five residents on their own and a group of residents in the lounge and briefly with a visitor to the home. As part of the inspection process the inspector used case tracking as a means of assessing some of the National Minimum Standards. The process allows the inspector to focus on a small number of people living at the home. All records relating to these persons are examined and the rooms they occupy are looked at. Other residents are invited to pass their opinions to the inspector if they wish. The response from surveys sent to residents for their views on how the home is run was good, twelve completed questionnaires were retuned. Comments were positive about the standard of care provided by the staff and management of Glen Marie care home. Records of two staff members were also examined. A tour of the premises was undertaken. Examination of the homes documentation, policies and procedures formed the basis of the inspection process. What the service does well:
All twelve surveys returned from residents for their comments on how the home is run and standard of care provided were positive confirming the support and care of residents is a priority. Comments included, “Very Happy”. And, “Everyone is First class”. The senior carer has achieved a high level of training in management and care and has recently completed a recognised management qualification. When spoken to he said, “I have done my RMA (Registered Managers Award) and feel the benefit”. As of the previous inspection a training room on site is available and is used to get tutors to provide courses for people working in care across Blackpool. As part of providing the facility staff at the home can attend the courses free and develop their skills and competencies. Staff spoken to said, “There is always Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 6 training going on”. Another staff member said, “Training for staff is always available”. The home provides a new treatment room on the ground floor for residents to use when district nurses visit .The room has a specialist treatment chair powered by electricity to ensure residents can receive any dressings or support in comfort and safely. The manager said, “District nurses have commented on how useful it is”. A resident spoken to said, “We don’t have to struggle to our rooms now if the nurse comes”. At the time of the inspection an entertainer was visiting the home and residents observed enjoying the singing. Residents spoken to said, “Twice a week she comes the singing is beautiful”. Another said, “ I like to sing with them”. A member of staff spoken to said, “All the residents enjoy the cabaret”. Examination of medication records confirmed good recording practices are used with photographs of each resident on there medical record and self administering medication forms signed by the GP to say it is safe for the resident to self administer medication. Examination of records confirms good recording systems are in place to monitor resident’s intake of food and drinks daily to make sure there health needs are monitored and maintained and any concerns would be noticed. What has improved since the last inspection? What they could do better:
Further redecoration and refurbishment is required and should be done in some areas of the home in particular bedrooms and hallways to provide comfort and pleasant surroundings for the residents. Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 7 The application form for potential staff must ask for a full employment history with any gaps explained to ensure the protection and safety of the residents is maintained. 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. Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: The records of two residents were examined and had full assessment information. Both residents are funded by social services and been assessed by social workers with information on file for the care staff at the home to develop a care plan to ensure all health and welfare needs are identified and recorded. A staff member spoken to said, “Social work assessments are always obtained before a resident is admitted”. Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 10 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 the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously. Resident’s welfare is closely monitored and health needs are identified and met. EVIDENCE: Records of two residents were examined and accurately reflected the individual’s health and social care needs. Care plans were up to date and regular reviews taking place ensuring the welfare of residents is continuously monitored. A staff member spoken to said, “The resident always signs the reviews if it’s a problem we ask a relative”. Records examined confirmed risk assessments have been completed and are constantly reviewed and updated reflecting any changes that have occurred individually and in the environment ensuring the resident’s needs are being met. Significant events had been recorded and daily entries by key workers made had been made demonstrating the care given. Medication practices observed were safe and good records had been kept ensuring residents health is maintained. A member of staff spoken to said,
Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 11 “Only staff that have had medication training administer”. As a course of good practice any resident self administering signs a declaration and also the GP signs to say the resident is fit to administer there own medicines. A staff member said, “Doctors sign all people who self administer”. A photo of each individual is placed on their own medication record as a safety measure to ensure residents are receiving the correct medication. A new treatment room with adaptations has been developed to provide residents with a safe area to receive treatment from district nurses and ensure privacy is maintained. Resident’s dignity was observed and ensures there privacy is respected. This was confirmed by observing staff members knocking on doors before entering rooms. One resident spoken to said, “The staff are respectful”. Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 12 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 the following standard(s): 12,13,14 and15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. EVIDENCE: Lunchtime meals served were seen, tasted and were wholesome, home baked with fresh vegetables providing a nutritious meal. Menus examined are balanced and interesting. Meal times are set although flexible enough to accommodate preferences. Resident surveys and residents spoken to commented on the high quality of food at the home. Comments included “The food is nice”. And, “there is always a choice”. Discussion with management confirmed diabetic diets and food from different cultures can be provided ensuring residents from any religious faith can be accommodated. Activities are centred on each individuals preferences ensuring flexibility and residents can enjoy their own personal interests, which are recorded on their care plan. At the time of the inspection an entertainer was visiting the home and the residents were in the lounge listening to the singer. One resident said “I Like the singers and join in”. The singer was spoken to and said “ Its good coming here because the residents join in “.
Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 13 Observations of residents rooms showed personal belongings are allowed into the home so to provide a homely atmosphere for each individual. Residents spoken to confirmed visitors are allowed at any time of the day or night. One said, “I go out for a walk every day and my relatives come at any time”. Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for recording and reporting of complaints are good ensuring people feel listened to. The management and staff have good knowledge and understanding of adult protection issues, which protect residents from abuse. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents and relatives on admission and is included in the homes brochure ensuring the residents feel protected. Staff spoken to are aware of the complaint and abuse procedures. One member of staff said, “Induction covers complaints and my NVQ (National Vocation Qualification) level 3 informs us of abuse issues”. Comments from surveys by residents confirmed they know who to speak to should they wish to make a complaint. There have been no complaints since the previous inspection. Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 15 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 the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is safe and clean maintained to a good standard providing comfortable surroundings for the residents. EVIDENCE: A tour of the building found the home to be clean and tidy despite some building work being finished off. A resident spoken to said, “The alterations have not affected the cleaning of the home”. Examination of maintenance records showed there is a rolling programme of general repairs and renewal of the premises. There has been substantial building work undertaken to improve the appearance of the home and provide better facilities for the residents and staff. A staff member spoken to said “Its been hard work making sure the residents are not disturbed and do the building work but it is a lot better”. One resident said, “The lounge is a lot nicer and pleasant to sit in”.
Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 16 Some parts of the home in particular bedroom and hallways should be improved by redecoration and refurbishment to ensure the residents live in comfortable pleasant surroundings. The new laundry area is situated in an area away from the dining room so that soiled items and clothing are not carried through where food is prepared, cooked or eaten. New improved policies and guidance are in place for the laundry and the control of infection ensuring the home is kept clean, and hygienic. One member of staff said the laundry is a lot better and easier to work in”. Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The procedures for the recruitment of staff are good ensuring the safety and protection of the residents. Training for staff is very good ensuring they have the skills and competencies for their roles. EVIDENCE: Observation of duty rotas and discussion with management and staff confirmed there were sufficient numbers of staff both domestic and carers on duty to ensure the resident’s needs are met. One member of staff spoken to said, “We are able to take residents out and spend time with them because of the staff on duty”. A visitor to the home spoken to said “There is always someone around for the residents”. A resident said, “I can’t fault the girls they are always on hand”. Examination of two staff files confirmed the recording procedures of the home are good. The staff records include, application forms and individual photographs on each of their file as a means of identification. CRB (Criminal records Bureau), POVA (Protection of Vulnerable Adults) checks and references were in place to ensure the residents are protected. The application form must be changed to ask for a full employment history with any gaps explained as required by regulation and provide protection for the residents. Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 18 Examination of training records and staff spoken to confirmed the good training opportunities available. Staff members spoken to said “The training facility on site means we can attend courses”. Another said, “Training is always on offer”. A senior member of staff has completed the RMA management award and is able to provide support and contribute to the daily routines of the home. Records show the home now has 60 of staff that has completed NVQ (National Vocational Qualification) level 2 in care, which exceeds the 50 , required by the National Minimum Standards and ensure staff has the skills and competencies to provide care and support for the residents. Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 19 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed well and good systems are in place for the protection of staff and residents. EVIDENCE: The registered manager has completed the necessary qualifications required to meet the National Minimum Standards in management and care ensuring he has the skills and competencies to provide the support to staff and care to the residents. Residents and staff members were very positive in their comments about the homes management. Residents found the manager to be approachable, supportive and helpful. A member of staff said, “John is always available for
Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 20 us”. Another said “Very supportive always willing to listen”. One resident spoken to said “You can have a laugh with John”. Inspection of records for residents were comprehensive, well written and up to date ensuring staff are aware of residents needs. Examination of records confirmed regular tests to emergency lighting, fire procedures and extinguishers had been carried out ensuring the safety of residents and staff is maintained. Records show the management has good systems to gather staff, residents and relative’s views to enable ongoing improvements to the home. Regular staff and resident meetings are recorded and suggestions are carried out if agreed by parties. A resident spoken to said “They are always open to suggestions”. Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP29 Regulation 19 Requirement A full employment history must be obtained with any gaps explained before staff are employed. Timescale for action 31/10/06 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 OP19 Good Practice Recommendations Furnishings and decoration of the home should be of good quality and domestic in character. Glen Marie Rest Home DS0000009862.V311026.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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