CARE HOMES FOR OLDER PEOPLE
Glen Tanar Rest Home 65 Cavendish Road Bispham Blackpool Lancashire FY2 9NJ Lead Inspector
Mrs Ruth Edgington Unannounced Inspection 20th August 2007 09:15 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 Tanar Rest Home DS0000063150.V343818.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 Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Glen Tanar Rest Home Address 65 Cavendish Road Bispham Blackpool Lancashire FY2 9NJ 01253 352726 01253 352533 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) Fylde Care 2004 Ltd Miss Marisa Whybrow Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Glen Tanar Rest Home DS0000063150.V343818.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 home is registered for a maximum of 21 service users in the category of Older People (OP) (service users over the age of 65 year) 23rd May 2006 Date of last inspection Brief Description of the Service: The Glen Tanar is situated in a residential area within easy access of the promenade and busy shopping area of Bispham. The home provides accommodation for a maximum of 21 persons aged 65 years or above. The accommodation comprises of one double bedroom and 19 single bedrooms, only one of which has ensuite facilities. There are adequate bathing and toilet facilities and a large lounge and dining area. A passenger lift enables the residents to have access to the rooms situated on the first floor. Various aids are provided around the home to assist the residents in their daily lifes The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owners and staff and the service that residents can expect if they choose to live at the home. Prospective residents and their relatives are provided with sufficient information to help them to make an informed choice about whether to move into the home. A copy of the most recent inspection report is located in the hallway for residents and visitors to read. The range of fees at the home are £287.91 to £336.49 covering all aspects of care, food and accommodation. Additional charges are made for chiropody and hairdressing. The manager provided this information on 20th August 2007. Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced site visit was undertaken as part of the home’s Key Inspection. The site visit commenced at 9.15am and took place over 4.45 hours. Prior to the visit the homeowner completed an Annual Quality Assurance Assessment document (AQAA), which provided information about the home and how the service provided was meeting the National Minimum Standards. Comments cards were sent to a number of residents, their relatives and relevant healthcare professionals. Three residents and two relatives completed the forms, which provided their views about the home. During the visit a number of residents, two relatives, five members of staff, the manager and the owner of the home were spoken to. A random selection of residents, staff and administrative records were looked at and a tour of the home took place From observations made, comments received and written documentation examined, the information has been put together to produce this report. What the service does well:
This is a care home where the residents are well looked after. The residents are able to mix with others in the home or have their privacy whenever they wish and are encouraged, within their capabilities, to be individual and their personal routines and lifestyles are respected. The registered manager is very experienced, qualified and competent and is well supported by a homeowner, ensuring that the home is run in the best interests of the residents. The staff team work well together and were seen throughout the visit to be very caring in the way in which they looked after the residents and assisted with personal tasks in a sensitive manner. A relative commented, “The staff seem to have the right approach.” There was a good atmosphere in the home and the staff, and residents were very relaxed and interacted well. One resident said that they were very happy in the home and would not change anything. Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 Page 6 From observations and discussions during the visit, evidence was gained to confirm that the homeowner, manager and staff had a good understanding of equality and the diverse needs of the residents, which ensures that individual needs are met. They are all committed to enabling residents to live as independently as possible whilst ensuring their privacy, dignity and opportunity to make their own choices. What has improved since the last inspection? What they could do better:
The AQAA documentation that the homeowner completed clearly showed their plans for improvements to be undertaken in the next twelve months and how these were to be achieved. One area that had been identified in this document was that the information contained in the care plans was to be reviewed. Whilst the care plans looked
Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 Page 7 at had been reviewed in the last month it was evident previously they had not been reviewed on a monthly basis. The manager confirmed that all care plans were being updated and would in future be reviewed on a monthly basis on order that the needs of the residents continue to be met by the care provided. 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. The summary of this inspection report can be made available in other formats on request. Glen Tanar Rest Home DS0000063150.V343818.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 Tanar Rest Home DS0000063150.V343818.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. 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 are clear to ensure that the care needs of residents are met. EVIDENCE: The home has an admission process that includes a full assessment of the individual needs of any prospective resident. The assessment is undertaken before admission and involves the prospective resident, their representative and any social worker or other professional involved in the residents care. This process ensures that the assessed needs of the residents can be met by the service and facilities in the home. Evidence was found to confirm that prospective residents, or if more appropriate their representative, receives written confirmation that the home can meet their assessed needs and also confirming the proposed day of admission. Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 Page 10 The records of three residents were looked at in detail and were found to contain full assessment information that had been obtained prior to admission, therefore ensuring that the home could meet their assessed needs. The information included their physical, emotional, dietary, religious and cultural needs. From observations made and comments received during the visit, evidence was found that the staff were well aware of the needs of the individual residents. This home does not provide intermediate care. Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 7 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 were met. EVIDENCE: Individual records are kept for each resident containing information in relation to their health, personal and social care needs. Examination of three of the residents’ files showed that a care plan had been devised for each individual from the information collected. This included Risk Assessments, which identified the level of risk and the intervention required by the staff. Personal histories were also included, which were helpful to staff in identifying and meeting their needs. Significant events were recorded and daily entries made of the care given and evidence was also seen of involvement of health care professionals. During the visit one resident had informed the staff of a particular health problem that
Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 Page 12 they had developed. Staff immediately contacted the doctor in order that the appropriate action could be taken to alleviate the resident’s symptoms. The manager stated that the care staff were now becoming more involved in the recording and reviewing of care plans, which were in the process of being reviewed and up dated and evidence was seen that this was being done. The information seen on the files was very comprehensive, however there was a lot of duplication of information. The manager confirmed that she would look at this when reviewing the care plans in order that the care needs of residents continue to be met. Comments received from residents and visitors during the visit confirmed that they are involved in all aspects of their care. One relative commented that the staff always inform them straight away of anything affecting the wellbeing of the resident. Observations were made during the visit of the caring attitude of the staff and how they assisted the residents with their personal care ensuring that their right to privacy and respect was upheld. All staff are made aware of the medication policies and procedures in the home and training is given to those who administer the medication to ensure that the residents are protected and that their needs are met. Examination of the medication records confirmed that these were correct and up to date. Medication is kept secure in a locked cabinet, however the manager said that the homeowner was in the process of purchasing a lockable trolley, which would be more secure and suitable for the dispensing of medication to the residents. Documentation was seen confirming that residents were asked on admission if they wished to keep their own medication or were happy for staff to take over that responsibility. Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 &15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The social activities and meals are both well managed, creative and provide variation and interest for people living in the home. EVIDENCE: The preferences, interest, social, religious and cultural needs of each resident is recorded on their file and the information forms part of their care plan in order to ensure that their individual needs are identified and met. Residents spoken to said that routines within the home were flexible and they were able to make their own decisions about how to live their lives. One of the residents likes to go out walking unaccompanied and although some degree of risk had been identified evidence was seen that appropriate steps had been taken to ensure their safety whilst enabling this activity to continue. Residents spoken to were happy with the arrangements in place for social activities. The activities being provided had improved since the last visit and staff said that they tried to do some activity every afternoon depending on what the residents want to do. This was confirmed through comments made
Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 Page 14 by a relative and residents spoken to. One resident commented that they chose not to take part but had been out to a local show and had enjoyed this. Visitors are made welcome and this was confirmed through observations made during the visit of a number of visitors who came into the home and spent time with individual residents. One relative commented, “I never inform them when I visit, but I am always greeted warmly”. In the main the resident or their relatives handle their financial affairs. Records being kept by the home in respect of residents unable to manage their own finances were being well maintained. Residents are provided with a varied and balanced diet. Information recorded on each resident’s file indicated his or her dietary needs and their likes and dislikes. A record is kept of all meals served and the staff spoken to said that they had sufficient information regarding individual dietary needs to ensure that these were met. Comments received indicated that residents were satisfied with the meals provided. One relative commented that a particular resident was not easy to cook for but that the staff went along with their wishes and the food was good home cooking. Observations were made of assistance being given to residents were required help with their meals. It was also noted that residents’ meal times were very staggered to meet individual needs and they were not rushed. One resident spent a great deal of time at the table and eventually sat with the staff during their meal. It was also noted that residents were provided with drinks at all times and fresh fruit was available to them in the lounge to have when they wanted. Through discussions and observations evidence was gained that the practices in the home enable equality and diversity for the residents. Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements in place for handling complaints ensure that people feel confident that their complaints will be listened to, taken seriously and they will be protected at all times. EVIDENCE: There is an appropriate complaints procedure in place, which is clearly written and easy to understand. This is included in the information provided to the residents and a copy is displayed in the home. Comments received from residents and relatives confirmed that they knew who to complain to if required. The Commission for Social Care have not received any complaints since the last inspection visit. Through discussions evidence was gained that the staff have a good understanding of the procedures to be followed in the event of any allegation or suspicion of abuse or neglect. Evidence was seen that some staff had undertaken training on Abuse Awareness and the manager stated that she was due to undertake training being provided by the local authority so that she could train the staff in relation to the ‘Safeguarding Adults’ procedures that had been developed to ensure that all staff could recognise any allegations or suspicion of abuse and neglect and understand the procedures that should be followed. Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 7 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a planned maintenance and renewal programme for the redecoration and refurbishment of the home to ensure residents live in a comfortable, homely and safe environment. EVIDENCE: The home has been well maintained and decorated for the comfort of the residents. Since the last visit there have been major improvements made throughout the home and also to the outside of the home. Windows have been replaced, gutters and facia boards replaced and the outside had been repainted. A new gardener has been employed and they were spoken to during the visit. The gardener said that they took great pride in their work, which was very apparent for observations made. New garden benches have been bought to enable residents to sit out in a safe, pleasant environment. Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 Page 17 The homeowner confirmed that the refurbishment was ongoing and there were further plans for improvements throughout the home. One of which had commenced and this was to divide the large lounge into two rooms to enable the residents to have more privacy and to have choice of who to sit with and carry out their daily activities. If required the doors could be opened to provide one large room. It was noted that additional grab rails had been fitted to assist the residents to retain their independence and assist with mobility. The residents spoken to said that they were very happy with the improvements being made. A tour of the building confirmed that residents’ bedrooms had been personalised with their own belongings. The home was found to be clean and hygienic ensuring a pleasant environment in which to live. Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment process will be robust for the protection of the residents. They will be cared for by a competent, qualified and experienced staff group. EVIDENCE: Staffing levels were sufficient to meet the needs of the residents living at the home. The records of three staff who were on duty were looked at in detail and were found to contain all the documentation required, which confirmed that the correct recruitment procedures had taken place to ensure that residents were protected. Staff spoken to said that they were clear about their role and worked well as a team to ensure the individual and collective needs of the residents were met. Records showed that over 50 of staff had achieved a National Vocational Qualification (NVQ) ensuring that the residents were being looked after by a well trained and competent staff team. Discussions with staff and examination of records confirmed that training had been provided to ensure that staff had a clear understanding of the specific care needs of the residents accommodated. The manager had produced a training record that showed clearly what training had been identified for each member of staff and confirmation was seen that the appropriate courses had been booked.
Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 Page 19 Staff spoken to said that they felt supported and included in all aspects of the residents care. Comments received from relatives indicated that the staff were always cheerful and helpful. One relative commented that they try and make the residents happy and comfortable and always enable them to keep in touch by telephone if they wish. Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 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 run in the best interests of the residents. EVIDENCE: The homeowner also owns another care home at which there is a registered manager in post, enabling them to spend time in the home each week. The registered manager at Glentanar is an experienced and competent person. Since the last inspection visit the manager has successfully completed NVQ level 4 in Care and now holds the required management qualifications for the post. Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 Page 21 Prior to the visit the homeowner had completed the AQAA (Annual Quality Assurance Assessment) in a very detailed and professional manner, which clearly showed what the home did well and how they felt that they could improve the service for the benefit of the residents. There was a clear understanding of the principles of equality and diversity and that residents should receive equal treatment and access the same resources without favouritism of discrimination. The minutes of the last residents meeting, senior staff meeting and general staff meeting were looked at and these demonstrated the commitment by the homeowner and manager to operate an open house policy and keep everyone informed. Residents spoken to confirmed that they were consulted about any changes taking place in the home and kept fully informed about forthcoming events being organised. Quality assurance systems were in place to gather the views of residents and visitors, although the manager confirmed that the residents and their relatives preferred voicing their opinions in person and therefore questionnaires were not completed. The home has acquired the ‘Investors in People Award’ which is an external quality assurance system demonstrating a commitment to staff training and development. The manager confirmed that she was in the process of reviewing all the policies and procedures and introducing any that were not in place to ensure that the practices in the home continued to meet the needs of the residents. The policies and procedures presently in place in the home ensure that the health, safety and welfare of the residents and staff are promoted and protected. Information was provided that confirmed that all safety equipment and systems were regularly serviced. Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 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 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 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 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 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 Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Glen Tanar Rest Home DS0000063150.V343818.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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