CARE HOMES FOR OLDER PEOPLE
Glen Tanar Rest Home 65 Cavendish Road Bispham Blackpool Lancashire FY2 9NJ Lead Inspector
Mrs Ruth Edgington Unannounced Inspection 22nd November 2005 9.15 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.V267830.R01.S.doc Version 5.0 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.V267830.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Glen Tanar Rest Home Address 65 Cavendish Road Bispham Blackpool Lancashire FY2 9NJ 01253 352726 01253 354791 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 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.V267830.R01.S.doc Version 5.0 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) 20th April 2005 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 en-suite 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. Glen Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced. The Inspection commenced at 9.15 am and took place over 3 hours. The Inspector spoke to five residents, three members of staff, the manager and the homeowner. During the inspection the Inspector looked at a number of records including those of selected residents and staff. What the service does well: What has improved since the last inspection?
There has been an increase in the number of staff employed in the home, which enables more time and attention to be given to meet the individual needs of the residents. The management consider training to be very important in making sure that the residents receive the care that the need. Staff spoken to were enthusiastic and eager to undertake the training that was being provided. They said that they felt valued and supported in their work. One resident who had been in the home for some time said that the home had improved since the new homeowner and manager had taken over. The Inspector found that improvements to the decoration and furnishings were continuing and that the bath on the ground floor had been replaced with a large walk in shower, which residents said was easier for them to use. Glen Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 6 What they could do better: 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 Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 7 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.V267830.R01.S.doc Version 5.0 Page 8 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): These standards were not assessed. EVIDENCE: Glen Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 9 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 & 10 There is no clear or consistent care planning system in place to adequately provide staff with the information that they need to satisfactorily meet resident’s needs. The medication procedures have improved and are being well managed. EVIDENCE: The records of three residents that had been admitted to the home since the previous inspection were examined. The Inspector found that although the information included an assessment of their needs, the home had not produced a care plan that set out in detail the health, personal and social care needs of the individual residents and how these needs are to be met by the care staff. The Inspector also found that there were no records confirming that risk assessments had been carried out. Staff spoken to were able to demonstrate that they were aware of the individual needs of the residents even though there was a lack of clear plans. This approach is dependent on staff memory and good verbal communication
Glen Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 10 systems. Residents are at risk of not having their health care needs met if these informal systems break down. The manager informed the Inspector that she had started to talk to the residents about their life histories in order that staff had a greater understanding of the individual residents and how their needs can be met. Residents spoken to were satisfied with the care that they received. One resident said “ we are very lucky to have a place like this and kind people to look after us.” The Inspector examined the policies and procedures for the administration of medication that the manager had upgraded since her appointment Evidence was seen that confirmed that staff responsible for administering medication had all received appropriate training. Glen Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 11 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): These standards were not assessed EVIDENCE: Glen Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 12 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 & 18 Arrangements for complaints are handled well and taken seriously ensuring that residents feel that their views are listened to and acted upon. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents on admission. The Inspector was aware of one complaint that had been made to the home since the previous inspection. The manager had resolved the situation and appropriate steps were taken to ensure that the situation did not occur again in the future. Comments received from the residents confirmed that if they were unhappy with their care they would know who to speak to. One resident told the Inspector that they had spoken to the manager about a concern that they had “ but it will be fine she will sort it out”. The Inspector was able to evidence that the manager had a good understanding of the procedures to be followed in the event of any allegation or suspicion of abuse or neglect. On examination of the training records evidence was seen that staff were to attend training on this subject. Glen Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 13 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): These standards were not assessed. EVIDENCE: Glen Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 14 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): 28,29 & 30 The procedures for the recruitment of staff are not robust and do not provide the safeguards to offer protection to the residents. EVIDENCE: There has been a number of staff employed since the previous inspection. Examination of three of these staff member’s files indicated that the recruitment procedures had not been followed correctly. Only one of these files contained a clearance through the CRB (Criminal Records Bureau), however it was evidenced that this had been received after the member of staff had commenced employment. There was no evidence on any of the files seen that a request had been made through the CRB for a POVA (Protection of Vulnerable Adults) check. The Inspector also found that on the files examined references were not being obtained as required, only one file contained two written references. The Inspector was able to evidence that staff were receiving appropriate training. A training matrix was displayed in the office and staff spoken to confirmed that they were encouraged to take part in training and were enjoying doing so. Eight staff members were in the process of doing level 2 NVQ (National Vocational Training) and one staff member had successfully completed the course. Glen Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 15 Observations of care practices showed that staff cared for residents in a pleasant and dignified manner. One resident spoken to said that the staff were kind and “know what they were doing are doing”. Glen Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 16 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, 36 & 38 There has been limited progress made in a number of areas since the previous inspection. Improvements are required to ensure that the health, safety and welfare of the residents are safeguarded. EVIDENCE: A new manager has been appointed who has a good understanding of the ways in which the home needs to improve. The Inspector was informed that she was in the process of submitting an application to the Commission for Social Care Inspection (CSCI) to become the registered manager. Examination of her file showed that she had obtained the Registered Managers Award and had completed many other relevant courses. The Inspector advised the manager that she would still be required to undertake level 4 NVQ in care. Staff and residents spoken to made very positive comments about the care and support that they received and the changes that had taken place.
Glen Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 17 Residents informed that Inspector that they were kept informed of any matters that affected them. Evidence was seen of a residents’ meeting that had just been held and which the Inspector was informed was to become a regular event in which the residents could be kept informed and let their views be known. The Inspector examined the records of monies that were being held on behalf of individual residents and found that the records required attention to ensure that a more detailed record of the expenditure, amount and who had undertaken this on behalf of the resident was kept. Glen Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 18 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 x x X X X X X X STAFFING Standard No Score 27 X 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 2 3 X 2 Glen Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15(1) Requirement Full and satisfactory information must be provided on the resident’s plan of care in relation to their health and welfare needs. (Timescale of 3/06/05 not met) The registered provider must ensure that unnecessary risks to the health and safety of the residents are identified and so far as possible eliminated. (Timescale of 3/06/05 not met) The registered provider must obtain in respect of the employment of staff, all the information specified in Schedule 2. (Timescale of 20/10/04 and 03/06/05 not met) The manager must submit an application to be registered. Timescale for action 31/01/06 2. OP8 13(4) 31/01/06 OP29 3. 19 31/01/06 4 OP31 8 31/12/05 Glen Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 20 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. 3. 4. 5. Refer to Standard OP28 OP31 OP35 OP38 Good Practice Recommendations 50 of care staff should NVQ level 2 qualifications The manager should obtain level 4 NVQ in care. The registered provider should review the system in operation for the recording of monies handled on behalf of residents. The registered provider should make arrangements for the training of all care staff in first aid to ensure that there is a qualified first aider on duty at all times. Glen Tanar Rest Home DS0000063150.V267830.R01.S.doc Version 5.0 Page 21 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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