Inspection on 09/10/07 for Glen View

This inspection was carried out on 9th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Glen View 05/10/06

Glen View 15/09/05

Glen View 20/04/05

Glen View 19/10/04

Glen View 29/06/04

Glen View 01/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Glen View 54 Gravel Hill Ludlow Shropshire SY8 1QS Lead Inspector Mike Moloney Unannounced Inspection 9th October 2007 11:00 Glen View DS0000020654.V346828.R01.S.doc Version 5.2 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 View DS0000020654.V346828.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 Adults 18-65. 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 View DS0000020654.V346828.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glen View Address 54 Gravel Hill Ludlow Shropshire SY8 1QS 01584 876262 01584 876262 julie.romeo@macintyrecharity.org www.macintyrecharity.org MacIntyre Care 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 Julie Romeo Care Home 6 Category(ies) of Learning disability (4), Physical disability (2) registration, with number of places Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 2006 Brief Description of the Service: Glen View is one of four care homes operated in Shropshire for Adults with Learning Difficulties by the MacIntyre organisation. The manager of Glen View is Julie Romeo. The home was established in 1992, as part of a resettlement scheme for Shropshire people who were, at that time, resident in long stay hospitals. The project was the outcome of a joint initiative between Shropshire Health Authority, Shropshire Social Services and MacIntyre Care. Glen View is a three storey building sited near the centre of Ludlow in a residential area, within close proximity of all the local facilities and services in accordance with the objective of community integration. Each service user has a single bedroom, There are spacious communal areas and a pleasant and secure garden. Further information about this home is available from its service user guide and about MacIntyre on its website at http:/www.macintyrecharity.org/ The fees are paid by the health authority on a block contract basis. Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This included: information from the provider, records kept in the home, medication records, discussions with the manager and members of the staff team, tour of the premises, previous inspection reports and observing the care experienced by people using the service. Verbal communication with the service users is difficult due to the nature of their disabilities. What the service does well: What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): There have been no new residents admitted to this home for some time and therefore it was not possible to assess the admissions procedure. EVIDENCE: Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. The nature of the individuals’ disabilities make direct communication with them very difficult but their reactions are monitored by the staff in order to ascertain whether or not they enjoy situations and activities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A number of records were looked at and these showed that the likes, dislikes, needs and wishes of the service users had been recorded. Those records also showed, and talking with the staff confirmed that this information was reviewed on a regular basis. This was seen to have happened very regularly in the case of a recent serious illness of one of the residents. More generally, the records also contained information about how each service user should be approached when carrying out such things as personal care, getting up in the morning and taking medication. A variety of documents were seen that identified what situations and activities contained hazards of varying Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 9 levels of risk and these also identified ways in which those risks could be reduced to an acceptable level. Talking with the staff established that, because of the difficulties that the residents experience when expressing themselves, they monitor reactions to different situations, people and food, so that they can tell when someone is happy or not and make the rest of the staff team aware of what they have seen. This information is then incorporated within their care plan. Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, and 17 Quality in this outcome area is good. Despite their communication difficulties people who use services are able to make choices about their life style and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records of the activities that two of the service users had been involved in were looked at in detail. The lists included such things as going out to various local towns, like Bridgenorth and Leominster for lunch, walking to Tesco, aromatherapy, going to the recycle bins, swimming and going to the local Gateway Club. Which people went to which activity matched what was recorded within the likes and dislikes part of their care plans. To get to a number of these activities the home has it’s own vehicle that appropriately qualified staff are able to drive. Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 11 The manager explained that new activities were occasionally introduced and the staff watch carefully so that they could gauge the service users’ reactions. When talking with the service users and saying the activity, such as ‘swimming’, some would smile, however, it is not possible to say whether or not that was because they liked the activity or that they were enjoying being spoken to or for some other reason. They did, however, appear to be happy and contented. During the inspection a number of the service users showed an interest in what was going on moving from room to room and floor to floor so that they could watch. They were not seen entering someone else’s room even when those that they were following did. During the inspection those staff that did go into residents bedrooms or bathrooms always knocked and paused before entering. The records of the meals that had been prepared for the service users were also looked at. As mentioned before their likes and dislikes lists included foods and staff confirmed that these had been taken into account when the menus had been planned. Their medical needs had also been catered for with one of the service users not being able to eat a particular type of food. The staff and the manager explained that to accommodate this he was given similar foods so that neither he nor any of the others thought he was being treated differently; the example being sausages- he was given his own that did not contain that particular ingredient. Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Support plans were seen to contain guidance to staff on how personal care and healthcare should be given. Records seen in both of the files looked at showed the dates, times reasons for and results of healthcare consultations. The administration and storage of medication was looked at with storage consisting of a secure cupboard in the dining room that contained the facility to store controlled drugs. Smaller, individual cabinets were seen awaiting installation into the individual bedrooms and the manager explained that once this had been done peoples’ medication would be kept in their rooms. The main cabinet would then be moved from the dining room to her office where it would house any controlled drugs and reserve stocks of other medications. Appropriate administrative systems were seen to be in place and the records Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 13 showed that they had been followed. The staff confirmed that they receive training in the safe handling of medication. Health action plans were seen but as yet these had not been fully developed. Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. Despite the nature of their disabilities people who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Given the nature of the service users’ disabilities they would find it impossible to access any formal policies for themselves. However, a policy was seen to be in place that could be used by any other person who has an interest in their welfare. The staff also have access to a ‘whistle blowing’ procedure as well as training in the identification and reporting of abuse. The records seen and the staff spoken to confirmed that they had received this training. The manager confirmed that no complaints had been received or allegations referred within the local vulnerable adult policies and procedures. Records of the monies managed for service users were available for inspection but not examined as the manager confirmed that they are subject to audits by her line manager and are subject to random audits by MacIntyre Accounts staff. Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This home is a three storey Victorian house in central Ludlow within easy walking distance of the local amenities. There is no off road parking available but there is road-side parking in a side street opposite the house where the home’s vehicle is parked. There is a shaft lift for people to use if necessary although a number of the service users were seen using the stairs perfectly well, especially those who had decided to monitor the inspection process! The inside of the house was seen to be well decorated and acceptably maintained. In particular all of the bedrooms were seen to have been Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 16 personalised and, because of their size some were equipped with extra furnishings such as sofas. The kitchen was seen to have been refitted since the last inspection and the manager talked about how the dining room would be more homely once the personal medication storage had been fitted in the bedrooms and the office. The garden was seen to be spacious and secure with some work being carried out to the beds that the manager said she hopes will be of interest to the residents. Access to that part of the garden is restricted while the work is under way. Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is good. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions and to support the smooth running of the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Throughout the inspection staff were seen to be interacting with the service users in a sensitive, caring and professional manner. Looking at the rota and talking to the staff established that there were enough staff on duty to meet the needs of the service users. The manager explained and staff confirmed that more staff are made available should the need arise for such things as outings. Records were also seen that confirmed that pre-employment background checks were carried out on people before they started working with the vulnerable people living at the home to ensure that they were fit to do so. Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 18 Looking at the records and talking to the staff established that the managers and individual staff meet on a regular basis to discuss issues of practice and any change in care needs in a confidential manner. Looking at the staff training records and talking with the staff confirmed that there are training opportunities for all of the staff ranging from the mandatory safety training to such things as National Vocational Qualifications in Care. All of the staff have at least National Vocational Qualification level 3 in care. Appropriate induction and foundation training was also available to staff who are new to the care industry. Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Talking with the manager established that she had completed her Registered Manager’s Award and is well on the way to completing her National Vocational Qualification level 4 in care, both of which are qualifications considered to be appropriate for people managing this type of service. The way that the MacIntyre senior management monitor the performance of the home was also discussed. Records of the monthly visits by the registered manager’s own line manager were seen and these showed that such things as residents care plans, staff supervision meetings, safety checks and service Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 20 users monies were checked. The manager also explained that the service user monies were also subject to ‘spot checks’ by the company’s accounts staff. A variety of policies and procedures were seen showing the home’s commitment to equal opportunities for service users and staff. A variety of records that showed that the safety of the environment in which the service users live is monitored were looked at and found to be up to date. These included records of the monitoring of fridge and freezer temperatures, hot water temperatures and the portable appliance test records. The home was also seen to have secure storage for hazardous materials as well as risk assessments that outlined their safe use. As stated elsewhere in this report the staff team receive appropriate safety training in infection control, the safe handling of medicines, first aid, food hygiene, manual handling and fire prevention. Glen View DS0000020654.V346828.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 Adults 18-65 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 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 22 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. 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 View DS0000020654.V346828.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Shrewsbury Local Office Commission for Social Care Inspection 1st Floor, Chapter House South Abbey Lawn Abbey Foregate Shrewsbury SY2 5DE 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 © 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 Glen View DS0000020654.V346828.R01.S.doc Version 5.2 Page 24 - 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. 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