Inspection on 26/10/05 for Glenarie House Nursing Home

This inspection was carried out on 26th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Glenarie House Nursing Home 04/06/07

Glenarie House Nursing Home 10/08/06

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

CARE HOME ADULTS 18-65 Glenarie House 26 Prescot Drive Newsham Park Liverpool Merseyside L6 8PB Lead Inspector John McCabe Unannounced Inspection 26th October 2005 13:00 Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 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 Glenarie House DS0000063674.V269740.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 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. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Glenarie House Address 26 Prescot Drive Newsham Park Liverpool Merseyside L6 8PB 0151 228 7440 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) Ms Angela Margaret Hoyle Care Home 20 Mental disorder, excluding learning disability or Category(ies) of registration, with number dementia (20) of places Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents between ages of 16 - 64 years Date of last inspection 5th May 2005 Brief Description of the Service: Glenarie House is situated in Newsham Park in a busy suburb of Liverpool. The house is a modernised Victorian style house, which over looks parkland. The majority of residents have their own single bedrooms; those residents who share bedrooms have consented to do so. An experienced psychiatric nurse who promotes an independent living lifestyle for the residents in a therapeutic community manages the home. All residents have their own psychiatrist, and Social Worker who maintain contact with the resident and regularly review the resident’s progress. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection commenced at 1300 hours. The acting manager was on duty. A full tour of the building was undertaken accompanied by the acting manager. The inspector spoke with both staff and residents. Residents gave permission for the inspector to view their bedrooms. Documents and records relating to residents welfare as well as the safety of the environment were reviewed and discussed with the acting manager. Staffs’ personnel files relating to the homes recruitment policy and training programmes were discussed with the manager and staff on duty during the time of the inspection. What the service does well: What has improved since the last inspection? Since the last inspection the homes acting manager has reviewed and updated most of the homes policies and procedures, including residents and staff files. These now contain more relevant information. This information is now also being transferred to a computerised database. All residents have been supplied with all new bedding. Glenarie House DS0000063674.V269740.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. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 7 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 Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. The home management must ensure that there is a more consistent approach to undertaking pre admission assessments for all residents. The assessment should include a full and informed consultation with the resident and family and other health care professionals known to the resident. The resident’s guide to the home is user friendly and informative. This allows any potential resident to gain an insight into what can be expected should they choose to take up a placement there. EVIDENCE: Before residents are admitted to the home on a permanent basis, the resident’s psychiatrist, community psychiatric nurse and social worker undertake a pre admission assessment. The initial assessments before a resident is admitted must also include a nursing assessment undertaken by senior psychiatric nurses in the home. However, during a review of a resident’s personal file it was observed that the senior nurse from the care home had not undertaken a pre admission nursing assessment for the resident. The pre admission nursing assessment compiled by the home senior nurses is essential to ensure that the residents care needs are identified and that the manager can be confident that the homes workforce has the skill mix to care Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 9 for the resident. The home assessment is the basis of the residents initial care plan, and also ensures that the home is admitting the correct category of resident as stated on the homes CSCI registration certificate. The resident can visit the home, or have an overnight stay before moving in on a permanent basis. The residents guide sets out clear and accessible information, about the care home, facilities, accommodation, fees, terms and conditions, contract and the qualifications of the staffs. Staff in the home undertake specialist care training to ensure that the residents assessed and changing care needs are met. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10. The staff in the care home encourage residents to live a normal independent life as possible, which includes taking responsible risks. This promotes independence and informed decision making opportunities for residents. EVIDENCE: All residents in the home have an individual care plan, which is formulated by the senior nurses and the resident. The care plan includes risk assessments, a record of a range of issues such as choices and preferences of activities, nutrition, medications etc. The name of the support worker who will support the resident is also included. Staff in the home provide residents with information, assistance and were required communication support to make decisions and take responsible risks about their own lives, and daily living activities. Residents meetings are held in the home on a regular basis providing opportunities to be involved in decision making within the home. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 11 Residents informed the inspector that the home was ‘the best they had been in’ and a number stated that they ‘enjoyed their independence, knowing that there was always a staff member to support them.’ All documentation, which refers to each resident and staff, is maintained and kept secure in accordance with Data Protection Act 1998. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17. The care home staff have a good understanding of the residents support needs. This is evident from the positive relationships, which have been formed between staff and the residents. Personal support in the home is offered in such a way as to promote and protect the resident’s privacy, dignity and independence. EVIDENCE: Residents in the care home are encouraged to take paid jobs, attend day centres, and participate in community activities. Many of the service users in the home are accommodated under funding arrangements set out in Section 117 of The Mental Act (1983). These residents receive financial welfare allowances on a weekly basis; many of the residents told the inspector that it was not worth going out for paid work, as they would lose their welfare benefits. The home encourages residents to maintain links with their family as well as community contacts. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 13 Resident’s are actively encouraged to take responsibility for housekeeping tasks, e.g. cleaning, laundry, and sorting their personal clothing. This is specified in the residents care plan although when needed, support workers will assist the resident in completing tasks. Residents spoken to on the day of the inspection commented they enjoyed the food in the home, and they also have a part in planning the menus. On chefs’ day off, carers do the cooking for the residents. Care staff should be supplied with protective clothing and have up to date food hygiene and handling certificates. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. The systems/protocols for the administration of resident’s medications are good, with clear and comprehensive arrangements in place to ensure resident’s medications needs are met. EVIDENCE: All residents in the home can access their NHS entitlements; which includes access to a GP, dentistry, chiropody and opticians services. Community Psychiatric Nurses (CPNS), Psychiatrists and Social Workers ensure that both the mental health needs as well as the resident’s physical needs are met. At all times during the inspection, staff were polite and courteous to the residents; residents told the inspector that the staff were ‘friendly’ and ‘helpful.’ Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 15 During the inspection the inspector reviewed the homes medication policies and procedures and inspected the Medicine Administration Records Sheets (MARS) of all the residents. These were found to be well managed. Residents who self medicate are risk assessed before they do so; a lockable facility is available in the resident’s room for storage of medications. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. The arrangements and policies in the care home for protecting residents are robust, (including Whistle blowing) and staff have a sound knowledge and understanding of Adult Protection issues. This assist’s in protecting residents from any potential abuse. EVIDENCE: The home has a complaints procedure and policy, which is documented in the resident’s guide/handbook. All information relating to complaints contains the address and telephone number of the CSCI. Since the last inspection, there has been one complaint to the CSCI, which is still unresolved. The care home has up to date information on the Protection of Vulnerable Adults (POVA), which all staff in the home are familiar with, as evidenced during discussion on the day of the inspection. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,2,6,27,28,29,30. The standard of decor within this home is good, with evidence of continuing improvements, through maintenance and planning. The home does present as a homely, safe and comfortable environment for the residents. EVIDENCE: The care home environment is good; all areas of the home are clean, light, well decorated and maintained including the rear garden area, which has a BBQ and seating for the residents. Residents gave the inspector permission to view their bedrooms and they were observed to have been personalised with pictures and artefacts that refer to their own choices and preference. All residents have been supplied with a complete set of new bedding. The communal lounges are bright and homely; one room is reserved for residents who smoke. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 18 The passenger lift is out of order and specialist engineers have been contacted to repair the lift as soon as possible. This is so the inconvenience to residents, some of whom have mobility problems, can be kept to a minimum. Many of the fluorescent lights in the home are without anti glare covers. The acting manager will arrange for new covers to be fitted to the lights. All bathrooms and toilets in the home provide privacy, and meet individual needs. The homes infection control policy is in date and valid. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36. The registered person operates a robust and comprehensive recruitment policy to ensure that staff have the required skills to provide care for all residents. Current arrangements for the supervision of care staff do not meet minimum standards. The purpose of effective supervision is to ensure that staffs performance/work with the residents is safe and promotes a sense of well being for each resident. EVIDENCE: The care home operates a robust and comprehensive recruitment policy to ensure that staff have the required skills to provide care for all residents. On the day of this unannounced inspection all staff files contained an up to date enhanced CRB/POVA certificate. The Personal Identification Numbers (PINS) of all the registered nurse in the home were documented on Nursing and Midwifery Council (NMC) stationary. Mandatory and specialist care training is facilitated in the home as evidenced on the day of the inspection. Not all care staff in the home have documented supervision six times per year. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 20 Effective regular supervision would ensure that all staff have the opportunity to discuss with the manager, and other senior staff any issues, which can effect or improve the care for the residents. Documented supervision of all staff also gives the staff and managers opportunities to discuss their own /or identified training needs. Documented supervision of care staff must be implemented as soon as possible. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,28,39,40,41,42,43. The acting manager is supported well by senior staff in providing clear leadership throughout the home. Staff demonstrated a good awareness of their roles and responsibilities. EVIDENCE: The management approach of the home is open, positive and transparent for both residents and staff. The acting manager of the home is currently applying to the Commission for formal registration. The documentation relating to the safety of the home is complete, up to date and valid (Except the visitors book) so ensuring a safe, comfortable, hygienic home for the residents. The records in the home demonstrate that the views of residents and staff are taken into consideration when the home policies and procedures are formulated. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 22 The certificates of worthiness and insurances for homes appliances, including the Employees liability Certificate are in date and valid. The home has a First Aid qualified member of staff on duty at all times of the day. This means that minor first aid issues can be addressed immediately and provides additional protection for both staff and resident’s. Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 23 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 3 3 3 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 14 15 16 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 2 3 2 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Glenarie House Score 3 2 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 DS0000063674.V269740.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? YA41 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 YA2 Regulation 14 Requirement The registered person must ensure that a pre admission nursing assessment is undertaken on all residents before they are admitted to the home. The registered person must ensure that all fluorescent light tubes in the home have anti glare covers fitted The registered person must ensure that the passenger lift in the home is repaired as soon as possible. The registered person must ensure that all care staff receive documented supervision six times per year. The registered person must ensure that the homes visitors book is kept up to date, and all visitors are requested to sign in and out of the building. This is to ensure the safety and well being of the residents; the visitor’s book must be referred to in case of emergency, such as fire evacuation. Previous Time Scale of the 05/05/05 NOT MET. Timescale for action 30/11/05 2 YA24 23 30/11/05 3 YA29 23 30/11/05 4 YA36 19 30/11/05 .5 YA41 17 30/11/05 Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 25 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 Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Glenarie House DS0000063674.V269740.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!