Inspection on 25/10/06 for Glenbrooke House

This inspection was carried out on 25th October 2006.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Glenbrooke House 13/12/07

Glenbrooke House 26/10/05

Glenbrooke House 11/05/05

Glenbrooke House 10/11/04

Glenbrooke House 19/05/04

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

CARE HOME ADULTS 18-65 Glenbrooke House Chowdene Bank Low Fell Gateshead Tyne and Wear NE9 6JR Lead Inspector Miss Andrea Goodall Key Unannounced Inspection 25th October 2006 9:30 Glenbrooke House DS0000047308.V313523.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 Glenbrooke House DS0000047308.V313523.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. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glenbrooke House Address Chowdene Bank Low Fell Gateshead Tyne and Wear NE9 6JR 0191 487 8330 0191 487 8340 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) Gainford Care Homes Ltd Mrs Norma Catherine March Care Home 10 Category(ies) of Learning disability (10), Physical disability (4) registration, with number of places Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th October 2005 Brief Description of the Service: Glenbrooke House is a large, detached Victorian house that has been restored and extended to provide accommodation for up to 10 people with a learning disability. The accommodation for service users is over 3 floors. The office and a games room are on a fourth floor.The home provides 4 bedrooms for people who may have mobility or physical disabilities. These bedrooms are on the ground floor where there is level access into the building, good access into lounges and dining areas and there are assisted bathing facilities. The bedrooms on the lower ground floor, first floor and mezzanines can only be used by people with good mobility. Decoration and furnishings are of a very good standard, and the home is warm and comfortable. It is suitable for its stated purpose and it meets the needs of the people who currently live here. The house is set in its own large private grounds. It is close to various local amenities, such shops, library, restaurants and clubs, and is close to public transport routes. The weekly fee ranges from £631to £745 (depending on different level of needs, different benefits and different funding arrangements with the local authority. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day and evening. Some time was spent talking with the people who live here, and looking around parts of the home. The inspector spent some time looking at care records, safety records and staff records. The inspector also talked with the Manager about any changes to the home. For part of the visit an Expert by Experience came to the home to talk to the people who live here. An Expert by Experience is someone who uses social care services. We are currently trying visits where Experts by Experience are an important part of the inspection team. They can help inspectors to get a picture of what it is like to live in or use a social care service. Miss Victoria Bowman, an Expert by Experience, joined the inspector on this visit. She talked with the residents, joined them for a teatime meal and looked at parts of the house. Miss Bowmans comments and observations are added to this report and can be identified in bold text. A couple of months before the visit, residents also filled in picture questionnaires with their views about their home, but most people needed help to do this. Five relatives also completed comment cards about the service. What the service does well: Residents said lots of good things about their home. One said, I like all the staff, I like going out, I like being here, and I like my holidays. Another resident said, I like being busy in the kitchen. The Expert by experience said that good things about the home included : - The environment was accessible, clean and welcoming. - The staff were friendly, sociable and had good communication with each other and with residents. - The residents were able to have privacy as they had their own private rooms. - The building was homely and comfortable. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 6 -There was a good range and choice of activities for residents. Relatives who took part in the discussions and in comment cards said that they are satisfied with the service provided at Glenbrooke House. One relative said, My (relative) is very happy here. The home is comfortable and well decorated. There are enough staff on duty through the day to help residents. Staff have lots of training in safety and in care so that they know how to look after people in the right way. The home is well run, and residents views are used to make sure its run the way that they want. What has improved since the last inspection? What they could do better: It would be better if there was a written guide to show staff how to help someone when they were upset or angry. In this way all staff would help them in the same way. Some residents might want to keep their own records in their bedroom so they could see them at any time. The home should help residents to find an independent advocate if they need one to fill in forms. The home could help residents get in touch with people who could help them look for jobs. The home should help residents to put their names on the electoral register. This means that they would be able to vote at election times. There should be a telephone that people can take into their own bedrooms so that they can make and receive calls in private. The Expert by Experience said areas for improvement are : - Residents could be more independent and some of the younger ones were helping the staff looking after the other residents. Some people could help by learning to cook. -There are no male staff. -Some of the younger residents had their own mobile phones but there was not any private phones to use. One person had a visual impairment and could only use a large button phone to communicate. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 7 -One young man liked rave and techno music and could be supported to attend these techno music events. There are some things wrong with the house that have been fixed once but are still broken, and the Provider now needs to put them right. These are: a broken toilet makes a lot of noise in one persons bedroom; the kitchen wall needs to be plastered; the damp walls and broken grab rail needs to be fixed in the disabled toilet; and the dishwasher needs to be fixed. 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. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 8 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 Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 9 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): 2 and 5. Quality in this area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents individual needs were comprehensively assessed before moving to the home to ensure that their needs could be met. Each resident has a clear contract that explains the terms and conditions of their residence. EVIDENCE: The home opened about 3 years ago, and the most recent resident moved in about one year ago. All the residents individual placements were agreed following multi-disciplinary assessments. These involved a range of health and social care professionals, the potential resident and their relatives or representatives. In this way the home ensured that only people whose needs can be met move into Glenbrooke House. It is good practice that the home acknowledges any change in needs of the people who live here. The home holds on-going reviews, with other professional where necessary, to ensure that it can continue to support any change in a residents needs. Each resident has a Residents Contract which outlines the terms and conditions of their residence at Glenbrooke. It also includes the individual level of fees that they pay. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 10 The contract is written in plain language and large print, with some pictorial information, to support the communication skills of the people who live here. The contract has also been verbally explained to one resident with a visual impairment. In this way the home helps residents to understand their rights and responsibilities. The contracts have been dated and signed, and are kept in residents files which they can access, with support, if they request. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 11 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 and 9 Quality in this area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents are included in their own care planning and their individual goals are outlined in a support plan. Residents have good opportunities to make decisions about their lifestyle, with support. Residents are supported to take responsible risks as part of a fulfilling lifestyle. EVIDENCE: Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 12 There are support plans in place for each resident. These include very good details of each residents needs and goals. The support plans clearly guide staff as to how and when to support each person with their needs and goals. Each goal includes some relevant pictures or symbols to help residents understand their own records. Goals include support to read mail due to visual impairment, and support to be safe when out in the community. One person can exhibit behavioural needs but there are no specific guidelines for staff about how to support the person at those times. In this way, it is possible that different staff are supporting them in different ways, and this could be confusing and could escalate the situation for the resident. Support plans are evaluated by staff every month, to check any progress or change in needs. In the sample examined most records were up to date, but one persons goals had not been evaluated at all. Support plans have been signed by residents to show that they have been included in their own care planning. Some people have the literacy skills and the physical ability to access their records, which are kept in the third floor office. Other people could only access them if staff promote this. Most of the people who live here would not initiate a request to see their support plans. It is possible that some people could keep their own support plans in their own bedrooms. In this way residents would have more ownership of their own support plans. The Manger agreed that this is a potential area for future development. From discussions and observations it is clear that the residents are involved in making their own daily decisions such as their individual appearance, what activities to take part in, and how to spend their day. It was clear from records of individual review meetings that each resident is also involved in making longer term decisions, such as where to go on holiday. The Expert by Experience reported that that staff gave service users choices. And they had an opportunity to try new things. The residents can choose their own holidays and choose where they would like to go. At this time there are no advocacy services available to support individual residents in the long term. However it may be that the home could contact advocacy services for residents at times when they require independent assistance to make decisions e.g. reviews, and completing questionnaires. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 13 There are limitation of right records that acknowledge when the potential risks to a resident sometimes limit their rights. For example, one resident does not keep a key to his own bedroom, due to his disability, as there is a risk that he might give it away to a stranger. Some of the daily routines and activities that residents choose can involve a possible risk, for example going out independently. There are risk assessments in place about these activities that help the home determine whether the risk is acceptable and whether there are steps staff can take to support the risk. For example one risk assessment relates to a resident who goes cycling alone but who may not fully appreciate the traffic dangers. The risk assessment indicates that the risk would be reduced if he attended a cycling safety training course. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 14 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): 12, 13, 15, 16, and 17 Quality in this area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents are supported to take part in appropriate activities. Residents are supported to maintain contact with family and friends, although the homes telephone does not currently enable residents to make calls in private. Residents are fully involved in menus and mealtimes and enjoy a healthy, nutritious diet. EVIDENCE: Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 15 At this time 7 residents have structured daytime occupations for around 3-4 days a week. These include long-standing attendance at day centres and social clubs. One young person has an individual support worker, funded by Social Services Department, for 4 hours a day between Monday and Friday to engage in community activities. The remaining 3 residents do not have structured occupations. Two are able to go out independently and tend to spend their day as they choose. The third resident goes out with staff and visits a relative once a week. This person said that sometimes there are not enough activities to do. One person has paid employment for one day a week, and it was clear from discussions that he finds this fulfilling and feels valued. It is possible that other people could have the capability to manage employment or voluntary work, but have not had the chance to try. In this area, residents have not been able to broaden their opportunities for development. All of the people who live here have contact with relatives and friends outside of the home. There are regular visits by relatives to the home, as on this day, and several residents have visits to the family home. Residents also meet up with their own friends at social events outside the home. Relatives who took part in the discussions and in comment cards said that they are satisfied with the service provided at Glenbrooke House. One relative said, My (relative) seems very settled at Glenbrooke. Another relative said, My (relative) is very happy here. (They) have come on leaps and bounds since moving here. Four residents have mobile phone so that they can make and receive calls from family and friends when in or out of the home. However other residents do not have this facility. The homes pay telephone is sited in the main hallway so does not allow for privacy when residents are making calls. The Expert by Experience reported that some of the younger residents had their own mobile phones but there was not any private phones to use. One person had a visual impairment and could only use a large button phone to communicate. The people who live here make very good use of the nearby local community facilities, including banks, shops, pubs, local transport, library, cafes and takeaways. The home is also just a short bus ride away from the Metro Centre. The Expert by Experience reported that one young man liked rave and techno music and could be supported to attend these techno music events. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 16 At this time none of the residents are on the electoral register, so are not able to vote in elections. In this way their civic rights are not upheld. Residents rights and responsibilities are promoted within the home. Most people have a key to their room and all can use their own rooms for privacy whenever they want. Residents confirmed that they receive their own mail unopened and are only supported to read it if they request that support. Residents have meetings where they comment on the running of their home. One resident organises the meetings and takes the minutes. They have recently devised a list of chores so that everyone has equal turns at washing up, setting tables and other household tasks. The Expert by Experience also reported that they had a dog at the home that all the residents had chosen for the home. They also took it in turns to look after the dog. Meals and mealtimes are very flexible as different people are in or out of the home at different times. There is a more structured menu for evening meals when most residents and staff are in. The evening meal menus are devised using residents suggestions and known preferences, as well as being healthy and nutritious. At other mealtimes and for snacks residents choose their own individual preferences at that time. Residents also enjoy a Saturday take-away and occasional meals out. All residents are involved in grocery shopping for the home. All are involved in some way in meal preparation with support from staff where necessary. Some people can make their own drinks independently, and one person said they would like to be more involved in making their own breakfast. The Expert by Experience reported that residents could be more independent and some of the younger ones were helping the staff looking after the other residents. Some people could help by learning to cook. The Expert by Experience found there were choices at meal times and they had their own menu to look at and choose what they wanted to have. The Expert by Experience enjoyed the food they had. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 17 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 and 20. Quality in this area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents receive personal support in the right way. Residents physical and emotional health care needs are met by the appropriate health care services. Residents are protected by the homes medication procedures. EVIDENCE: Most of the people who live here can manage their own personal care, with prompts and guidance from staff. Three people need physical support with their personal care because of their physical disabilities. Support is provided by female staff (there are currently no male staff). All residents have very individual styles and all choose their own appearance, clothes, and hairstyles. All the residents have their own GP and are supported by staff to use local community health care services. Some people also have the input of Occupational Therapy services, which assess and supply equipment to support of their physical disabilities. Some people have the input of clinical psychiatry or psychology services to support their emotional needs. Two residents have the input of Speech therapist to support their communication needs. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 18 Health care records demonstrate that home staff ensure that residents have access to the right health care services when required. At this time none of the residents feel confident to manage their own medication. One person had tried to in the past but became anxious about this responsibility and asked that staff manage this for him. However it is possible that, with lots of support, in time some people could manage parts of their medication independently. The home uses a Monitored Dosage System to manage the medication on behalf of residents. Medication is securely stored within the home. Only designated senior staff, who have had suitable training, are responsible for administering medication. Records of medication were up to date. At this time some residents are not prescribed painkillers, and there are no consent forms from their GP for staff to administer over-the- counter medication. This means that if those residents developed a pain or cold, the home would have to contact a GP. In this way, those residents may have to wait some considerable time for a simple medication. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 19 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 and 23. Quality in this area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents, and their relatives, know how to make a complaint. Residents are protected from potential abuse by the homes procedures and staff training. EVIDENCE: The people who live here have information about how to make a complaint, which is kept in their files. One person with a visual impairment has the information on cassette tape so that they can listen to it independently. It was clear from the minutes of Residents Meeting that the people who live here are periodically asked if they have any concerns or complaints. In the 10 residents responses to the questionnaire, all said that they knew who to tell if they were unhappy. In the 5 comment cards received from relatives, 4 stated that they were aware of the homes complaints procedure. There have been 4 complaints made on behalf of residents since the last inspection. Three of these concerned bedroom temperatures, sometimes too cold and sometimes too hot. The Manager confirmed that there are occasional problems with the heating system in this large house. The home has adopted the Gateshead Council POVA (Protection of Vulnerable Adults) policy and procedures. These are robust procedures for dealing with suspected abuse within all adult care services in the borough. The Manager is familiar with her responsibilities within these procedures, and most staff have had training in this area. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 20 Following a recent dismissal of a staff, all staff are to have retraining in POVA so that they are very clear about their duty of care to report any poor practice. The Manager stated that there are no occasions where staff at the home would carry out physical interventions, and such support is not necessary for the current resident group. The home supports and encourages residents to manage their own monies wherever capabilities allow. One person manages all his own financial affairs, with guidance if he requests it. Three other people manage their own monies when out of the house, but request that the home securely stores it when they are in the house. It is good practice that all residents have their benefits directly debited into their own individual bank accounts, and are supported to withdraw their own money. Residents pay rent, which is their contribution to the weekly fee, which is determined by Social Services Department calculation of their income. They each receive a receipt for their rent. Receipts of all transactions made by residents (with staff support) are kept in their individual financial records. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 21 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): Quality in this area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The homes premises are suitable for its stated purpose and provide good quality, comfortable and homely accommodation for the residents. However premises shortfalls are not quickly addressed. The home is clean and hygienic. EVIDENCE: Overall the standard of decoration and furnishings is of good quality at Glenbrooke. The accommodation is warm, comfortable and suited to the lifestyle of the people who live here. It is a large detached Victorian building but has been converted to feel like a cosy family house. The Expert by Experience reported that the environment was accessible, clean and welcoming. The building was homely and comfortable. The residents were able to have privacy as they had their own private rooms. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 22 A sample of the building was inspected and a few premises defects were noted during this visit. In one residents en-suite the toilet cistern is overworking and is very noisy all the time. This must be disturbing for the resident, especially at night. The Manager stated that a plumber had already been to look at this, but the problem persists. In another residents room the ceiling is damp. The flooring to the bathroom above has been resealed but the bedroom ceiling is still damp. The disabled WC on the ground floor is out of use because the walls are damp and the grab rail has come off the wall. The Manager stated that this has already been addressed once but the problems have re-occurred. Since the last inspection a new kitchen has been fitted but one wall has been left in a poor state and is full of holes. Residents have been waiting 4 months for this wall to be replastered. This detracts from the otherwise good quality of accommodation. Several residents said that they like their rooms and that they can keep their own things private. Most people have a key to their own bedrooms and make use of their rooms whenever they want. All of the bedrooms have en-suite toilets and some have en-suite showers. The home has one domestic staff who helps to keep the home very clean. Residents are also involved in some household tasks. The home has a well equipped laundry on the lower ground floor. Not all residents can access this. Staff support residents with laundry. The new kitchen includes a dishwasher but this cannot be used because it is leaking. This means that all dishes are having to be washed at the washbasin. For residents safety the hot water is restricted to 43°C, which is not hot enough for the hygiene of dishes. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 23 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): 32, 34 and 35. Quality in this area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents are supported by trained, competent staff. Staffing levels are enough to meet the current needs of the people who live here. The recruitment processes protect the people who live here. It is good that residents can be involved in the selection of new staff. Staff have good training and development opportunities. EVIDENCE: The staff team comprises the Manager, 2 Team Leaders, 8 support staff and one housekeeping staff. There are currently 2 vacant support staff posts. There is a good mix of age and experience amongst this small staff team. The Manager acknowledged that it would be beneficial to have some male staff, but that care posts typically attract female applicants. At this time 3 staff have attained NVQ level 3, and 4 have completed NVQ level 2. In this way over 50 of the staff team have a care qualification, and more staff are to complete this in the future. The staffing levels are sufficient to meet the number and needs of the people who live here. The Manager and a minimum of 3 support staff are on duty Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 24 through the day (8am-8pm). There are 4 staff on duty through the day at week-ends. There are 2 support staff through the evening and night (8pm8am). The staff are commended for being flexible to allow residents to attend planned late evening social events, for example concerts at the Arena. The Expert by Experience reported that the staff were friendly, sociable and had good communication with each other and with residents. There has been a low staff turnover, which means that there is good continuity of care for the people who live here. At this time there is one vacancy for a daytime support staff, and these hours are being covered by existing staff. The homes recruitment and selection policies are robust. However the Manager was reminded of the procedure for appointing staff in exceptional circumstances whilst awaiting their CRB disclosure. The home is also reminded that it is the Providers responsibility to refer unsuitable staff to the POVA register. The Expert by Experience reported that it is an area of strength that some of the residents can help to interview new staff. The home uses a number of different training agencies to provide suitable training for staff. There are individual training and development plans in place for each member of staff. It was clear from discussions with staff that they are enthusiastic about training and developing their careers within social care. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 25 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, 39 and 42. Quality in this area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents benefit from a well managed service. Residents views are used to design the service. Residents health and safety is promoted and protected. EVIDENCE: The Manager has many years experience within heath and social care services for people with a learning disability. She has attained suitable care and management qualifications for this role. She has been responsible for the management of this home since it began operating 3 years ago. The home uses a number of evaluative tools to monitor and review the management of the service provided at Glenbrooke House. These include formal monthly visits by a representative of the Provider; premises audits; and complaints. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 26 The home also seeks the views of residents in order to review the service it provides to them, through Residents Meetings, individual care reviews and occasional pictorial questionnaires. At this time some people cannot complete questionnaires without assistance and not all residents have independent advocates to support them with this. Staff received training in all health and safety matters, and the areas of the home that were examined were safe for use by the people who live here. All records of health and safety checks were up to date. Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 27 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 3 3 X 4 X 5 3 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 2 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 X 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 2 14 X 15 X 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 Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 28 YES 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. YA24 No. 1. Standard YA13 Regulation 12(4)b Requirement The home must ensure that residents are included on the electoral register so that their right to vote is upheld. The home must ensure that residents can make and receive telephone calls in private. (Previous timescale of 25/12/05 not met.) The provision made must be accessible to people with a visual impairment. The wall in the kitchen must be replastered and made good. The home must ensure that the toilet to one bedroom is fixed so that it does not disturb the resident who pays for this room. The damp ceiling in one residents bedroom must be fixed. The damp walls and grab rails to the disabled WC on the ground floor must be made good. The dishwasher must be fixed so that dishes are washed at hygienically high temperatures. The Provider must contact CSCI for approval of the exceptional DS0000047308.V313523.R01.S.doc Timescale for action 01/01/07 2. YA13 16(2)b 01/01/07 3. 4. YA24 YA24 23(2)(b) 23(2)(c) 01/01/07 01/01/07 5. 6. 7. 8. YA24 YA24 YA30 YA34 23(2)(b) 23(2)(b) & (j) 23(2)(c) 19(1)(b) Schedule 01/01/07 01/01/07 01/01/07 01/01/07 Glenbrooke House Version 5.2 Page 29 2 (7) circumstances when appointing staff with a POVAFirst check whilst awaiting a CRB response. 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. 2. 3. 4. Refer to Standard YA7 YA7 YA12 YA20 Good Practice Recommendations There should be behavioural guidelines in place to guide staff to provide consistent, de-escalating support to residents during behavioural episodes. Consideration should be given keeping support plans in residents own bedrooms for their own access where this would be acceptable to them. Residents should be supported to have the opportunity to consider occupational employment, whether paid or voluntary. The home should contact individual residents GPs about consent for the use of over-the-counter medications and/or having painkillers prescribed to them so that they do not have to wait for such medication when it is needed. The arrangements for all staff to have retraining in POVA should take place, and staff should be periodically reminded of their duty of care to report poor practice (e.g. at staff meetings and individual supervisions). The home should support residents to access independent advocates when completing questionnaires. 5. YA23 6. YA39 Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Glenbrooke House DS0000047308.V313523.R01.S.doc Version 5.2 Page 31 - 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!