Inspection on 31/07/07 for Glencoe Care Home

This inspection was carried out on 31st July 2007.

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 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

Glencoe Care Home 08/08/06

Glencoe Care Home 06/12/05

Glencoe Care Home 10/08/05

Glencoe Care Home 19/10/04

Glencoe Care Home 08/06/04

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

CARE HOMES FOR OLDER PEOPLE Glencoe Care Home 10-11 Chubb Hill Whitby North Yorkshire YO21 1JU Lead Inspector Pauline O`Rourke Unannounced Inspection 31st July 2007 09:30 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 Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glencoe Care Home Address 10-11 Chubb Hill Whitby North Yorkshire YO21 1JU 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) 01947 602944 Endeavour Care Ltd Mrs Linda Magill Care Home 19 Category(ies) of Dementia - over 65 years of age (19), Old age, registration, with number not falling within any other category (19) of places Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2006. Brief Description of the Service: Glencoe is registered to provide care and accommodation for up to 19 older people who may have dementia. The manager is Mrs Linda Magill and Endeavour Care Ltd owns it. It is an adapted property and is situated on three floors. There are thirteen single and three shared bedrooms, one of the single bedrooms has ensuite facilities. A passenger lift provides access to all floors. The dining room and two lounges are located on the ground floor. The home is located close to the town centre of Whitby and its leisure facilities and amenities. The premises a large detached house has newly provided off street parking for up to 4 cars at the front and a ramped patio area at the back of the house with a range of seating. Access to the front of the house is via a flight of steps. There is a newly constructed ramp to the side entrance to the home. The present fees range from £360 to £460 a week, the actual amount is dependent of a financial assessment. Additional charges are made for hairdressing, chiropody, toiletries, papers and magazines. The home provides beauty therapy, manicures and foot spa’s fee of charge. Information about the services provided are made available in the home’s Statement of Purpose, Service Users Guide and through published CSCI inspection reports available from the home and on the CSCI website www.CSCI.org.uk. Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection has used information from different sources to provide evidence for this report. These sources include: • • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on an Annual Quality Assurance Assessment Comment cards returned from people living at Glencoe, health and social care professionals and relatives. A visit to the home (carried out) by one inspector that lasted for six hours. A period of observation was carried out in line the Commissions Short Observational Framework Inspection, known as SOFI. This allowed the inspector to sit with the people in the home and monitor and record their interactions with staff, each other and visitors. During the visit to the home six people who live there, three staff and two visitors were spoken with. Care records relating to four people, four staff members and the management activities of the home were inspected. Care practices were observed, where appropriate, and time was also spent watching the general activity within the home. This enabled the inspector to gain an insight of what life is like at Glencoe for the people living there. Mrs Linda Magill the manager was available to assist throughout the visit and was available for feedback at the close. What the service does well: Glencoe is a homely and domestic environment for older people. People living in the home said that the manager is approachable and they had confidence that she would deal with any concerns they may have properly. Staff also said that the manager was approachable and supportive with their role. The staff seemed to work well together and on the whole dealt with people in a sensitive and respectful way. It was clear that there was good rapport between some of the people and the staff. Several people said that ‘the staff are friendly and kind’ ‘the girls will do any thing for you’. A relative said ‘the staff are always welcoming when we visit and mum always looks well cared for’. Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 6 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. Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, standard 6 does not apply. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who decide to use this service can be assured their needs will be met. EVIDENCE: The case files for four people were seen. They all contained assessment information and the manager said that she visits people before they are admitted. The manager is now using the assessment tool developed last year, this document should have more specific assessment information rather than general statements such as ‘needs help with personal care’. This assessment is in addition to the assessment carried out by a care manager. All the files contained a copy of the Service User Guide and these were individualised to each person so that they could operate as a Statement of Terms and Conditions. Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the care and support they need, although not always in a timely fashion. The staff provide support in a sensitive way that promotes the dignity of the people who live at Glencoe. EVIDENCE: The case files seen contained a care plan that was broken down in to the different elements such as, physical health, mobility nutritional profile, communication and memory orientation, plus other areas. There was a personal information sheet that gave a brief history of the person involved. The care plans are reviewed monthly by the manager in discussion with the key worker. Staff spoken with were knowledgeable about the plans and kept a daily record for each person. Where possible the person the plan is about is involved in the review and care planning process. There was a continence programme in place but one person who staff found difficult to help was left alone after being assisted to the toilet at 09:45, it was lunchtime before they were further assisted with their personal care. This meant this one person was Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 10 left in wet/damp clothing for sometime before they were made comfortable. Other people were helped by staff either on request or as part of the daily routine. Staff were transporting people on a bath chair this should not be used for everyday tasks around the home if people require the use of a wheelchair then one should be obtained for them. The bath chair has no footrests and so people are pulled backwards as going forwards would present a risk of people hurting their feet as they have to hold them off the floor. Evidence was also available in the file to show that people were accessing health services as required. A separate recording sheet is maintained for GP and district nurse visits, other health professional visits, such as the chiropodist, optician and dentist were also recorded. People who require intervention to prevent pressure sores developing have risk assessments in place, however there is a general use of pressure relief cushions in both lounges and it is recommended this is reviewed as the seats were seen to be occupied by different people at different times of the day. All of the plans contained a basic nutritional assessment and where necessary people had seen a dietician. There is a monitored dosage system for those service users who require medication. A medication round was observed and the procedure was properly followed. The administration records were found to be accurate and up to date. Medication is logged in and out of Glencoe so the quantity of medicines in the home at any time can be checked. All staff that handle the medication have received training through a Distance Learning Course in The safe handling of medicines. This training is further supplemented through supervision. A two-hour segment of the inspection was spent observing without interacting with staff or the people who live in the home. During this some of the time staff were observed treating people with respect and dignity. At other times they talked to people whilst standing at the other side of the room and on one occasion walked into the room and took hold of someone’s hand without speaking to them for a period of a few minutes. In the shared rooms screening is provided to ensure that people’s privacy is not compromised. People who could offer an opinion said that the ‘girls are very nice’ ‘they do anything for you’ Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to make choices on a daily basis and are supported to do this by the staff. They enjoy a varied diet and social and recreational activities that allows them to remain active within the home. EVIDENCE: People choose their own routine including what time they wish to get up and go to bed, what clothes to wear and what to do during the day. Activities are provided on daily basis and are planned with weather, available staffing and what people want to do. During the observation time several people were encouraged to play dominoes with a member of staff, whilst others were listening to music in one of the lounges. The people in the other lounge did not appear to be encouraged to take part in any activities and several spent most of the morning sleeping. Other activities available were puzzles, music, quizzes, health and beauty treatments and families are encouraged to participate in trips out. Visitors are welcome at anytime and a number of visitors were seen to come and go as they wished. The visitors spoken to stated that they were always Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 12 welcome and could see their relatives in private in their own room or one of the small lounges if they wished. Some visitors took their relatives out for the day. Visitors spoken with said that the “staff were always welcoming. They could have a drink with their relatives if they wished and that staff always kept them informed about their relatives”. A four-week menu is in place and this offers alternatives rather than a direct choice. As part of the admissions procedure people’s likes and dislikes are identified and these are incorporated in to the menu. Where information is not available from people in the home families are consulted. Snacks are available throughout the day and night and a high calorie diet is provided. There are no special diets provided at the moment although several people have a pureed diet. A discussion with the cook highlighted that current practice is to puree all the elements of the meal as one. He decided to try to puree the elements separately. This meant the meal was mush better presented and the different flavours could be experienced by the people who required this meal. The cook felt the trial had gone well and said he intended to continue producing this way. The meal observed was relaxed and unrushed. Staff took time to help people if they required it and people were able to come and go as they wished. Several people took their meals in the lounge. Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Glencoe and their representatives are able to express their concerns through the complaints procedure and are protected from abuse, so their rights are protected EVIDENCE: The service has a detailed complaints policy and recorded procedures to follow in the case of a complaint being raised. Since the last inspection a new concerns and complaints register has been established and any minor concern is recorded as is the resulting action taken. Visitors spoken with said if they had any concerns then they would be raised with the manager. One person spoken with felt the concern they had raised had not been dealt with in a professional manner although they were reluctant to take their concerns back to the manager. Staff were aware of the complaints procedure. An Adult protection protocol is in place and staff were aware of their responsibilities under this procedure. Staff have received training through National Vocational Qualification and the manager also reinforces the training in the staff meetings. Staff spoken with understood their responsibilities if they suspected any form of abuse or mistreatment of the residents. Staff are thoroughly checked prior to the commencement of their employment to ensure they are suitable to work with vulnerable adults. Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a warm, comfortable and safe environment. They cannot easily access their bedrooms, which, does not encourage their independence EVIDENCE: A short tour of the home was undertaken that showed as recorded in previous reports the environment of the home is good. Individual bedrooms were furnished by the occupant and represented. The shared rooms have screening to preserve peoples dignity when receiving assistance with their personal care. However in the main residents do not have access to their private accommodation throughout the day. Rooms are locked and can only be accessed with staff intervention. The case files seen did not show the reason for this being the case and there were no written risks assessments regarding this issue. Internally the home is in the process of some works to upgrade the décor. People were seen accessing all areas of the building downstairs. Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 15 The garden has been adapted to meet the needs of the people who live at the home and during the visit people were seen accessing this area with and without support form the staff. All areas of the home seen were clean and odour free. The laundry is situated in a separate building and is adequate for the level of laundry required. There are dedicate domestic staff and they clearly understood their role and said that they were supported by the manager if they required any equipment to do their job. Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff, that have been thoroughly vetted prior to the commencement of their employment, support people. They receive raining and are in sufficient numbers to provide the support required by the people in the home. EVIDENCE: At the time of the visit there was the manager, three care workers, two domestic staff, and a cook on duty. The staff team meets the needs of the people in residence. Staff spoken with said that there was enough staff on duty, and that they had time to spend with people particularly on an afternoon. The people in the home said ‘the staff are wonderful and will do anything for you’. The inspection process used observational ‘tools’ where a record is made of signs of ‘well being’ and ‘signs of ‘ill being’ in residents. These are used where reliable verbal feedback from residents cannot be obtained. The documents showed that in general there is a high degree of ‘well being’ in the home and this can at least in part, be attributed to the way staff interact with the people who live there. More than 50 of the staff have completed an National Vocational Qualifications level two in care, and several staff are in the process of completing the level three in care. The remaining staff are all registered on a National Vocational Qualification level two in care. Other training includes a Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 17 dementia care course, and mandatory course such as first aid, manual handling and fire safety. Three staff files were seen and these contained all the necessary preemployment checks along with evidence of supervision and appraisals. Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well managed and systems are in place to protect their health and safety. EVIDENCE: The registered manager is experienced in the care and management of older persons homes. She is in the process of completing the Level 4 NVQ in the management of care services. People spoken with during the visit said that the manager is always available if they want to speak to her and they have confidence in her ability to change things if they are not right. Staff also said that the manager was fair and operated an open door policy to all. The quality assurance systems are in place and the views of visitors/relatives and people who live in the home are sought and she is looking to include Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 19 visiting professionals. A discussion with the manager suggested they look at using pictorial questionnaires with the people in the home to try and elicit their opinion about life in the home. The provider visits monthly and completes a report this information is used in the quality assurance process. A quality assurance audit tool has been obtained and the manager is looking at how she can introduce this in to the home. When it is necessary people can leave their personal monies in the office safe. The records and cash held were checked and all tallied. Receipts are kept and the monies are checked on a weekly basis. The health and safety records were checked and all were found to be up to date. Risk assessments for fire, the environment, COSHH and people who live in the home. All accidents and incidents are recorded and when necessary they are reported to the Commission of Social Care Inspection. Whilst the accidents are reviewed on a regular basis it was suggested to the manager that they incorporate these in to the monthly reviews carried out. This might then show any patterns of incidents and allow staff to alter the care plan accordingly. Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP2 Good Practice Recommendations The assessments carried out by the manager should contain more detailed information about the individual looking to come in to Glencoe. So that the care staff can be properly informed of the level of support they require. Staff should stop moving people around the home on a bath chair. If people require a wheelchair then they should have their own. This preserves their dignity and is safer that using the bath chair. The manager should look at the general use of pressure relief cushions in the lounge area and ensure that those people who need them only use them. The manager should review the process of locking people’s rooms when they vacate it on a morning and where it is deemed necessary then a risk assessment should be carried out and placed in their case file. 2 OP7 3 OP8 4 OP19 Glencoe Care Home DS0000044875.V343628.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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