CARE HOMES FOR OLDER PEOPLE
Glencoe Nursing Home 23 Churchtown Road Gwithian Hayle Cornwall TR27 5BX Lead Inspector
Diana Penrose Announced Inspection 20th February 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 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 Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Glencoe Nursing Home Address 23 Churchtown Road Gwithian Hayle Cornwall TR27 5BX 01736 752216 01726 752216 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Alexandra Maggs Mrs Tracey Ann Brooking Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability (10), Terminally ill (5) of places Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. To admit one named person with a learning disability, which is outside of the home’s registered categories. 28th July 2005 Date of last inspection Brief Description of the Service: Glencoe is a Care Home providing accommodation, personal and nursing care for up to 20 older people. The home is situated on the edge of the village of Gwithian, near to the towns of Camborne and Hayle. It is set in its own grounds, with ample parking and is easily accessible by road. Accommodation is provided across two floors. The upper floor is accessible by lift. The environment is pleasant and homely, attractively decorated and very clean. There is ample communal space in addition to resident’s own bedrooms. Most of the bedrooms are single rooms. There are two double rooms. The Registered Provider is actively involved in the running of the home and spends three or four days each week at the home. The Registered Manager and staff present as competent, friendly and caring. Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspector visited Glencoe Nursing Home on the 20 February 2006 and spent five and a quarter hours at the home. This was an announced visit. The purpose of the inspection was to gain an update on the progress of compliance to requirements identified in the last inspection report dated 28.07.05. In addition the inspector focused on the following key areas of care: assessment and care planning, food, privacy, choice, adult protection, some of the environment, staffing, recruitment, training and quality assurance. On the day of inspection 20 residents were living in the home. The methods used to undertake the inspection were to meet with a number of residents, staff, the registered manager and the registered provider to gain their views on the services offered by Glencoe. Records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. What the service does well:
The home makes every effort to meet the requirements and recommendations set by the Commission for Social Care Inspection. The home provides a warm, clean, homely environment for residents and all those spoken with are happy with their surroundings. There is ample communal space and recent decoration has improved the appearance of the home. The Registered Manager visits prospective residents whenever possible prior to admission. She undertakes an assessment to make sure the home can meet the needs of the person before making any decision to admit them to the home. She gets as much information as possible and contacts the family, Social Services, GP and Nurses as necessary. The assessment is recorded and used to produce a written plan of the care to be given to the resident. There is a new care planning system in place that is detailed to ensure staff know what is required to meet the residents needs and assessments are included to reduce any risks. Residents said they have been involved with the planning process. The plans are reviewed every month and any changes recorded. Daily records are kept for each resident and they are informative. Residents said their privacy and dignity are respected at all times and this was observed during the inspection. Residents control their lives for as long as they are able to do so, their individual preferences are respected and the routines of daily living are flexible. Residents said they get up and go to bed as they wish and residents were observed eating breakfast in the middle of the morning. Nutritional needs are assessed and a wholesome menu is on offer. There were no negative comments about the food and residents enjoyed an appetising
Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 6 lunch with little waste. The cooks are undertaking an NVQ in food preparation and said they have found it beneficial. Records are maintained as required and the last Environmental Health Officers report stated that excellent standards are maintained at the home. Staff are trained to recognise the signs of abuse and how to report incidents and allegations. There is an adult protection policy in place. All those spoken with feel there are sufficient staffing levels and that the care provided is to a high standard. All care staff will be qualified to at least NVQ level 2 in care by the end of March 2006, which is excellent. The recruitment system is robust and all relevant police checks are made. Staff have terms and conditions of employment and a relevant job description. New employees undertake an induction to the home. There is a training programme and a great deal of training takes place in the home. Quality assurance monitoring takes place annually and results have been positive. A very informative newsletter is produced monthly for staff and they are all encouraged to contribute to this. The home holds minimal money on behalf of residents; appropriate records are maintained and receipts are kept. What has improved since the last inspection?
The registered provider and registered manager aim to provide a high quality service and environment for residents and staff and have met all of the requirements and recommendations set at the last inspection. A great deal of decorating has taken place that has made the home brighter and fresher. Tasteful pictures have been provided in the corridors and communal areas along with good quality artificial plants, residents are very pleased with the changes made. New furniture has been provided in the lounges and a new cooker and additional fly screens in the kitchen. A curtain screen has been fitted in a double room to allow better privacy for residents. Two new bathroom suites have been installed and new flooring to all toilets. The laundry has been refurbished and now has a hot water supply for hand washing. Requirements made in respect of medications have been addressed and a new medicines trolley has been ordered. Care plans are reviewed monthly with the involvement of the resident and / or their representative. The adult protection policy and the training records have been updated. All residents are now registered at one GP surgery, with the consent of the residents and representatives. This has made it easier with communications and a Doctor visits the home every month, irrespective of other visits in between. New bed linen is to be provided and the registered provider was looking into this during the inspection. Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 7 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. Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 8 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 Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Residents are only admitted to the home following an assessment of their needs to ensure the home can provide adequate care. EVIDENCE: The Registered Manager explained the procedure for the initial assessment of prospective residents and completed assessment documents were inspected. New documentation is used and the Registered Manager added a section to record who is involved in the assessment, during the inspection. Information from Social Services and hospital staff is obtained and this process has improved. An individual plan of care is compiled from the initial assessment. Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 10 Individual care plans are generated for each resident that inform and direct the staff in their care provision. Systems are in place to ensure that residents are respected and their privacy is upheld at all times. EVIDENCE: Each resident has a written care plan, which is reviewed monthly. A new care planning system has been introduced that provides more information and direction for staff. Social, religious and cultural needs must be included and the Registered Manager agreed to do this forthwith. Risk assessments include Barthel scoring, Waterlow scoring, nutrition, moving and handling and falls. The care plans are compiled with the resident or representative and signed where possible. Daily records are maintained and the care staff record in these as well as the nurses. The documentation is comprehensive and informative. Residents said their privacy and dignity are respected at all times. Staff were observed to uphold resident’s privacy during the inspection and knocked on doors before entering. Appropriate screens are provided in the two shared rooms. There is a policy and privacy is acknowledged in the statement of purpose. Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 and 15 Residents are helped to maintain control over their lives and staff respect their individual preferences and choice. Dietary needs of residents are well catered for with a varied selection of food available that aims to meet their taste and preference. EVIDENCE: Residents can control their finances for as long as they wish and are able to do so. One resident said she controls her own money. There is a system for selfmedicating although no residents are doing so at present. Residents said they have control over their lives and their individual preferences and choice are respected. The routines of daily living are flexible. Residents have their own belongings around them and some have their own furniture. Nutritional needs are assessed and the speech and language therapist involved as necessary. A varied and wholesome menu is on offer with fresh fruit and vegetables provided. Homemade cakes are available every day and special occasions are catered for. All residents and visitors spoken with said the food provided is very good. The cooks are undertaking an NVQ in food preparation and said they have found it beneficial. Records are maintained as required and the last Environmental Health Officers report stated that excellent standards are maintained at the home. Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Arrangements are in place for the protection of residents safeguarding them from harm or abuse. EVIDENCE: The Registered Manager has attended an adult protection training course. She provides in house training with the use of a video and training pack. She has been trying to get staff onto the local adult protection training days. It is recommended that a copy of the local inter agency procedures be obtained. Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 and 26 The home and grounds are well maintained providing a safe environment for residents, staff and visitors. There is sufficient indoor and outdoor communal space for residents to be comfortable and choose where they would like to be. The home is clean and free from offensive odours making it a pleasant place to live in. EVIDENCE: The home is warm, homely and clean and the grounds are tidy. Recent decoration has improved the appearance of the home. There is sufficient communal space and new furniture has been supplied in the lounges. There is an outside patio with seating provided. The kitchen has a new cooker and fly screens have been fitted to the skylight. Some bedrooms have been redecorated along with the corridors. New pictures and good quality artificial plants have been included and the residents are pleased with the effect. The laundry is sufficient for residents needs and has recently been refurbished, a hot water supply for hand washing has been provided. The laundry floor has yet to be addressed. Hand-washing facilities in other areas of the home are satisfactory. There is an infection control policy and protective clothing is used.
Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 14 The carpet in communal toilets has been replaced with washable floor covering for infection control purposes; en suite toilets are to be addressed next. Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 Staffing levels meet the needs of residents and staff morale is good. Recruitment procedures are robust and offer protection to the residents. The home provides appropriate training for staff to help them be more competent in their roles. EVIDENCE: The Registered Manager said there are sufficient staffing levels to meet the resident’s needs. There is a qualified nurse on duty at all times and on average there are 3 carers in the mornings, 2 in the afternoons and 1 at night. There is an on-call system and extra staff are brought in if the need arises. Two new overseas staff are settling in and the home has no vacancies. Residents and visitors said they feel there are enough staff on duty, four visitors comment cards were received and all indicated that the staffing levels are satisfactory. Residents said the standards are high and that the Registered Manager is very approachable and has very good control of the home. Almost all care staff are qualified to at least NVQ level 2 in care. The Registered Manager said that by the end of March 2006 100 will be qualified and this is excellent. There is a robust recruitment system in place and the personnel files are neatly organised into sections. Three personnel files were inspected and all contained the relevant records and checks. Staff receive terms and conditions of employment and a job description. A training and development programme is being compiled. Records of training are maintained and copies of training certificates are kept in the personnel files. There is an induction programme for new employees that is
Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 16 comprehensive. It is recommended that a sheet be devised for the basic induction to the home. Statutory training takes place as required in house. Continence training took place when the new continence pad regime commenced and a dementia training day is being organised. Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 35 The home is run in the best interest of the residents and they benefit from the Quality Assurance systems in place. There is a suitable system in the home for dealing with residents’ money with safeguards in place to protect the residents’ financial interests. EVIDENCE: Quality assurance monitoring takes place annually with satisfaction questionnaires distributed to residents, relatives and GP’s. The results have been very encouraging. Four CSCI comment cards have been received from visitors and all have been positive. A staff newsletter is produced by the Registered Manager and distributed monthly, it is a very informative document and all staff are encouraged to contribute to it. There is a policy for resident’s finances. The home only holds money for two residents and appropriate records and receipts are kept. The registered provider checks the accounts periodically. One resident’s money was checked
Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 18 and found to be correct. The relatives are invoiced for any hairdressing or chiropody. Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 19 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 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 20 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. 1 Standard OP7 Regulation 15(1)(b) Requirement Social, religious and cultural needs must be included in the care plans Timescale for action 08/05/06 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 Refer to Standard OP18 OP30 Good Practice Recommendations A copy of the local inter agency adult protection procedures should be obtained A record sheet should be devised for the basic induction to the home. Glencoe Nursing Home DS0000061826.V281301.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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