Inspection on 21/11/07 for Glendale

This inspection was carried out on 21st November 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Glendale 06/03/07

Glendale 24/11/05

Glendale 09/05/05

Glendale 01/12/04

Glendale 30/06/04

Glendale 13/01/04

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

CARE HOME ADULTS 18-65 Glendale 138 Stockton Road Hartlepool TS25 5AX Lead Inspector Tanya Newton Unannounced Inspection 21st November 2007 1:15 Glendale DS0000021746.V354527.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 Glendale DS0000021746.V354527.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. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glendale Address 138 Stockton Road Hartlepool TS25 5AX 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) 01429 271366 P/F londonroad@tiscali.co.uk Milbury Care Services Ltd Sonia Morrell Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th March 2007 Brief Description of the Service: Glendale is a detached bungalow set in its own large gardens in a residential district close to the centre of Hartlepool. The property blends in well with other houses in the area. The home is registered to provide residential care and support for up to 4 people with a learning disability. Accommodation is provided in single bedrooms. From information provided by the home, the current scale of charges ranges from £900 to £1500 per week. Additional charges, between £8 (if service users receive lower rate Disability Living Allowance benefit) and £25 (if service users receive higher rate Disability Living Allowance benefit) per week are made as a contribution towards the home’s wheelchair adapted minibus. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over four hours. The inspector spent time with two staff and the manager and observed interaction between people living and working at the home. Prior to the inspection the home had completed a selfassessment document, which provided the Commission for Social Care Inspection (CSCI) with information to aid the inspection. Comments from people consulted during the inspection are included throughout the report. What the service does well: What has improved since the last inspection? What they could do better: An up to date electrical wiring certificate is required and the carpet in the lounge and hallway needs replacing as it is very worn looking. A relative has complained about this. Fitting gates and additional lighting outside should Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 6 improve the homes security. The manager has been advised to seek additional support when decisions are being made for people who are unable to consent. Two requirements and two recommendations have been made as a result of this report. These are listed on page 25. 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. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 5 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Admissions to the home are well managed. EVIDENCE: Glendale is registered to accommodate up to 4 people with learning disabilities. There are no vacancies. The 4 people who live at Glendale have been there since the home opened approximately 7 years ago. The inspector was unable to communicate with the 4 people who live at Glendale about their experience of moving in to the home. However, appropriate assessments were conducted. The home has its own assessment and care planning documents for this purpose. Copies of assessment documentation, care plans and other relevant information from the local authority social services department and health professionals, confirm that people’s care needs are regularly reviewed. Although there are no vacancies, any person considering a move to Glendale would be welcome to visit with relatives, have a meal and stay overnight if necessary. In this way they could get to know the home before moving in. Any Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 9 move into Glendale would be on a six-week trial basis. At the six-week stage a formal review meeting would be held to consider permanency. Glendale has a Statement of Purpose and a Service Users’ Guide to provide people with information about the home. These documents have been produced in easy to read, pictorial formats and with photographs. Staff had also made a DVD film about the home. The home’s activity in this area is commended. Contracts have been updated to reflect fees and any additional payments required. For example, additional charges made for use of the home’s transport - £8 per week for people on Lower Rate Disability Living Allowance (DLA) and £25 per week for those on the Higher Rate of DLA. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People’s needs are met. They are offered choice and any decision-making is appropriately supported. EVIDENCE: From observations made during the inspection, within the limits of their communication and understanding, the people living within Glendale are offered choices. On the day of the inspection everyone living at Glendale had been out to collect his or her money and to return medication to the pharmacy. A choice of food was offered to people on their return. Care plans have been prepared for each person living within Glendale and these documents contain detailed information. Likes, dislikes and lifestyle preferences are recorded. Care plans were very person centred and contained pictures and photos to make them more accessible to people living at the home. Since admission, care reviews have been regularly held. Risk Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 11 assessments have also been prepared and risk management arrangements ensure that people can live as independent a lifestyle as possible. Day-to-day communication within Glendale ensures that any changes in need are identified and brought to the attention of other staff. To enhance this communication, and provide an additional forum to consider care planning arrangements and any other issues in the home, house meetings are also held. Where people lack capacity to make decisions the manager should access the appropriate support i.e. from next of kin or through the individuals care manager. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Appropriate activities are arranged. People live as part of the local community and have their rights supported. Contact with family / friends is encouraged. Dietary needs are met. EVIDENCE: Activities are arranged and records are kept to evaluate them. Although there is a list of activities planned, this is not rigidly adhered to. This enables staff to be flexible to people’s needs and wishes. Since the last inspection of Glendale, people have enjoyed holidays to Lourdes, Blackpool and Majorca. Staff said, “There are lots of social activities, recently an air show, trips out and activities to improve communication”. One staff member said “I play guitar to the people living here”. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 13 Wherever possible, contact with family and friends is supported. Relatives provided positive feedback, which included “ We are very happy with the care at Glendale, our relative is looked after and is very settled”. People’s rights are upheld. All four people living at Glendale are able to attend church regularly. Responsibilities are also recognised. As part of their care planning arrangements, bedroom management is diarised – with appropriate support provided by staff where required. A wholesome and nutritious diet is provided. Menus are available in pictorial formats to encourage choice. Fresh fruit was seen to be available. Where people require assistance with dining it is provided in a sensitive and dignified manner. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People’s personal, emotional and healthcare needs are appropriately met. Any medicines required are dealt with correctly. EVIDENCE: Although the inspector was unable to communicate with people living at the home to any significant degree, the inspector spent time in their company. The people accommodated have a high level of care needs. They appeared to be well cared for and comfortable in their home. The people who live at Glendale are on the whole dependent upon staff and others to make choices and decisions on their behalf and best interests. However, within the limits of their communication and understanding, people’s individual preferences are accommodated. From discussions with management and staff, where personal support is required it is provided appropriately. Care plans show that wherever possible, people are provided with guidance and encouragement to undertake their own Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 15 self-care tasks, thus promoting independence in a dignified and respectful manner. Care plans in the home are detailed and well written. They are easy to read and make good use of pictures and photographs as an aid to understanding. They document people’s emotional, personal and health care needs and the actions required and being taken to meet them. Care plans are thus a record of the care provided, but are also informing the delivery of care within the home. Care plans incorporate principles of ‘Person Centred Care’. Goals and objectives are included. Copies of assessment documentation, care plans and other relevant information from the local authority social services department and health professionals, confirm that people’s care needs are regularly reviewed. One-person accommodated is supported to ‘self-medicate’ and take any medicines he needs. Although none of the other service users retain, control or administer their own medication, because of their needs and dependency this is considered appropriate. Appropriately trained senior support workers administer medication in the home. Other staff had also received instruction to understand the medicines prescribed, potential side effects etc. There are adequate policies and procedures in place relating to the receipt, recording, storage handling, administration and disposal of medicines. The home uses a monitored dosage system. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Complaints and adult protection procedures are available in the home to safeguard service users and support staff. EVIDENCE: The home has detailed complaints and adult protection procedures. Copies of these are available for staff use. Information about complaints, how and who to make them to, is also provided in the home’s ‘Service Users Guide’. The home also has ‘I’m Worried Please Contact Me’ cards for people to contact senior managers. Any complaints or concerns are appropriately managed. Policy and procedure documents relating to adult protection provide information and guidance to staff. Staff interviewed voiced a commitment to the people they work with and to upholding people’s rights. Nearly all staff had NVQ’s (National Vocational Qualifications) and had attended POVA (Protection of Vulnerable Adults) training. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Glendale is a homely environment for people to live. Some maintenance issues are required to improve the premises for people living at the home. EVIDENCE: Glendale is a large detached bungalow set in substantial gardens in a residential area close to the centre of Hartlepool. The property blends in well with other houses in the road. The home is registered to provide care and accommodation for up to 4 adults who have learning disabilities, in four single bedrooms. The property was purchased and converted about 7 years ago and is in generally good order. Glendale has a homely environment. Most areas have been redecorated by the home’s own staff. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 18 The inspector had a look around the property, which was found to be clean, tidy and generally free from odour. Each person living at Glendale has their own bedroom, which has been individually furnished and decorated to reflect their personal styles. Bedrooms and communal living areas are spacious. However, the carpet in the main lounge and hallway needs to be replaced. It looks tired and worn and contains odours in some areas. It was cleaned following the requirement in the last inspection report, but now requires replacement. Bathroom facilities have been redesigned to meet the needs of the people accommodated and to allow staff sufficient access to provide assistance. These are much improved. The home has a shared lounge and a large kitchen/dining area, which everyone is able to access. There are large gardens to the front and rear. The home would benefit from additional lighting and gates to the front and sides of the property to improve security. The roof is also in need of some repair. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 People who use the service experience excellent quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The home has a settled, well-trained and well-led staff team. Recruitment procedures are satisfactory and high standards of staff training are provided. EVIDENCE: A committed, well-trained staff team provide care to people living at Glendale. Many of the staff have worked at the home for a number of years and know the people living there well. There is a high commitment within the home to staff training, all staff complete mandatory training in first aid, food hygiene, manual handling, fire and POVA (Protection of Vulnerable Adults). Additional training on dementia and autism has also been arranged. Virtually all staff (90 ) had an NVQ (National Vocational Qualifications) at level 2 or 3. Most staff had also completed LDAF (Learning Disability Award Framework) training courses. Activity in this area is commended. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 20 Staff said that they enjoyed working at the home and that morale was high. Some of their comments included “We work as a team, everyone gets on well” and “I have lots of job satisfaction, people here are well cared for and we have seen their development, staffing levels allow time for people both on their own and in a group”. Recruitment procedures are considered to be satisfactory and safe. Appropriate references are obtained and CRB (Criminal Records Bureau) disclosure checks are carried out. Due to the needs of the people accommodated, the agreed staffing levels for the home require 2 staff to be on duty throughout the waking day, with an additional member of staff when outside activities demand. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The home is well managed with clear quality assurance systems in place. The home needs to gain an electrical wiring certificate to safeguard people living and working at the home. EVIDENCE: The home’s manager has an NVQ (National Vocational Qualification) level 4 in care and also has a Registered Managers Award qualification. She provides sound leadership to the home’s staff team. Staff interviewed spoke of good communication, effective teamwork and significant improvements since she became manager. One member of staff interviewed said, “Sonia is a very good manager”. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 22 Procedures are in place to ensure that people’s health and safety is protected. For example, risk assessments relating to activities outside the home are appropriately carried out. The electrical wiring certificate dated February 2006 states unsatisfactory. A completion certificate is required to show that the issues raised within this report have been addressed. Milbury Care Services Limited has policies, procedures and systems relating to quality assurance. Regular audit checks are undertaken and forwarded to the regional office. Monthly visits and reports required under Regulation 26 of the Care Homes Regulations 2001 are completed and detail the action needed and being take to address any shortfalls in the home. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 4 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 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 2 X Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA30 Regulation 23 Requirement The carpet in the main lounge and hallway needs to be replaced. The home must ensure that there is a current up to date electrical wiring certificate in place. Timescale for action 31/03/08 2. YA42 23 15/01/08 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 YA9 YA24 Good Practice Recommendations The manager should gain additional support from others where decisions are required for people who lack capacity to consent. The home should improve security within the grounds by fitting gates and outside lighting to the front and side of the property. Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB 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 Glendale DS0000021746.V354527.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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