CARE HOMES FOR OLDER PEOPLE
Glendale Court Third Drive Landscore Road Teignmouth TQ14 9JT Lead Inspector
Peter Wood Announced 6th September 2005 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 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. Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service Glendale Court Address Third Drive Landscore Road Teignmouth Devon TQ14 9JT 01626 774229 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) gloria.taylor@btbroadband.com Mrs G Taylor Mrs G Taylor Care Home 24 Category(ies) of OP - 24 registration, with number of places Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 08/02/05 Brief Description of the Service: Glendale Court is registered as a Care Home providing Personal Care for twenty-four elderly service users who need care by reason of old age, in the category of OP. The home is a detached property in a quiet residential area of Teignmouth, is well kept and managed and is sufficiently adapted and equipped to meet the needs of its service users, most of whom are comparatively less dependent than many service users in other care homes. Most service users have ensuite single bedrooms, while the public rooms include a dining room, lounge, atrium and sun lounge. Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was announced and took place over one day in September 2005. A pre inspection questionnaire had been completed by the owners of the home. The initial part of the inspection was spent with the owners and manager discussing changes since the previous inspection. A sample of documentation, particularly in relation to resident assessment, care planning and implementation, and regarding health and safety aspects was examined. Lunch was taken with the residents and virtually every resident was consulted for their views of their experience of living at this home, mostly in the privacy of their own rooms. Surprisingly, none of the comment cards (from residents, relatives or other visitors to the home) have yet been received at the Commission’s office. The owners, manager, staff and residents of the home assisted throughout the inspection. What the service does well: What has improved since the last inspection?
The owners have continued to upgrade the fabric and facilities of the house. The most recent example is the extension to the front of house, incorporating an improved ramp, enclosed porch and new office. A bath lift to the second floor bathroom has been provided, as has a new set of French doors, new washing machine and tumble dryer. Each of these enhances facilities for the residents. Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 6 Good systems for admission allow service users and their relatives to be confident that their needs can be met. The home meets residents’ needs flexibly within the resources of the Home. EVIDENCE: Glendale Court has a good Service Users’ Guide and a Statement of Purpose, so that prospective residents and their relatives know what the home offers. The owner or manager undertakes an assessment prior to a resident’s admission by visiting the prospective resident at his or her own home or hospital. This is followed by good assessments that generate quite comprehensive care plans. This ensures that the home admits residents only when they are confident that they can meet their needs. The home does not offer intermediate care. Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 Service users health, personal and social care needs are being met and service users are treated respectfully. The home’s practices relating to medication administration protect the service users from risk. EVIDENCE: Arrangements are in place for meeting the personal and health care needs of the service users. The home uses professionally produced assessment and care planning documentation to include all the items in the standards. Brief recording of the implementation of the care plans is written on individual sheets relating to individual residents placed in a ring binder which replaced the Day Book, though the Night Book is retained as an efficient communication tool between staff. However, that book necessarily records information, on the same page, about several residents, some of which is of a confidential and sometimes personal nature. This may infringe the Data Protection Act and is not best practice. It would be good practice to phase out the use of the Night Book just as the Day Book has been replaced. The Home has a robust procedure in place for the administration of medication. Residents were observed to be, and reported that they were, treated with respect by staff. Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 Page 10 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 standard(s) 12, 13, 14 and 15 Social activities are managed well and provide daily interest for the service users. Meals are nutritious and varied. EVIDENCE: The Home offers a good range of activities and residents confirmed that the daily routines were flexible to suit individuals needs. Those with relatives who lived locally enjoyed being visited and taken out by them, while the home offers some trips and outings into the local community. Visitors are made welcome at more or less any time. There is a good range of meals and choice is offered. The lunchtime meal taken in the pleasant dining room was attractive and nutritious. Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 Page 11 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 standard(s) 16, 17 and 18 Complaints and suggestions from service users, relatives or other visitors to the home, are treated seriously. Residents are listened to and issues resolved promptly. EVIDENCE: The home has a brief complaints procedure prominently displayed in the hall. In accordance with the standards the owners resolve issues before they become formal complaints. Previous discussions with the owners and staff evidence that they are aware of issues surrounding Adult Abuse leading to confidence that residents are safeguarded from abuse at this home. Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 Page 12 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 The residents live in a very pleasant, well-maintained home that is comfortable and provides sufficient facilities to meet their needs. EVIDENCE: The location and layout of the home is suitable for the client group. Two major extensions and many other alterations have improved the home. The most recent is the extension to the front of the property featuring an improved ramp to assist those with mobility difficulties, an office and a waiting area. All room sizes meet the revised National Minimum Standards. All hot water taps in the baths and wash hand basins are now thermostatically controlled to reduce the risk of scalds. All radiators have been assessed for the risk they may pose to scalding residents, and those considered at risk have been covered or otherwise made safe. The whole house was clean and free from offensive odours. Since the last inspection the provider has obtained a bath lift to the second floor bathroom, anew washing machine and tumble dryer, enhancing the laundry service to residents.
Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 Residents are cared for by competent staff in sufficient numbers to meet the needs of those currently living in the home. Recruitment processes protect vulnerable service users. EVIDENCE: The home has staff in sufficient numbers and competence by reason of experience and in-house training, under the personal supervision of an owner, a nurse by profession. In-house training over the past twelve months has included Fire training, manual handling and first aid. The home’s recruitment procedure is designed to ensure that all checks are completed for new staff prior to them commencing employment, to make sure that only bone fide staff are employed at the home. New staff are thoroughly monitored initially to ensure that they are suited to the caring task, and leave quickly if they are not. Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, 37 and 38 Service users live in a well managed home. The owners and their staff team strive to provide a stimulating, safe environment that respects and protects service users’ rights. EVIDENCE: The owners are currently sufficiently qualified and experienced to operate the home professionally and for the wellbeing of service users. Mrs Taylor is a Registered General Nurse, has a diploma in Higher Education, including management and professional development, and is an NVQ Assessor. However, the National Minimum Standards require that registered managers (which includes owners who act in that capacity) achieve the new qualification of Registered Managers Award plus level 4 NVQ in care by the end of 2005. The owners need to obtain clarification from a competent training provider that Mrs Taylor’s current qualifications are acceptable equivalents to the RMA NVQ4, or obtains any necessary additional qualifications.
Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 Page 15 Care was being delivered in a dependable way, and safe systems of work were in place. Although all records inspected were in order, a recommendation is that the owners continue their review of documentation, taking into account issues such as data protection and privacy. An example where residents’ privacy could be enhanced, and greater compliance with the Data Protection Act assured, would be to mirror the previous revision of the day book by revising the current night book diary into separate sheets for individual residents, perhaps kept together within a ring binder, rather than as at present recording personal information of several residents on the same page. Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 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 Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 Page 17 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 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 31 Good Practice Recommendations The owners are recommended to obtain clarification that their current qualifications are acceptable equivalents to meet the standard which will become effective at the end of 2005 . It is recommended that the owners revise the current night book diary into separate sheets for individual residents to enhance their privacy. 2. 38 Glendale Court D54 D07 S3705 Glendale Court V239475 060905 Stage 4.doc Version 1.20 Page 18 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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