Inspection on 18/09/06 for Glendale Residential Home

This inspection was carried out on 18th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

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

CARE HOMES FOR OLDER PEOPLE Glendale Residential Home 14 Station Road Felsted Dunmow Essex CM6 3HB Lead Inspector Jane Greaves Final Key Unannounced Inspection 18th September 2006 09:40 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 Glendale Residential Home DS0000067783.V311998.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. Glendale Residential Home DS0000067783.V311998.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glendale Residential Home Address 14 Station Road Felsted Dunmow Essex CM6 3HB 01371 820453 01371 820453 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) The Oaks Residential Homes Ltd Mrs Julie Fitch Care Home 16 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (16) of places Glendale Residential Home DS0000067783.V311998.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 16 persons) One person, over the age of 65 years, who requires care by reason of dementia and whose name was made known to the Commission in July 2006 The total number of service users accommodated in the home must not exceed 16 persons 28th February 2006 Date of last inspection Brief Description of the Service: Glendale Residential Home is a large detached property situated in the village of Felsted in the county of Essex. The home is in keeping with the surrounding area and is close to the local amenities. The property has been registered as a care home since 1988 to provide personal care for 16 people over the age of 65. Service users are accommodated in 14 single rooms and there is one room available as a double if required. The service users bedrooms are situated on both floors of the home and there is a through the floor passenger lift to the first floor. The home presents itself as welcoming and clean with pleasantly decorated communal areas that are furnished to a good standard. To the outside of the property there is a well maintained and private rear garden laid to lawn with flower beds and mature trees and there is a patio area central to the extended part of the premises. To the front of the home there is ample off street parking for several cars. A copy of the most recent inspection report issued by the Commission for Social Care Inspection was displayed on the notice board in the dining room. Fees charged for care and accommodation at Glendale Residential Home are £550 per week as at 18th September 2006. Not included in the fee are personal items such as chiropody (£10) hairdressing (£7 - £17) and toiletries. Glendale Residential Home DS0000067783.V311998.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection took place on 18th September 2006. 21 of the 38 National Minimum Standards and the intended outcomes of these were assessed at this visit and 17 were met. The inspection process included discussion with the residents, Registered Manager, the deputy manager, care workers, the cook, nine relatives and a visiting healthcare professional. A sample of staff and residents records, supporting documentation and other records required to be kept in the home was undertaken together with direct and indirect observation. This report has been written using accumulated evidence gathered prior to and during the inspection What the service does well: What has improved since the last inspection? What they could do better: Medication for one resident was stored in a cabinet in the en-suite facility; the residents’ health, safety and welfare would be better protected if the Glendale Residential Home DS0000067783.V311998.R01.S.doc Version 5.2 Page 6 medications were stored appropriately with regard to temperature and humidity Opportunities for staff training and development must continue to be encouraged, developing skills and awareness of staff in areas specific to service users needs. 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. Glendale Residential Home DS0000067783.V311998.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 Glendale Residential Home DS0000067783.V311998.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. No resident moved into the home without having had their needs assessed and being confident that these would be met. EVIDENCE: When a new resident was considering choosing Glendale Residential home as a potential domicile the registered manager ensured that every opportunity to sample the facilities and services provided was offered. Trial visits including overnight stays were offered to prospective residents. The manager and deputy manager undertook pre admission assessments of individuals’ needs and preferences before admitting them into the home; this assessment was undertaken with the assistance of the prospective resident and their family or representative. On the day of admission into the home a member of care staff was allocated to sit with the resident and their family/representative to expand on the information provided through the pre admission processes. At this point a ‘family history’ was completed to form a ‘pen picture’ of the resident’s past life and interests. Glendale Residential Home DS0000067783.V311998.R01.S.doc Version 5.2 Page 9 The registered manager reported that the care plan was developed from this pre admission assessment after a few days of the resident living at the home. Family members praised the home for the sympathetic manner in which the management and staff team provided and gleaned information throughout the assessment process. One visitor spoken with at this inspection site visit reported that “ the whole thing about placing a relative in a care home is traumatic and exhausting for all concerned, the team here made it comparatively easy and were incredibly supportive” Glendale Residential Home DS0000067783.V311998.R01.S.doc Version 5.2 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, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals’ care was delivered in accordance with the assessment of need and kept under review. EVIDENCE: Care plans contained detail of individuals’ healthcare needs and requirements with actions to be taken by the care staff to meet the identified needs. Goals were set with detail regarding the actions required to meet these. Visits from healthcare professionals were clearly documented. Some care plans sampled at this site visit did not contain evidence of family/representative involvement in care plan formulation or reviews however family members spoken with as part of this inspection confirmed that they were kept informed regarding any changes to their loved ones plan of care. It was reported that opportunities for exercise were regularly offered to the residents as part of the activities programme, some ladies took part in a ‘movement to music’ session during the morning of this visit. The registered manager reported a good relationship with the local GP surgery and the district nursing team. Glendale Residential Home DS0000067783.V311998.R01.S.doc Version 5.2 Page 11 Medication for one resident was stored in a cabinet in the ensuite bathroom. Advice sought from the Commission for Social Care Inspection pharmacist inspector stated that ‘a bathroom is far from an ideal place to store medication of any type due to usually high temperature and humidity’. All the staff team had received externally provided training in the safer handling and administration of medicines however the registered manager and care staff did not demonstrate a clear understanding of the prescribed medications held within the home and safely store medications within the care home setting. Medication Administration records were appropriately maintained. The residents living at the home reported they were treated with respect and dignity. Glendale Residential Home DS0000067783.V311998.R01.S.doc Version 5.2 Page 12 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): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents found the lifestyle experienced at the home satisfied their religious beliefs and recreational interests and they received a wholesome and appetising diet. EVIDENCE: Dedicated activity staff attended the home on two mornings and two afternoons per week to provide the opportunity for residents to engage in leisure and recreational activities. It was reported that visiting family members often enjoyed taking part in these sessions with the residents. Examples of the activities undertaken in the home are as follows; puzzles, manicures, bingo, crosswords, reading, games, outings to the craft centre, and walks into the village. A church service is held at the home every three weeks and an organist regularly attends the home to play for the residents. Local schoolchildren undertaking the Duke of Edinburgh award visit with the residents often. A ‘reminiscence box’ from the local museum containing various household items, newspapers postcards, gas mask etc was loaned to the home for a short period. The registered manager reported that the box was responsible for many lively and fascinating animated debates amongst the residents. Crossword puzzles involving all the residents were also reported to be a successful way to encourage the residents to interact with each other. Glendale Residential Home DS0000067783.V311998.R01.S.doc Version 5.2 Page 13 Most residents were happy with the activity programme provided by the home however some did say there was a need for more choices of stimulating pastimes to challenge their minds. There were no strict routines involving the residents at Glendale. On the day of this visit staff members were heard to say that resident X wished to stay in bed for another half and hour and that was accepted to be the norm. Residents confirmed that if they fancied a ‘lie in’ then it was respected and that times of going to bed were equally individuals’ choice. Residents were able to receive visitors at any time of the day, a quite lounge to the front of the building was available to receive visitors in private or residents were able to entertain in their private rooms. The inspector met with 9 visitors at the inspection site visit and all praised the management and staff team for the welcome extended to them at each visit. Residents were encouraged to bring personal items and furniture into the home in order to personalise their private rooms. Some care plans contained inventories of personal items brought into the home however the registered manager reported that family members often bring items in without informing the staff therefore the inventories were not always accurate. Menus were varied and nutritious however there was no choice of meals offered. Staff reported that the activity person, with the aid of all the residents, created the menu and on the odd occasion where a resident did not like the planned meal an alternative was provided. Family members reported that their loved ones were very happy with the menu provided and felt there would be too much confusion if a daily choice was offered. The residents confirmed that the menu was to their liking and did not feel that a choice was warranted, one person said “they know what we like, what is the point of any more?” On the day of the site visit the inspector enjoyed dining and chatting with the residents. Meals were delivered at the same times daily however if a resident was to be late back or wished to eat early before going out somewhere then this was arranged. Glendale Residential Home DS0000067783.V311998.R01.S.doc Version 5.2 Page 14 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The open culture within the home gave the residents and their families the confidence that their views would be listened to and taken seriously. EVIDENCE: There had been no complaints received by this service or the Commission for Social Care Inspection since the previous inspection visit. Visitors to the home reported that whilst they had not had occasion to complain regarding the care received by their loved ones they were confident that the staff and management team would take any concerns seriously and act upon them expediently. Residents spoken with were not aware of a formal complaints procedure however all were confident that any worries would be resolved satisfactorily. 14/20 staff members employed to work at the home were in receipt of current training in the Protection of Vulnerable Adults. The registered manager had attended the Protection of Vulnerable Adults ‘train the trainer’ course in order to facilitate regular training updates for the staff team. Glendale Residential Home DS0000067783.V311998.R01.S.doc Version 5.2 Page 15 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lived in a clean bright and well maintained environment. EVIDENCE: A physical tour of the premises was undertaken at this inspection site visit. The house and grounds were well maintained and provided a pleasant and homely environment. Residents’ rooms contained personal possessions and photographs creating an individual feel. Communal areas felt comfortable; one visitor felt that more footstools should be provided for the residents. Glendale Residential Home employed dedicated cleaning staff; the home appeared clean and fresh on this day with no unpleasant odours present. Records showed that 14/20 staff members had attended infection control courses/refresher courses. Glendale Residential Home DS0000067783.V311998.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents could not be confident that the staff attending to their needs had received training appropriate to the work they were to perform. EVIDENCE: The registered person was able to demonstrate by means of completed staff rotas that appropriate numbers of staff were on duty at all times with extra staff available to cover emergencies or busy periods. Three staff recruitment files were selected at random, all contained the information required to protect the health, safety and well being of the residents including a satisfactory enhanced Criminal Records Bureau disclosure. Records stated that 7/20 care staff had achieved NVQ level 2 in care, and one had achieved NVQ 3. 70 of the staff team had attended mandatory training such as the Protection of Vulnerable Adults, manual handling and infection control. The registered manager had developed a matrix to identify outstanding staff training requirements. This recording tool had not been updated to reflect the true status of the staff training and development plan within the home. Some care staff did not demonstrate awareness of the need for the mandatory Glendale Residential Home DS0000067783.V311998.R01.S.doc Version 5.2 Page 17 training and regular refresher courses. A discussion was held with the registered manager regarding the inclusion of all staff members in the training programme. Glendale Residential Home DS0000067783.V311998.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 25 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefited from living in a home that is well managed. EVIDENCE: The registered manager for this service has 5 years experience in care home management and has completed the Registered Manager’s Award. Evidence was available to confirm that the manager undertook regular training to update her knowledge skills and competence. The registered manager had completed ‘train the trainer’ courses in Manual Handling and the Protection of Vulnerable Adults and intended to undertake a ‘train the trainer’ course in the care of people with Dementia. Glendale Residential Home DS0000067783.V311998.R01.S.doc Version 5.2 Page 19 Glendale Residential home prides itself on delivering individual care and support and honouring individuals’ preferences and choices, it was reported that in order to deliver this standard of service provision the registered manager needed to commit 20 hours per week to care shifts out of the contracted 36 hours. Discussion was held with the registered manager around the resulting negative impact on record keeping, maintaining staff training programmes and day-to-day management duties of the service. There were clear lines of accountability within the home. The registered manager was able to demonstrate that an annual quality assessment was made of the services and facilities provided at Glendale Residential Home. This assessment involved gathering the views of the service provision from residents and their families/representatives. The last surveys issued to families were in May 2006, not all had been returned. A summary of responses received and corresponding action plan to address identified shortfalls had not been developed. Discussion was held with the registered manager around involving stakeholders from the community, such as Chiropodist, hairdresser, GP, pharmacist, with the quality assurance programme. Families and representatives were responsible for the residents’ finances however the registered manager maintained pocket monies for most residents. These were stored under lock and key, maintained in individual plastic wallets with a notebook to keep records of all transactions made. The balances for two residents were checked and agreed, receipts were present for all transactions and recorded appropriately. Evidence was available to confirm that health and safety checks of all electrical equipment, portable appliances, hoists, lifts etc were regularly undertaken. Evidence of water temperature checks in residents’ rooms was available for each month until May 2006, the registered manager reported that an alternative manner of recording this data had been developed and was not available for scrutiny at this site visit however assured the inspector that the checks were undertaken monthly. The temperature of residents’ bath water was tested before assisting the individual into the bath to prevent the risk of scalding. Health and safety training was provided for staff members from an external source. Policies and procedures were subject to annual review with practice reviews on going. Risk assessments were in place for working practices. e.g. Slips and trips, disposal of waste, use of wheelchairs etc. Glendale Residential Home DS0000067783.V311998.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 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Glendale Residential Home DS0000067783.V311998.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. 1 Standard OP28 Regulation 18(1)(a) Requirement The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. This specifically relates to the ratio of care staff qualified to NVQ level 2 working at the home. The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform including structured induction training. This specifically refers to the provision of all mandatory training for the whole staff team. DS0000067783.V311998.R01.S.doc Timescale for action 31/03/07 2 OP30 OP18 18(1)(c) 31/12/06 Glendale Residential Home Version 5.2 Page 22 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 OP9 OP9 Good Practice Recommendations It is a recommendation of good practice that morphine based medications be treated as Controlled Drugs It is a recommendation of good practice that medications are stored in an appropriate facility with regard to temperature and humidity. Glendale Residential Home DS0000067783.V311998.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Glendale Residential Home DS0000067783.V311998.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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