Inspection on 01/05/07 for Glendon House

This inspection was carried out on 1st May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Glendon House 13/08/08

Glendon House 05/09/07

Glendon House 04/04/06

Glendon House 10/01/06

Glendon House 17/06/05

Glendon House 01/02/05

Glendon House 30/06/04

Glendon House 17/02/04

Glendon House 09/09/03

Glendon House 26/03/03

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

CARE HOMES FOR OLDER PEOPLE Glendon House 2 Carr Lane Overstrand Cromer Norfolk NR27 0PS Lead Inspector Ann Catterick Unannounced Inspection 1st May 2007 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 Glendon House DS0000027384.V338887.R02.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. Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glendon House Address 2 Carr Lane Overstrand Cromer Norfolk NR27 0PS 01263 578173 01263 579164 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) info@glendonhouse.fsnet.co.uk Mr Rhoderick Smart Mrs Frances Smart Position Vacant Care Home 36 Category(ies) of Dementia - over 65 years of age (36), Old age, registration, with number not falling within any other category (36) of places Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Thirty-six (36) Older People may be accommodated. Thirty-six (36) people with dementia may be accommodated. The total number not to exceed thirty six (36) Date of last inspection 4th April 2006 Brief Description of the Service: Glendon House is a care home providing care and accommodation for 36 older people who are suffering from dementia. Mr Rhoderick Smart and Mrs Frances Smart own the home. The manager position is vacant at the time of writing the report. Details of the services offered within the home can be found in the Service User Guide. The fees within the home range from £375-£500. Details of services included within this fee and those excluded are identified in the Service User Guide. The original house was built in 1917, and has been tastefully extended and adapted over the years. The home has 30 single bedrooms and 3 double rooms. Twenty-eight of the single rooms have en suite facilities and all of the double rooms have en suite facilities. A large part of the grounds has been made into a safe and secure garden area for service users. The home provides comfortable accommodation in an attractive setting in a small coastal village, being very close to the sea. Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was a key unannounced inspection and took place on the 1st and 2nd of May. The inspection was over a period of 12 hours. The home has not had a registered manager for over two years. Managers and prospective managers have been appointed but have not remained in post for very long. The home has not had the manager post filled since November 2006, but it is understood that an appointment to the post has recently been made with the provision of the new manager taking up her duties at the beginning of June. The lack of a permanent manager has however had a significant impact on the home and the quality of care being provided. Prior to the inspection a request was sent to the home for a pre inspection questionnaire to be completed. This was due to be returned to the Commission by the deadline of 13/03/07. It was still not received by the date of the inspection and despite a promise to return it within a further seven days, it had been received by the time of the drafting of this report. Only two pre inspection questionnaires were received. These were both from relatives and made positive comments. It is disappointing that more were not forthcoming. Since the last key inspection a random inspection had taken place on the 29/06/06 following a concern with regard the home not always having sufficient staff on duty. This concern was substantiated and the proprietor agreed to ensure enough staff would be on duty at any one time in future. Following a further complaint, a Statutory Requirement Notice with regard staffing was issued and followed up by another random inspection on 07/09/06. At this time it was found that the registered person was complying with the Notice. The inspector had the opportunity to talk with residents, staff, relatives and the senior homes manager within the organisation as well as look at care plans, staff files and other policies and documentation. This inspection found that the outcomes for many of the standard areas were not fully met and that the outcome in some areas was poor. What the service does well: Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 6 The home does have an activity person who spends some time with residents on a regular basis. Visitors are always made welcome in the home. Those staff spoken to had a genuine desire to offer good quality care and had a commitment to further develop their skills through training. Comments from relatives “We are always made welcome.” “Very pleased with mothers care.” “Staff are kind.” “I feel staff are brilliant.” Comments by staff “Good staff team.” “Would always report poor practice.” “Would like to complete NVQ level 2.” “Enjoy my work, supportive staff team.” What has improved since the last inspection? What they could do better: Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 7 Assessments completed prior to admission need to be more comprehensive and need to be dated. Care plans need to be completed, up to date and followed. There needs to be enough suitably trained and qualified staff to be on at all times of the day and night to meet the needs of residents. The home’s medication policy and procedure needs to be followed at all times. The policy and procedure for safeguarding adults should be followed at all times. The home needs to be clean and free from offensive odours. All radiators need to be formally risk assessed and, where necessary, converted to low surface temperatures or covered to avoid potentially injury to residents. The rota needs to show an accurate account of who is on duty at any one time. The policy and procedure for recruitment and selection need to be followed at all times. Staff need to complete the appropriate training to fulfil their role. The home needs to regularly monitor the quality of the service and publish findings. All staff in the home need to be appropriately supervised. The registered person must ensure that they fulfil their responsibility as described under Regulation 37 of the Car Home Regulations. Comments made by relatives and/or visitors “Sometimes a lot of staff, sometimes not enough.” “Residents are not always taken to the toilet. “ “The chairs are smelly and dirty.” Comments made by staff “No staff meetings since Sandra left.” “Medication in the morning takes at least two hours.” “When we are short staffed we are not able to use agency staff.” “Training for moving and handling not helpful as it did not relate to caring for residents with dementia.” Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 8 “No time for residents.” “Sometimes there are only two staff on at night times.” “Laundry is almost a full time job.” “Never seen any books re dementia care.” “I am not having formal supervision.” 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. Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 9 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 Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 6 People who use the service experience adequate outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Documentation suggests that residents have their needs assessed prior to admission but this could not be accurately evidenced, as most assessments seen were not dated. EVIDENCE: Pre admission assessments were seen on file but these were dated with the date of admission and the space to indicate when the assessment took place and by whom was left blank. Some care plans had recent history and information with regard situation prior to admission, for example, “admitted to hospital following fall and then transferred to Glendon House”. Other care plans had no indication of previous situation and limited information appeared to have been obtained prior to admission. Within some care plans there was evidence of information from Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 11 health and social care professionals that had been received before admission. There is opportunity for further improvement in the assessments of service users completed prior to admission. A recommendation has been made in this area. Intermediate care is not provided in this home. Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience poor outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are being placed at risk by inadequate and unclear care planning. Residents are not always being protected, or their health promoted by practice around medication. Dignity and privacy is not always promoted and protected. EVIDENCE: The format for care plans is good but those seen were not fully completed and did not give clear guidelines on how resident needs and preferences could be met. For example a resident who had fallen had no risk assessment with regard mobility. The social care plan was blank and there was no social history. Another resident had no clear plan of how they could be moved and handled safely. In some care plans how needs were to be met were identified but not happening in practice. For example within a care plan it stated that a resident had difficulty swallowing and should have a soft diet. At breakfast time the Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 13 resident had been given toast and at morning coffee was given a bourbon biscuit. Either the care plan was wrong or this resident should not have been given these foods. Within another care plan there had been a review on 25/04/07. The review stated that the resident needed to be assisted to walk with the aid of a zimmer frame and two carers. He was seen being assisted by two carers but was not using a zimmer frame. Care plans are only of value if they are complete and the information provided is transferred into practice. The home has a good format but many of the pages of the care plans were blank. A requirement has been made in this area. Weight charts were seen in care plans. One chart suggested that a resident had put on 9 Kilos in one month, which is highly unlikely. This resident had two weight charts within the care plan which could lead to confusion. Waterlow charts were seen in some care plans and several residents were receiving support from the community health service. Details of pressure equipment being used for residents was seen on file. On the first morning of the inspection the staff member who was administrating medication was also involved in other tasks, such as assisting residents with their breakfast and answering the telephone. With these distractions there was a high risk of error. Some medication that had been received into the home the previous evening had not been recorded as received. Some of this medication was administered without an accompanying MAR chart to complete. The manager must ensure safe practice with regard to medication. A requirement has been made in this area. All laundry is done on the premises and care staff are responsible for the laundry and return of clothes to the residents. One relative said that on occasion they had seen her mother’s clothes being worn by another resident and on occasion her mother had been wearing another residents clothes. This practice does not promote dignity. The inspector noted that in a single room two residents were present, one sitting in the chair and another asleep on the bed. When making enquiries staff explained that the resident on the bed was not the normal occupant of the room and had been known to lie on other resident’s beds before. The resident was assisted to leave the room. There needs to be enough staff on duty to ensure that residents’ privacy and dignity can be protected at all times. A requirement has been made in this area. Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 14 Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience adequate outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents do have some opportunity for meaningful activities but spend significant periods of time on their own with the main interaction with staff being when being assisted with a personal care task. Friends and family of residents are always made welcome in the home. Food provided appears to be nutritious and varied. The experience of meal times could however be improved if more staff were available to assist at this time. EVIDENCE: The home has an activity person who offers some activity on a regular basis. Care staff do not have much opportunity to spend social time with residents as most of their time is spent completing personal care tasks with residents and completing domestic tasks in the home such as laundry or preparing and serving the teatime meal. Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 16 On the first day of inspection residents were seen to spend long periods of time on their own with little contact with staff and no stimulation. There did not appear to be enough staff on duty to meet the full range of needs of residents. One comment from staff was that there is no time for residents. Another staff member felt that there was some time for social interaction in the afternoons. Visitors spoken to said they were always made welcome. There are no residents who manage their own financial affairs and any money spent is provided by the home and then the family or financial advisor is invoiced for the money. Residents are able to bring personal possessions with them at the time of admission and can have their rooms locked if they choose to do so. The home has a full time cook. The cook was aware of the importance of nutrition and used powdered milk, cheese and cream to increase the calorific value of soups, drinks and vegetables. This is good practice. The menu is varied and residents have a choice of what they would like to eat. For some residents it would be difficult to make an informed choice and the home may wish to consider other ways of promoting choice. There did not appear to be enough staff on to meet the needs of residents at breakfast on the first day of inspection. For example, two residents needed to have assistance with managing personal hygiene and a resident tried to eat his paper napkin. Some residents had clearly finished breakfast but were not assisted away from the dining area as staff were completing other tasks. A recommendation has been made in this area. The inspector was informed that the larder is locked when the cook goes off duty at 3pm and care staff do not have access to the dry store cupboard. Bread and biscuits are usually left out but there was concern that residents did not have the opportunity or choice with regard snacks during the evening and night. A recommendation has been made in this area. Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience adequate outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their families have the information needed to enable them to make complaint if they chose to do so. The residents in the home cannot be assured that the correct procedures relating to the safeguarding of vulnerable people will always be applied appropriately. EVIDENCE: The home has a complaints procedure that is made available to residents and their families. Since the last key inspection some relatives have contacted the Commission, as they were not satisfied with the responses to concerns or complaints they had made to the home. This was discussed with the Lisa Rutter, senior home manager within the organisation, and she advised that these matters have now been resolved. Two adult protection issues have occurred since the last key inspection. The first of these was dealt with by the home following discussion with the adult protection unit. The second was dealt with by the home and no referral was made to the adult protection unit or the Commission. Details of this allegation came to the professionals involved from another source. Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 18 The manager who dealt with the matter has accepted that she did not follow the appropriate guidelines as described in local Safeguarding Adults procedures. A requirement has been made in this area. Staff spoken to said that they would always report poor practice. Some staff had recently received training in this area. Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 and 26 People who use the service experience adequate outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a comfortable environment that meets most of their needs. Clearer signage in the home would empower residents to have more of an understanding about the home in which they live. Not all areas of the home were free from offensive odours on the first day of inspection. EVIDENCE: There is no up-to-date annual development plan for the home. A maintenance person offers day-to-day maintenance to the three homes owned by the providers. Generally the environment has the opportunity to provide good quality comfortable accommodation to the residents who live in the home. Since the last inspection the laundry area has been improved and all staff using this area said that it was a much more pleasant environment to work in. Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 20 There has been some work done to the garden area with new shrubs and flowers but there was no evidence to suggest that residents are enabled to use the garden area. The overall decoration in the home is good but some of the chairs looked grubby and in need of cleaning or replacing. A visitor to the home made a comment regarding the poor state of the armchairs in the home. A recommendation has been made in this area. There is a welcoming entrance area with two cosy seating areas, two lounges, a large dining area and a conservatory. Not all radiators are covered or of low temperature and due to the vulnerability of the residents this area needs to be formally risk assessed. A requirement has been made in this area. The signage in the home is poor and therefore residents are not empowered to understand their environment. For example toilet doors look the same as any other door and a resident with dementia may have difficulty finding the toilet. Some bedroom doors had names on and numbers but these were not always clear. A recommendation has been made in this area. On the first day of inspection not all areas were free from offensive odours. This related particularly to the downstairs bedroom corridor. There was only one domestic carer on duty that morning between 8.00 and 3.00 and this level of domestic staff did not appear sufficient to keep the home clean and free from offensive odours. Two professionals visiting the home on another occasion have made comment about the very strong smell of urine in a resident’s bedroom. This room was reported to be in a poor condition with the resident sitting in an armchair in the room at the time. A requirement has been made in this area. Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience poor outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents living in the home cannot be sure that there will be enough staff working in the home at any one time to meet their needs. There is no clear system for working out what training staff have received and what training staff need to complete. Recruitment and selection practice is not safe and does not ensure the safety of residents. EVIDENCE: The staff rota for two weeks was inspected and showed that at times there were not sufficient staff on duty to meet the needs of residents. It was seen that on some days, at times, only four staff members were on duty. Care staff also have other roles and responsibilities, which take them away from the direct care of residents. Senior care staff administer medication at tea and suppertime. Care staff have to prepare and serve tea as the cook finishes at 3pm. All of the laundry is done on site and there is no laundry assistant. Staff stated that one member of staff is in the laundry room at any one time Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 22 throughout most of a shift. The inspector was informed that at least 15 residents needed the assistance of two staff when being offered personal care. On the first morning of inspection 14 residents were left alone in the dining area for some time over the breakfast period as the staff on duty were assisting other residents. At this time one resident tried to eat their napkin and assistance was sought from a kitchen assistant who then found a member of the care staff to assist. There were not enough staff on duty to meet residents needs at this time. A requirement has been made in this area. The rota given as a true account of the staff who had been on duty over a two week period was found to be inaccurate. Staff named on the rota as being on duty were not on duty and not aware that their names had been added to the rota. For three nights over a weekend period there were only two night staff on duty to care for 36 residents. These staff were also expected to work in the laundry and complete domestic tasks, such as hovering and shampooing carpets. This is not an acceptable situation and puts residents at risk. A requirement has been made in this area. There is no training profile for staff and it was very difficult to inspect staff training as it was unclear, on personal staff files, what training had been completed and there was no general log of training completed. It was difficult to assess how a manager would be able to keep up to date with training completed and training needed. A requirement has been made in this area. Statements of terms and conditions were seen on some files but not on others. Information requested about training prior to the inspection had not been made available to the Commission. The manager advised that 12 staff had completed NVQ level 2 but this was difficult to verify. Some staff files were inspected. Two staff who were working in the home did not appear to have had a file created. Loose papers were found and inspected. There was no evidence of a CRB check being applied for. There was a police check from Slovakia but this had not been translated. No induction information, no start date or no supervision was found. A requirement has been made in this area. There was no clear evidence to suggest that the Common Induction Standards induction has taken place with new staff. The home has not had a registered manager for over two years and those managers or prospective managers that have taken up post have not stayed in role for any length of time. Despite the support from a manger of one of the other establishments in the group, this has clearly had a significant impact on the outcomes in this area. Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 23 Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 and 38 People who use the service experience poor outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are living in a home that has had no continuity of management for some time and this is clearly having an impact on the service being provided. Residents are receiving a service from staff who are not always sufficiently trained and supervised to care for residents in a safe and professional way. EVIDENCE: The home has not had a registered manager for over two years and this is having a significant impact on the quality of care being provided within the home. There have been managers, and/or prospective managers appointed but none have stayed to make application to become the Registered Manager. A requirement has been made in this area. Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 25 Some management imput has been forthcoming from the registered manger of another home, but the senior member of care staff working in the home on the days of inspection was clear that she did not see her role as managing the home. There is no up to date quality assurance system in place and the quality of the service provided is not being measured. A requirement has been made in this area. A Regulation 26 visit was carried out by the owner of the home on 02/03/07 and it is hoped these will now be completed on a monthly basis. Resident’s money is not looked after in the home and money is spent when need be and family or financial advocates are invoiced for this. Formal supervision is not taking place and the work issues, training needs and development plans for staff are not formally recorded or discussed in any way. A requirement has been made in this area. Not all records seen were up to date or kept in good order. Two staff members who worked in the home did not appear to have files made up and only limited information about them could be found. For example it was unclear on when they commenced work or what initial induction they had. A requirement has been made in this area. Moving and handling practice in the home is poor. Staff were seen moving residents in an unsafe way and staff were not assisting residents according to instructions in their care plan. There was evidence that some staff had completed moving and handling training on recent months. Staff felt that the moving and handling training they had received had not helped them in assisting residents with dementia. Records on training were poor and it did not seem that all staff had up to date manual handling training. Training that gives staff the skills to work with the residents they are caring for needs to take place. A requirement has been made in this area. No one has been notifying the Commission of those incidents that are identified under Regulation 37 of the Care Home Regulation 2001. For example, notifications of death or admissions to hospital. A requirement has been made in this area. Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 26 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 2 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 2 2 x x x x x 2 2 STAFFING Standard No Score 27 1 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 x 2 x 3 1 x 1 Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 27 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 Requirement All residents should have a care plan that identifies their personal, health and social needs. This will ensure that care plans identity all of the needs and preferences of residents to enable staff to be best informed on how to care for each resident. The staff responsible for medication need to ensure that the home’s policy and procedures are followed at all times. This will ensure that safe practice is always carried out and that residents are protected by the policy and procedures. There must be sufficient staff on duty to ensure that the privacy and dignity of residents is protected and promoted. This will ensure that residents are able to receive a service that meets their needs in this area. The policy and procedures for safeguarding adults should be followed at all times. This will ensure that everything is done to protect residents from harm. All radiators should risk assessed DS0000027384.V338887.R02.S.doc Timescale for action 01/07/07 2 OP9 13.2 01/07/07 3 OP10 4.a 01/07/07 4 OP18 13.6 01/07/07 5 OP25 13.4ab 01/07/07 Page 28 Glendon House Version 5.2 6 OP26 16.2k 7 OP27 18.1a 8 OP27 17.2 9 OP29 19 10 OP30 18.1c 17.7 11 OP31 18.1 12 13 OP33 OP33 24 18.2 and, where necessary, be covered or of low surface temperatures. This would ensure that residents are protected from unnecessary hazards. The home needs to be kept clean and free of offensive odours. This will ensure that the environment that residents live is comfortable and meets their environmental needs. There must be sufficient suitably qualified, competent and experienced staff on duty throughout the day and night to meet the needs of service users. The home must have a rota of staff who are working in the home which is accurate and reflects who was at work on any particular shift. There needs to be a thorough recruitment and selection process that is followed at all times to ensure that this procedure safeguards the people who live in the home. Staff in the home need to be provided with the appropriate training to fulfil their role and a record of this training needs to be kept in the care home. There must be a manager working in the home who can meet the requirements of the post. This will ensure that the managerial responsibilities within the home will be met. The home must regularly monitor the quality of the service and publish the findings. All staff working in the home should be appropriately supervised and this should include formal supervision that addresses, practice issues, training issues and development DS0000027384.V338887.R02.S.doc 01/07/07 01/07/07 01/07/07 01/07/07 01/07/07 01/08/07 01/09/07 01/07/07 Glendon House Version 5.2 Page 29 14 15 OP37 OP38 17.2 37 needs. This would ensure that staff receive the support they need to fulfil their role. All records as described in 01/07/07 Schedule 4 should be complet, accurate and kept up to date. Notifications of death, illness and 01/06/07 other events must be reported to the Commission, as described in Regulation 37 of the Care Home Regulations 2001. 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 3 4 Refer to Standard OP4 OP15 OP19 OP19 Good Practice Recommendations A more detailed initial assessment process would benefit the home with regard having all the information needed to ensure the home can meet need. It would be good practice to ensure that there are more staff in the dining area at breakfast time to enable staff to be able to assist residents when and if they need it. It would benefit service users if clearer signage was used throughout the home to assist residents in becoming familiar with their environment. That the armchairs that appear unkempt and grubby are cleaned or replaced Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Glendon House DS0000027384.V338887.R02.S.doc Version 5.2 Page 31 - 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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