Inspection on 12/04/07 for Glenesk Care Home

This inspection was carried out on 12th April 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 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

Glenesk Care Home 13/04/06

Glenesk Care Home 09/01/06

Glenesk Care Home 11/01/05

Glenesk Care Home 09/09/04

Glenesk Care Home 01/03/04

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

CARE HOMES FOR OLDER PEOPLE Glenesk Care Home The Cresent, Queen Street Retford Nottinghamshire DN22 7BX Lead Inspector Lee West Key Unannounced Inspection 12th April 2007 11:30 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 Glenesk Care Home DS0000008681.V333967.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. Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glenesk Care Home Address The Cresent, Queen Street Retford Nottinghamshire DN22 7BX 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) 01777 702 339 F/P 01777 702 339 Mr Mohammed Akbar Mrs Barbara Khan Miss Kaneez Fathma Akbar Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th April 2006 Brief Description of the Service: Glenesk care home provides, permanent or respite, personal care and accommodation for 22 older people, male and female, who have diverse care needs. Privately run, and managed by two registered managers, the home does not provide nursing care. The home is an extended, adapted house with 18 single and two double bedrooms. There is a well laid out private garden, which is accessible for all service users. Situated near the centre of Retford, Glenesk is off the main road in a quiet residential area. There is car parking space at the front of the home. The fees charged range between £290 and £334 according to the level of care needs of service users. Glenesk have developed an informative statement of purpose and service user guide, which are available within the home, containing the information required to support choice. Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which began at 11.30am and was over 5.5 hours. The method used during the visit was Case Tracking. A number of service users were spoken with about their experiences and expectations of living at the home. Their care plans and other records, prepared and made available, including service user and relative surveys, were analysed. A tour of the premises was also undertaken to see the rooms and facilities used by service users case tracked. Staff, visiting professionals, and other visitors’ views were also sought with information from our records to inform the judgements within this report. Barbara Khan was the registered manager on duty during the first part of the inspection and Kaneez Akbar was on duty during the afternoon. Both, managers and the home’s staff all gave valuable assistance during the process. What the service does well: What has improved since the last inspection? The signs outside the home, and at the road entrance have been changed, and are now eye catching, with a graffiti resistant surface. These replaced signs which needed attention and were difficult to see. The policies and procedures have been improved and updated and a handbook of information for prospective service users has been produced, containing the Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 6 home’s statement of purpose and other information a prospective service user would need to make an informed choice about the suitability of the home for their needs. Both the bathrooms are now in service, with the moving aids now in working order. The quality audit inspections carried out monthly, by the provider, or representative, have been improved to include records of any events occurring in the home. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Glenesk Care Home DS0000008681.V333967.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 Glenesk Care Home DS0000008681.V333967.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 6, Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The service user guide provides sufficient information for prospective service users to make an informed decision about the suitability of the home. EVIDENCE: Glenesk have produced improved and updated policies and procedures, published in a booklet, together with a new, service user handbook, which contained the information a prospective service user needs to make a decision on the suitability of the home to meet care needs. These were seen and were available for all prospective service users. Pre-admission assessments were seen with the service user’s care plans and people spoken with confirmed they were aware there had been an assessment of care needs and they were, “happy with the support given by the carers.” Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 9 Some service users hoping to return home said, “they try to keep me going and do as much as I can for myself. I want to go home as soon as I can, but they are really kind here.” Glenesk Care Home DS0000008681.V333967.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Generally the service users’ care plans set out personal and social care needs and these are met by staff, who treat them with dignity. Some health requirements were not identified, leading to carers possibly missing changes in condition. EVIDENCE: Care plans seen contained personal and social care needs and some health requirements, but some were not reflected in the plan. An example of this was one service user had dressings to pressure areas, which were being dealt with by the District Nursing Services, but this was not identified within the plan as an area to monitor. All the service users case tracked and spoken with said they preferred the staff to give them their medication, as, “it keeps it safe and I don’t have to worry,” another said, “I prefer the staff to give me the medicine as I know I get the right dose then.” Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 11 Medication procedures were observed and were in line with good practice. All medication was stored correctly, in the locked trolley, in the dining room. There was a policy in place, in the improved policies and procedures, to support service users who wish to self medicate. The Chemist has provided training for the administration of medication and this was evidenced in the staff files. Service users were approached with dignity and politeness and those spoken with confirmed that the staff, “always treat us with respect.” They said also, “the carers always knock on my door, and never complain if I have to buzz them and I know they are busy.” Glenesk Care Home DS0000008681.V333967.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are helped to maintain independence and maintain contact with family and friends. EVIDENCE: Service users spoken with said, “there are now more activities to do during the week and this makes the days less long.” Service user surveys received all indicated the level of activities provided was satisfactory, “there was a variety of activities to go at.” There was evidence of regular activities, with photographs within an album, which showed male and female service users taking part in the activities. On the notice board in the entrance were “This month’s activities, which consisted of Easter crafts and also Red Nose Day activities, which raised £50.” The activities co-ordinator, has now developed a structured programme, 2 hour sessions 3 days one week and 4 days the next week, and keeps a diary of who attends and what is successful. This was seen during discussions with the co-ordinator. Service users spoken with confirm that the co-ordinator also Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 13 spends time with individuals who prefer to stay in their bedrooms, which the service user said helps to reduce the isolation. Daily newspapers are delivered to the home for those service users who wish to have their own newspapers. One service user who was at the home for short term care said, “I would be lost without my daily newspaper. It keeps me in touch with what’s going off – and it lets me know what day it is.” Visitors spoken with said they were made to feel welcome at any time, and were offered drinks. During the inspection visitors who were unfamiliar were asked who they were visiting and the service user was then asked if they were happy to see the visitor, before the person was shown to the service user’s room. This enhanced the service user’s control over their lives, with freedom to choose. Families were made welcome and the managers were observed to be friendly and open to them. The family members spoken with said they were happy with the management of the home and that both were approachable and listened to them. The two meals observed were wholesome and appetising. Service users said, “the food here is great and there’s plenty of it.” There was a 4 weekly menu, with special foods for diabetics. Birthday teas, with cakes and buns are individually arranged and service user survey responses reflected the “high quality of food and homemade cakes.” Glenesk Care Home DS0000008681.V333967.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints procedures are in place and staff are aware of their roles in safeguarding adults, protecting the service users from harm. Service users are supported in maintaining their legal rights, which helps them to maintain an input into their community. EVIDENCE: The complaints procedures were set out in the improved, reprinted, policies and procedures and service user handbook and service users spoken with said, “the managers are very approachable if there is a problem.” Service user and relative survey responses confirmed the service users’ and their families’ awareness of the complaints procedures. Service users spoken with said they were satisfied that any problems or complaints would be listened to and dealt with properly, but stated they did not have any complaints to make. Visitors, family and professional also confirmed they were satisfied that any concerns or issues they may have would be dealt with professionally and properly. Service users also said they were encouraged to use their votes when elections are held. Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 15 Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 16 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, 20, 21, 23, 24, 26, Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home was clean, pleasant and hygienic, with access to all areas for service users, providing a comfortable and safe environment for service users. EVIDENCE: All areas of the home were clean and hygienic, with adequate lighting. Records showed work was being carried out to rectify routine maintenance requirements. The service users spoken with said they were comfortable in the home and were satisfied with their own rooms. They confirmed they had their own personal possessions around them. Rooms inspected were clean, tidy and suited to the service user’s needs. Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 17 Relative and Service user surveys received also reflected satisfaction with the home’s environment and facilities, none containing negative responses. The bathroom on the first floor has now been improved with the addition of the chair hoist. Both bathrooms were available for use. The signs outside the home, one at the entrance to the grounds and one at the end of the long, unmade, road, had been replaced, with bright, graffiti-proof signs, which were clearly seen when approaching the home. This assists people unfamiliar with the area to find the home. Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 18 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, 30, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff numbers and skill mix support the service users’ protection and care needs. EVIDENCE: The numbers of staff on duty during the day have now been increased. This was evident from the duty rota and the numbers of staff present during the inspection. The manager said this was to meet the needs of the service users, as some require more assistance from the staff. Service users spoken with said they were satisfied with the numbers of staff and that they were able to get up and go to bed when they wanted. Comments made included, “they are always busy, but they have time for me and I can’t fault them.” “they always come when I press the buzzer.” Survey responses were mainly satisfactory, but some relatives said, “more staff are needed after 5.00pm.” another said, “they always seem to be very busy and it would benefit my relative and the other people in the home if staff could pop into the lounge occasionally and check on service users more regularly.” Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 19 Certificates were seen in staff files of training in First Aid, Food Hygiene, Moving and Handling, Infection Control, Safeguarding adults (POVA), Health and Safety and Fire safety. National Vocational Qualifications have been achieved by some of the care staff and records of this were seen in their files. Staff spoken with confirmed they had attended this training and could describe their roles when asked, particularly in safeguarding adults and safety of service users. There were insufficient references, with only one reference and no application form found in some staff files, but Criminal Records Bureau checks were recorded in all the files case tracked. There were no contracts of employment, or terms and conditions in the staff files. The registered manager confirmed that this was being developed and a draft copy was seen, but was not being used at this time. Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 20 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, 36, 37, 38, Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Two registered managers, who job share, run the home in the best interests of the service users. There have been some improvements in the management procedures, but there remain some areas of recording to be improved. EVIDENCE: Both registered managers were working during this inspection and although their backgrounds are different, they were observed to communicate well with each other and both were aware of all aspects of the service users’ requirements. One manager is working towards National Vocational Qualification Level 4 in Management, but the other manager has not undertaken any management Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 21 training for some time and requires some updating in management skills to enhance performance and support the best interests of the service users. Service users’ finances are not handled by the home and service users spoken with said they dealt with their own money and they were happy with this situation. Staff files contained evidence of regular supervision and appraisal, and staff spoken with said they were supervised regularly and that the managers listen to them if they have any ideas for personal development. The home has relocated the main office into an office on the first floor, records, except care plans, are kept in this office. Some staff records had required information missing, such as evidence of identity, photograph, completed application forms, insufficient numbers of references, or contracts with terms and conditions, but generally the records were kept up to date and accurate. The mandatory checks, including water temperatures and fire alarm testing were recorded and dated, to support the safety of service users and staff. The quality reports, to comply with Regulation 26, have been amended to include recording of any events or incidents in the home, in response to a recommendation in the last inspection report. Recent service user questionnaires, sent out by the managers, were generally positive, and the negative responses were recorded and addressed. The service user and relative surveys received by the Commission were all positive about the management and administration within the home. “The managers are always approachable and listen to our comments,” quoted one relative. Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 22 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 3 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 Standard No Score 16 3 17 3 18 3 3 3 3 X 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 2 3 Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(1) Requirement Service User care plans must include information about the health and medical conditions so any risks created by these are identified and dealt with properly and staff members are aware of any possible problems that could occur. All staff should have a contract of employment, containing all the terms, conditions, roles and responsibilities expected of the employee and employer. A copy of the signed contract to be available in the staff files, to clarify their roles and protect the employment rights of staff employed at the home. Timescale for action 30/05/07 2. OP29 17(2) Sch 4 30/05/07 3. OP37 19(1) Sch 2 Staff files should contain records 30/05/07 of completed application forms, two professional references and evidence of identification, including photograph, to evidence the fitness of recruits to be carers of vulnerable people and protect the service users. Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 24 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 OP31 Good Practice Recommendations Training in current management practices for the registered manager not undertaking the National Vocational Qualification, would enhance skills in the management element of her work and support the management structure within the home, protecting the service users Glenesk Care Home DS0000008681.V333967.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. 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