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Inspection on 12/01/06 for Glengarriff House Nursing Home

Also see our care home review for Glengarriff House Nursing Home for more information

This inspection was carried out on 12th January 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

Since the last inspection the home has made improvements to both the care planning process and the availability of recruitment information. They have also implemented the annual supervision plan for staff.

What the care home could do better:

There were no requirements made at this inspection and the home demonstrated a good standard of care and support for service users. Some recommendations were made in the interests of good practice and these were relating to arrangements for the disposal of unwanted medication, recording end of life arrangements and completing all information sections in service user files even where information is not available for example with `not applicable` or `not known`.

CARE HOME ADULTS 18-65 Glengarriff House Nursing Home 8 King Street Market Rasen Lincs LN8 3BB Lead Inspector Wendy Taylor Unannounced Inspection 12th January 2006 08:35 Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 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 Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Glengarriff House Nursing Home Address 8 King Street Market Rasen Lincs LN8 3BB 01673 844091 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) Prime Life Limited Mrs Jane Ginnelly Care Home 18 Category(ies) of Learning disability (18), Learning disability over registration, with number 65 years of age (1) of places Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care with nursing to service users whose primary needs fall within the following categories: * Learning Disability (LD) 18 male or female * Learning Disability (LD) Over 65 years of age - 1 female The maximum number registered for is 18 The Category of Learning Disability (LD) over 65 years of age applies to the service user named in the Notice of Proposal to register dated 11/04/05 25th July 2005 2. 3. Date of last inspection Brief Description of the Service: Glengarriff House is owned by Prime Life Homes Ltd, and currently Ms Nicki Broddle is the acting manager. The home is located in the centre of the market town of Market Rasen. The town offers a variety of local amenities such as pubs, cafes and restaurants, banks, shops and a post office. Glengarriff House provides care and support (which includes nursing) for up to eighteen people with a learning disability. The main house is a two storey building with a first floor extension providing accommodation to twelve people. It stands in its own grounds with gardens to the front and rear, and ample parking also at the rear. Within the grounds there is also a semi- independent living unit consisting of four flats for six people. Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day in January 2006 and is the second visit of this inspection year. Eighteen people are currently living at the home. There are no outstanding requirements or recommendations from the previous inspection, and none were made at this visit. Service users and staff were spoken to during the visit and a tour of the home took place. The inspector spent time observing care practices and interaction between service users and staff. Service user and staff files were also looked at as well as general records. What the service does well: What has improved since the last inspection? What they could do better: There were no requirements made at this inspection and the home demonstrated a good standard of care and support for service users. Some recommendations were made in the interests of good practice and these were relating to arrangements for the disposal of unwanted medication, recording end of life arrangements and completing all information sections in service user files even where information is not available for example with ‘not applicable’ or ‘not known’. Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 6 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. Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The standards in this section were not inspected at this visit, however the key standards were inspected at the last visit and no shortfalls were found. EVIDENCE: Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,9 The home maintains an environment in which service users are respected as individuals and their rights are upheld. Service users benefit from detailed care plans that are consistently followed. EVIDENCE: Three service user files were looked at. Care plans were available for needs such as epilepsy, communication, mental health, eating/drinking, occupation, leisure, finances and challenging behaviour, and are in accordance with assessments. There is evidence of regular in-house review processes and annual multi agency reviews. Care plans make reference to risk taking and risk management plans are in place for needs such as missing persons and road safety. There is a section in the plans called ‘My Life’ which refers to maintaining individual rights and choices and developing independence. All other plans also refer to these issues where appropriate. The inspector saw that choice and independence are features of the interactions between staff and service users. There was also observation throughout the visit that care plans are consistently followed especially in the Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 10 management of challenging behaviours. One service user spoke about how she is being supported to move to her own house in the future. Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13,14,16 Service users continue to enjoy a varied social life and they benefit from a good level of participation within the local community. EVIDENCE: Care plans make reference to promoting community participation for individuals and there was a clear activity programme in place. A range of literature is available in the home relating to community facilities and activities. During the visit some service users were supported to go to a local café and nature park and there was evidence that they are also supported to use local banks and shops and the local community centre. Service user were also seen to be engaging in in-house activity such as following keep fit videos and doing games and puzzles. There is evidence that some service users do voluntary work in local shops and café’s, utilising qualifications that they have gained through college. Staff were seen to knock on bedroom doors before entering and helping service users to understand the need for respecting other people’s privacy. Service users have keys to their own rooms, unless risk assessments highlight alternative needs. Service users and staff told the inspector that post is given Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 12 directly to the service user to be opened, but support is given if requested or required. Staff were observed to encourage service users to engage in household tasks such as vacuuming and tidying their bedrooms and putting laundry away. Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20 The home ensures that service users health needs are met and they benefit from robust medication policies and procedures. EVIDENCE: Health Action Plans were available for each service user, which set out how health needs are to be met. There is a record of visits to health professionals such as the GP or chiropodist. There is also evidence of three monthly reviews by a Consultant Psychiatrist who visits the home. The manager said that ‘well-woman’ and ‘well-man’ clinics are utilised where service users wish to attend. One service user described how their current health needs are being managed, and she described how staff had supported her to visit the GP. There are care plans for specific health needs such as epilepsy in place. The home has a comprehensive medicines policy and all administration records were found to be satisfactory, including those for controlled medicines. There are also clear protocols for ‘when necessary’ medications. Storage for all medicines including controlled medicines is secure and appropriate. The home has three monthly pharmacy audits and there were reports in the home to evidence this. It is highlighted in one report that the pharmacy are organising medication administration training for the home. There is a recommendation made regarding disposal of unwanted medicines. Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Service users benefit from robust policies and procedures, and from a knowledgeable staff team who encourage them to voice their opinions. EVIDENCE: There have been no complaints or reports of adult protection issues since the last inspection. There is evidence of staff training in adult protection procedures and they were able to demonstrate their understanding of the issues. There are comprehensive complaints, adult protection and whistle blowing policies within the home and staff are provided with a handbook regarding whistle blowing. This handbook also describes adult protection issues. Staff were observed throughout the visit to be listening to service users views about everyday issues and responding to any requests for assistance or support. One service user told the inspector that if they have anything to talk about the staff are always there and will help out. Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,29,30 Service users continue to enjoy a comfortable and homely environment, which is well maintained. They benefit from a good standard of hygiene and from staff who have a clear understanding of infection control issues. EVIDENCE: The home has domestic style furniture and décor that is maintained to a good standard. Service users bedrooms are well personalised. Records for maintenance are clear and up to date. On the day of the visit the house was clean and tidy. Staff were observed to be using protective clothing where necessary. There was evidence of staff training in infection control procedures and they were able to demonstrate their knowledge of the subject. The home has a separate laundry area with sluicing facilities. There is a specialist bath in a ground floor bathroom and handrails situated in appropriate places around the home. There are currently no requirements for hoists or other mobility aids. Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,34,35,36 Service users are protected by robust record keeping procedures. There is a well-trained and supported staff team who are able to meet the needs of service users. EVIDENCE: Three staff files were looked at and they contained all information required by the National Minimum Standards, including Criminal Record Bureau checks. Staff said that they receive regular supervision and records confirmed this. Job descriptions were available on file and staff demonstrated that they are clear about their roles and responsibilities within the home, including the key worker role. There was evidence in files that staff have received training in dementia, challenging behaviours, infection control, fire safety, food hygiene, and Makaton. Records show that there are 2 staff trained to NVQ Level 3 and 2 staff currently doing Level 3; 9 staff doing NVQ Level 2 and 4 staff have completed the Learning Disability Award Framework. Their NVQ Assessor was supporting staff during the visit. Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 41,42,43 The home was well organised and managed, and service users are protected by health and safety processes. EVIDENCE: Record keeping within the home was found to be up to date and satisfactory including records for fire alarm tests, fire drills, fire equipment tests and emergency lighting. There were COSHH risk assessments and data sheets available, and environmental risk assessments for issues such as smoking. The acting manager and deputy manager are currently undertaking the Registered Manager award. Staff said that they get very good support and the acting manager is approachable and operates an ‘open door’ policy. The acting manager demonstrated a clear overview of the daily issues and provided direct support to staff in managing challenging situations that occurred during the visit. There was evidence of clear delegation of work and good levels of communication between the staff team. Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 3 32 X 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 4 14 3 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 X X X X X 3 3 3 Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 19 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA20 YA21 YA41 Good Practice Recommendations It is recommended that the home make clear arrangements for the disposal of unwanted medicines. It is recommended that care plans include clear instruction regarding end of life arrangements following consultation, where applicable, with service users and/or their relatives. It is recommended that the home complete all information sections in residents files, for example using statements such as not applicable or not known where necessary’. Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Glengarriff House Nursing Home DS0000002629.V274854.R01.S.doc Version 5.1 Page 21 - 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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