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Inspection on 02/06/08 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 2nd June 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

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

The home provides accommodation for people with a defined learning disability. Staff, are well trained and supported by the registered manager and have a knowledge of residents needs. The staff team work well together and have established a good working relationship with the community health care teams and local GPs.

What has improved since the last inspection?

Details of any complaints are now kept within the care home which was not the case at the last inspection. The staff training programme has been reviewed and additional training provided.

CARE HOME ADULTS 18-65 Glengarriff House Nursing Home 8 King Street Market Rasen Lincs LN8 3BB Lead Inspector Ken Hague Unannounced Inspection 2nd June 2008 09:30 Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 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.V367034.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 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.V367034.R01.S.doc Version 5.2 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) info@prime-life.co.uk www.prime-life.co.uk Prime Life Ltd Miss Nicola Jayne Broddle 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.V367034.R01.S.doc Version 5.2 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 6th December 2006 2. 3. Date of last inspection Brief Description of the Service: Glengarriff House is owned by Prime Life Homes Ltd. 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 for 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, across a courtyard there is also a semi- independent living unit consisting of four flats for six people. The registered manager is Nicola Broddle. The fees are £411 to £1050 per week depending on the assessed needs of each client. Additional charges are made for services such as chiropody, hairdressing and toiletries. Information about these costs as well as the dayto-day operation of the home, including a copy of the last inspection report, can be found in the home statement of purpose and service user guide. These documents are made available to all new potential residents and explain the resources and services offered, by the care home. A dedicated intermediate care service is not provided by the home. Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience Adequate quality outcomes. The inspection took place over 5.5 hours. The registered manager was present throughout the inspection. Feedback was given at the conclusion of the site visit. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents and related care practices. A sample of care records was inspected. Two members of staff were interviewed. An (AQAA) Annual Quality Assurance Assessment was completed by the care home and sent to the Commission for Social Care Inspection prior to the site visit. This is a self- assessment document completed by the providers of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. It is normal procedure to obtain written feedback from residents, staff and relatives prior to the site visit using a document called “have your say”. This document sets out a number of questions for people to answer. In the case of this key inspection 2 were returned from service users, 3 from staff and one from a relative. Observations were made of the interactions between staff and residents through out the site visit. What the service does well: What has improved since the last inspection? Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 6 Details of any complaints are now kept within the care home which was not the case at the last inspection. The staff training programme has been reviewed and additional training provided. 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. Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 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.V367034.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard2 Quality in this outcome area is Adequate This judgement has been made using available evidence including a visit to this service. Residents benefit, from a thorough assessment process, and are assured that their needs can be met. However detailed risk assessments have not been consistently carried out for all new residents. EVIDENCE: There are policies and procedures in place to ensure that the health care and social needs of each resident, are identified at the point they are admitted to the care home. This process includes a detailed comprehensive risk assessment, which leads to the development of a risk management plan where any risk is identified. In the case of one resident this procedure had been followed. In the case of a two other residents no comprehensive risk assessment was on the care records. It was established by observations and discussions with the registered manager and staff that there was risk identified for both of the other residents. Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 & 9 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. Care plans do not identify the needs of each resident and state how these needs will meet by the resources of the home. EVIDENCE: Three residents were case tracked during the site visit. One of these residents spent the whole of the time of the site visit on the stairs inappropriately dressed. Staff stated that his care records did not provide advice and instructions on how to manage this situation. His care plan did not advise staff how to preserve his dignity and privacy when he was in this distressed state. The managers of the care home have stated to CSCI that this resident requires an alternative placement, as the resources of their care home cannot now meet his identified needs. Steps are being taken by Social services to find an alternative placement. Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 10 The company accepts that this resident’s care plan did not advise staff how the resident’s needs were to be managed in the interim period. Action has been taken since the site visit to review and amend his care plan. In the case of a second resident who damages the walls and furniture in her bedroom again no action plan was in place to deal with this problem. A third care plan seen on the day of the site did provide sufficient information to ensure that the needs of this resident were met. Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16 & 17 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. A range of activities are provided for residents but activities are limited by the numbers of staff on duty. The home’s menu offer choices and meets the dietary needs of residents. EVIDENCE: Activities offered to residents are set out in the AQAA. The registered manager stated the choices the wishes of the residents regarding their social life are identified at the initial assessment. She described the range of activities, which are made available for residents to participate in. However on the day of the site visit no activities were taking place. This was because one member of staff had failed to come into work. The registered manager agreed that on some occasions it is difficult to provide activities when the resident’s demands are very high with present staffing levels. She stated that residents do attend community events in the local area. Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 12 There was evidence found in a relative’s “Have your say” document to say that residents are assisted to attend local religious services. The registered manager supplied a copy of the menu, which demonstrated choices. Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 &20 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Resident’s health care needs are met in the way they personally choose to receive help. The updated medication policy for the care home is being followed ensuring that medication is administered safely. EVIDENCE: Staff have an in-depth knowledge of the residents needs. This was evidenced in staff discussions and discussions with the registered manager. Staff stated that making sure that resident’s needs are met in the manner and choice of the individual resident is given high importance. Staff said that emotional support is very important to many of the resident staying at the care home. It is therefore important for us to understand them as individuals. The “have your say” documents returned by residents and relatives contained evidence that the health care needs are being met by the care home. Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 14 Staff and the registered manager confirmed that the medication policy is being followed. The administration of controlled medication was observed. The medication procedure was followed records were completed appropriately. Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Resident’s benefit from procedures about complaints and adult protection, which are comprehensive and up to date. EVIDENCE: The evidence from the inspection of the complaint procedures, records at the home and discussion with staff and residents is that the complaints procedure is accessible to all residents. This ensures residents can raise concerns or make a formal complaint. Three complaints have been received since the last key inspection. Two are on going. No complaints to the company have been upheld. Staff interviewed during the site visit stated the management are very approachable and would act immediately if any complaints or concerns were raised with them. There has been two Adult protection enquiries held at the home since the last key inspection. One has been completed and action taken by the company. The second is to be discussed in July 2008 with the company, now that enquiries have been completed by social services. The inspection of training records and discussion with staff provided evidence that staff have received training in the identification and prevention of abuse. Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 & 30 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. The Environment of the care home is poor. Staff are not following the infection control procedure. EVIDENCE: A relative stated in her survey “the style of care home, by that I mean the whole ambience of the home, is very poor. It is of shabby appearance. I really think and a good housekeeper would be of benefit to help with the residents clothing and to bring some sort of the order”. Observations made support the above comments. The home was very poorly decorated. It was not clean. Essential items such as curtains for the protection of resident’s dignity had been pulled down and not replaced. All areas within a care home seen during the site visit required cleaning. Two bedroom floors were very dirty. The staff stated that they had not had time to clean it. Cleaning equipment and liquids were not kept in a locked cupboard Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 17 for safety. The cleaner was only employed for 15 hours per week. There was evidence of ongoing maintenance to cope with the predictable damage caused by some residents. Since the site visit the registered manager has informed the Commission for Social care Inspection that cleaning hours have been increased. The company has now commenced an action plan to address the environment issues the work is expected to be completed by end of July 2008. The manager stated on the 26th of June 2008 that she is confident that the infection control policy is now being followed by all staff. Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,34 &35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are supported by well-trained staff, who have been recruited safely using the up-to-date recruitment policy of the care home. EVIDENCE: Staff stated that in their opinion there are always sufficient staff on duty to meet the needs of residents, included the night time period. Staff confirmed that they had been provided with training opportunities since the last key inspection include some specialised courses. This statement was supported by the training plan and training records of the care home. There was evidence of all new care staff being given inductions. On the day of the site visit 47 of care staff held an NVQ 2 or equivalent. The inspection of a recruitment records for one member of staff provided evidence that the homes recruitment policy is being consistently followed. All of the documents required by the care home regulations had been obtained prior to any member of staff commencing employment. Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,39 & 42 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. There is Positive leadership; guidance and direction to staff. Staff are being adequately supervised. Working practices do not promote the health and safety of residents. The infection control procedure has not been followed. EVIDENCE: There is a registered manager in post. Staff stated that she is very approachable and supportive. Staff stated she is committed to ensuring services provided by the home are of a good quality. The registered manager demonstrated throughout the day of the site visit a sound knowledge of the care home regulations and a commitment to ensuring quality care is provided by the home. Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 20 There are updated policies and procedures in place, which ensure the financial interest of all resident’s are safeguarded. The home only manages the personal allowance for some residents. Records are kept to demonstrate that the homes policy is being followed. Risk assessments for residents were not being managed. This places resident and staff at risk. The failure to follow the infection control policy in relation to the cleaning of the home and the securing of dangerous chemicals potentially places resident’s health at risk. Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 21 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 2 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 1 25 X 26 X 27 X 28 X 29 x 30 1 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 3 x 2 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 2 x Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15-1 Requirement Care plans must tell staff how identified risks are to be managed by the resources of the home. To prevent injury to staff and residents 2 YA24 23-2 The home must be maintained to provide a safe and comfortable home for residents. 30/08/08 Timescale for action 16/08/08 3 YA30 13-3 To ensure all residents are provided with an appropriate and safe facilities The home must be kept clean. 14/07/08 This will to prevent odours and possible infections. The health and safety and infection policies of the home must be followed. To ensure residents are protected from any source of harm 4 YA42 13-4 14/07/08 Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 23 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 YA8 Good Practice Recommendations It is recommended that signs and notices around the home be translated into easy read words and pictures, including the complaints procedure. It is recommended that the service users have access to the activity plan. It is recommended that the registered manager has allocated management hours, so as to monitor the service provision. 2. 3 YA14 YA39 Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Glengarriff House Nursing Home DS0000002629.V367034.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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