Inspection on 25/07/05 for Glengarriff House Nursing Home

This inspection was carried out on 25th July 2005.

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

Glengarriff House Nursing Home 02/06/08

Glengarriff House Nursing Home 06/12/06

Glengarriff House Nursing Home 12/01/06

Glengarriff House Nursing Home 22/11/04

Glengarriff House Nursing Home 14/06/04

Glengarriff House Nursing Home 22/07/03

Similar services:

Hillside

Applegarth

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Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Glengarrif House Nursing Home 8 King Street Market Rasen Lincs LN8 3BB Lead Inspector Wendy Taylor Unannounced 25 July 2005 @ 9am 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 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 Stationary 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. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 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 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 Care Home with Nursing 18 Category(ies) of LD - Learning Disability - 18 registration, with number LD(E) - Learning Disability (over 65 years) - 1 of places Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is registetred 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 Date of last inspection 22 November 2004 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 accomodation 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.. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day in July 2005. Eighteen people were residing at the home on the day of inspection. There were no outstanding requirements or recommendations from the previous report. Five service users, 1 relative, 1 visiting professional and 1 member of staff were spoken to during the inspection. Service user and staff files were looked at, and a tour of the building was carried out. General observations of interactions and care practices were made throughout the visit. Comments made by the people spoken to included ‘I’m chuffed to be living here’, ‘can’t get anywhere better’ and ‘staff are lovely’. What the service does well: What has improved since the last inspection? 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. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 7 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 standard(s) 1,2,3,5 Service users and their relatives benefit from comprehensive information, which enables them to make a clear choice about where to live. They are assured that the home can meet their needs by way of a thorough assessment process. EVIDENCE: The home has a comprehensive statement of purpose and service user guide, which are both available in pictorial format. The acting manager agreed to ensure that Commission for Social Care Inspection details were updated within the complaints policy and included in the service user guide. Three service user files were looked at and they contained initial and on-going assessments including nutrition, communication, mental health and behaviour. There was evidence that assessments were reviewed and updated alongside care plans were necessary. There were also Community Care Assessments on each file. Contracts including terms and conditions were available on some service user files and others were kept at the company’s head office. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 8 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 standard(s) 6 - 10 The home provides an environment in which individuals are respected and independence is promoted. Service users benefit from the opportunity and support to make decisions about their own lives. Records are generally well maintained but more work needs to be done in regard to care plans. EVIDENCE: Care plans were available on individual files with the exception of one new admission. Care plans such as those for occupation, ‘my life’ and personal care, demonstrate the promotion of independence for the individual. Risk assessments were available for issues such as scalding, finance and security of room keys. There was evidence of care plans being reviewed and revised where necessary, and evidence of annual care management reviews. Service users were being offered the opportunity to participate in household shopping and cleaning routines to whatever level they wished and were able. They were offered choices in all daily activity for example staff prompted with questions such as ‘what would you like to do today’ and where do you want to go’. They also demonstrated respect for individual privacy and dignity by knocking on bedroom doors, attending to personal needs in private and addressing service users in a respectful manner. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 9 One service user said that she gets help to cook, pay the bills and do the shopping but she can live her own life. Another service user said that she has keys to her room so others can’t go in, and she can do what she wants with her day. She said that staff always help her when she asks and she likes living at the home. The home was able to demonstrate that alternative forms of communication are encouraged, such as Makaton, to ensure that all service users are able to express their needs and wishes. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 10 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 standard(s) 12,14,15,17 Records demonstrate that dietary needs are met and service users benefit from a choice of food. Service users enjoy a range of activities both in the home and in the local community, and they benefit from the promotion of family involvement. EVIDENCE: There was evidence of activities within care files such as attendance at parties, fayres, shopping and general trips out. Service users said that they often go to the local shops and restaurants, and they can choose whatever activity they like to do. There was evidence in care files that family involvement is encouraged and the inspector saw a service user being supported to telephone family members. One relative said that she had ‘peace of mind’ since her relative had come to live at the home. She said that it was a welcoming environment and there were good levels of staff support. Service users said that meals were very good and they can have what they want to eat. The inspector saw two service users having breakfast at a time of their choosing. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 11 Varied and balanced menus were available and nutritional assessments were available in individual care files. Staff demonstrated awareness of individual likes and dislikes. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 12 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 standard(s) 18-21 Service user’s benefit from clear and detailed care planning and a well informed, respectful staff team. Records are generally well kept but further work regarding the consistency of recording information would be beneficial. EVIDENCE: Individual files contain a care plan entitled ‘My life’ which provides evidence that care and support is provided in a manner that is suitable to the service user. Care plans include physical health needs such as epilepsy and they contain a health action plan. There were also care plans for needs such as skin care, communication, mental health, behaviour and eating and drinking. Files also contain records of support service input such as physiotherapy, chiropody, dentist and opticians. Some of these records are not fully completed but the information is available elsewhere in the file. Staff demonstrated that they had detailed knowledge of service user needs, including their health requirements. Daily notes reflect care plans. Staff demonstrated respect for individual privacy and dignity by knocking on bedroom doors, attending to personal needs in private and addressing service users in a respectful manner. The home has a comprehensive medicines policy and administration records and storage were satisfactory. Protocols were in place for medication that is administered only where necessary. Individual files contained information on the arrangements to be made in the event of the person’s death. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 13 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 standard(s) 22,23 The home ensures that the service users have the opportunity to voice their views and opinions. Service users benefit from a robust complaints policy and adult protection procedures. They also benefit from the staff team’s knowledge and awareness of the policies and procedures. EVIDENCE: There has been one adult protection issue reported since the last inspection. The issues was appropriately managed and satisfactorily resolved by the home and the local social services. There have been no complaints made to the home or to CSCI since the last inspection. The home has a robust complaints policy and a copy of the local adult protection procedures. Staff demonstrated a clear understanding of the complaints and adult protection procedures, and records demonstrated that they have received training in adult abuse. Service users said that staff always listen to what they have to say and give them help when they need it. Staff were observed to listen and act upon the views expressed by service users during the inspection. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 14 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 standard(s) 24,25,26,27,28,30 The home provides a comfortable and homely environment. Staff maintain a high standard of cleanliness and encourage service users to personalise their bedrooms. As well as personal space, service users benefit from a choice of shared spaces that can accommodate a variety of activities. EVIDENCE: On the day of inspection the home was cleaned to a high standard, tidy and comfortably furnished. The acting manager said that there are plans to provide a quiet seating area on the first floor for those who do not wish to use the lounge or other communal areas. Flats and bedrooms were personalised in line with individual wishes and needs and have door locks in place to provide privacy where required by the individual. Service users said that they had chosen their own décor and were very happy with their personal space. Bathrooms and toilets provide ample space for a service user to be supported with their personal needs. General environmental risk assessments are in place. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,34,35,36 There is an appropriately trained staff team who are able to meet service user’s needs however the home needs to provide regular staff supervision. Recruitment practices within the home are generally robust and protect the service user, however the home needs to demonstrate that all required information is available. EVIDENCE: Three staff files were looked at. One file contained two verbal references but none in written format. This had been highlighted in a recent in-house audit and the acting manager said that they are currently seeking written references. There was evidence that annual appraisals had been carried out with staff and supervision contracts had been agreed. The acting manager said that individual supervision sessions had not yet commenced but an annual plan has been drafted, which she agreed to forward to the Commission. Training records demonstrated that all staff have commenced the Learning Disability Award Framework, 9 members of staff have signed up to complete NVQ Level 2 and 1 member of staff has commenced NVQ Level 3. There was evidence that annual adult abuse training has been booked and the manager has presented report writing training to the majority of staff. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 16 Records also demonstrated that staff have received training in challenging behaviour, first aid, dementia, Control of Substances Hazardous to Health, basic food hygiene, medication, fire safety and moving and handling. Staff demonstrated that they are fully aware of their roles within the home and they demonstrated motivation towards carrying out their roles. A visiting professional said that the home work in a very co-operative manner with outside agencies, they are knowledgeable about service user needs, they complete required paperwork in a timely manner and they are welcoming to visitors. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,42 The home is well managed, ensuring that service user’s health and safety is maintained. Service users and staff benefit from an open and supportive management approach in which their views are respected. Records are generally well maintained although some risk assessments need to be signed and dated. EVIDENCE: The home has a range of policies and procedures e.g. physical intervention, health and safety, access to records, continence, fire safety and Legionella controls. Policies were updated in November 2004. Risk assessments for the environment were seen and individual service user risk assessments were contained in personal files. The general kitchen safety assessment was not signed or dated and the fire risk assessment was not dated. Other fire records were satisfactory, materials included in Control Of Substances Hazardous to Health regulations were stored appropriately and data sheets were available. Portable appliance testing is carried out and records were satisfactory. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 18 There was evidence of regular service user meetings in which they are able to express their views and opinions, and of in-house auditing processes. There is now a new system to record management visits to the home (Regulation 26). Staff said that the acting manager provides good support and will always make time to speak to staff when they need it. The acting manager was seen to provide very clear, appropriate advice and support to staff throughout the inspection. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 x 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 x 2 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Glengarrif House Nursing Home Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x 3 3 C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 20 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 6 Regulation 15 Requirement The responsible person must ensure that all service users have an individual plan of care. The reponsible person must ensure that two written references are available on each staff file. The responsible person must ensure that staff are appropriately supervised. It is recommended that this includes a recorded meeting held at least six times per year. Timescale for action Within 1 week from the date of inspection. 25 September 2005 25 October 2005 2. 34 19, Schedule 2 (5) 18(2) 3. 36 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 5 19 Good Practice Recommendations It is recommended that a copy of the contract/terms and conditions for the placement are kept on all service user files. It is recommended that support service records such as physiotherapy, chiropody, dentist and opticians are kept up to date in order to maintain consitency and clarity of information. C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 21 Glengarrif House Nursing Home 3. 42 It is recommended that home review environmental and fire safety risk assessments for dating and signing. Glengarrif House Nursing Home C53-C04 S2629 Glengarrif House V240029 250705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 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. 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