Inspection on 09/02/06 for Glenhomes Residential Home

This inspection was carried out on 9th February 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.

Other inspections for this house

Glenhomes Residential Home 27/02/07

Glenhomes Residential Home 05/05/05

Glenhomes Residential Home 16/11/04

Glenhomes Residential Home 30/07/04

Glenhomes Residential Home 10/03/04

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

CARE HOMES FOR OLDER PEOPLE Glenhomes Residential Home Greenmount Lane Heaton Bolton Lancashire BL1 5JF Lead Inspector Lucy Burgess Unannounced Inspection 9th February 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Glenhomes Residential Home DS0000009286.V263453.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 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. Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Glenhomes Residential Home Address Greenmount Lane Heaton Bolton Lancashire BL1 5JF 01204 841988 01204 841988 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) Mr David Anthony Hughes Mrs Glenys Hughes Mr David Anthony Hughes Care Home 21 Category(ies) of Dementia (1), Old age, not falling within any registration, with number other category (20) of places Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should at all times employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. 5th May 2005 Date of last inspection Brief Description of the Service: Glenhomes Residential Home is a care home providing personal (residential) care for older people. It is a large converted, semi-detached building, built on four floors (the fourth floor is not used by residents), with a passenger lift provided. There is a lawned area with mature borders and a patio area to the front of the building and parking space at the rear entrance to the home. The home has 21 places. There are seventeen single bedrooms and two double bedrooms (one of which has en-suite facilities). The home has 2 comfortable lounge areas with separate dining room facilities. Mr & Mrs Hughes owns the home. Mr Hughes is nurse qualified holding both the RGN and RMN nursing qualifications and also NVQ 4 Care Managers Award and is the registered manager and works in the home on a daily basis. Mrs Hughes is also nurse qualified (RGN). Mr & Mrs Hughes also own a second care home for older people in Bolton, Glenbank Residential Home. Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over one day for a period of 5 hours. The inspector took the opportunity to look round a number of bedrooms, kitchen and communal areas, view records as well as talk with a number of residents and staff. The visiting district nurse was also spoken with. Discussion and feedback was also held with the proprietor. The home is registered to provide accommodation for 21 people. There were 18 residents at the home at the time of the inspection. What the service does well: What has improved since the last inspection? No requirements were made at the last inspection. Where adult abuse training was recommended action has been taken to address this, however some staff have yet to attend. Staffing at the home has not changed offering consistent support and stability for the residents. Overall, Glenholmes provides a good quality service for each of the residents. Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 6 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. Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 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 Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None EVIDENCE: The key standards were looked at during the inspection carried out on the 5 May 2005. Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 to 10 The health and personal care needs of residents continue to be assessed and addressed appropriately. Care practices ensured that residents were treated with respect and their dignity upheld. Storage of medication was found to be satisfactory however improvement could be made to records ensuring practice is safe. EVIDENCE: Individual files were in place for each of the residents. Information included personal details, next of kin, GP and social worker, where relevant. Other records included a life history, care plan, risk and personal care assessments, professional appointments, clothing list and daily records. Care plans identified the needs of residents, how they were to be met and what support was required. On examination of a number of plans information detailed all aspects of the resident’s health, personal and social care needs, which appeared to be planned for. Risk assessments had also been completed in several areas including moving and handling, environment as well as issues specific to the needs of individuals. Plans and assessments are reviewed on a Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 10 minor monthly basis ensuring information is relevant to the current needs of the residents. Records are also made with regards to individuals’ weight. Where weight loss had been noted for one of the resident’s arrangements had been made for additional ‘build up’ drinks to be offered. Should further weight loss be noted additional advice and support would be requested from the GP and district nurse team ensuring that the resident’s health and well-being was maintained. The home ensures that where issues or concerns have arise in relation to the health and well-being of residents arrangements would be made with the relevant health care professional ensuring residents are well cared for. The medication system was inspected. Generally a safe system was found. All medication is provided by BOOTS chemist. On examination of the MAR sheets records are not made evidencing that medication has been checked into the home and corresponds with the record sheet. No records have been made with regards to medication returned to the supplying pharmacy however a returns book has now been received. The manager should make arrangement for all medication to be checked on receipt and signed for when any returns are made ensuring that the stock is managed effective and safely. The inspector observed medication being administered. Each residents was supported with their medication individually and a drink provided so that administration was easier. Records were completed as medication was given. It was noted that changes had been made to the record sheets in relation to the prescribed medication. Where information is changed this should be dated and signed to confirm when and who agreed it. At present the home does not have anyone requiring controlled drugs, however safe storage is available should this be required. The home also has a separate fridge for any medication, which may need to be refrigerated. Medication is only administered by those staff that have received the appropriate training with exception of one of the senior carers. The manager is currently looking into a suitable course. During the visit the inspector spoke with the visiting district nurse. Feedback received was very positive with regards to the approach offered by staff. The nurse found the staff to be very caring and supportive. If the home had any concerns regarding a residents’ health contact would be made with the nursing team to ensure that the appropriate care was being provided. The nurse also expressed that staff were willing to learn and would follow directions given. Glenholmes was described as a good care home, with good working relationships with the district nurse team. Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 to 15 Activities are provided within the home. Attendance varies due to individual preferences. The home’s open visiting policy means that residents can continue to see their family and friends as they wish. A choice of meals is provided. The main meals served in the home were good, offering choice and variety ensuring that the dietary needs of residents were fully met. EVIDENCE: A variety of activities are offered within the home. Activities include visiting workers who provide an exercise class, ‘sit me fit’ and crafts. Other activities are also provided by staff. The home has identified a senior carer who will have the additional responsibility for establishing an activity programme, developing activities both in and away from the home. During the inspection a number of the residents were seen to enjoy doing some needlework. Other residents spoken with preferred not to join in the activities and followed their own routines. This included going out for walks, visiting the local shops or sitting in their room listening to the radio or watching television. Visits to and from family and friends are encouraged. Visits take place either in the communal lounges or the privacy of residents’ bedrooms. Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 12 The kitchen is situated in the basement of the home and was found to clean and tidy with adequate equipment and food stocks. Meals are served in the dining room, however one resident spoken with expressed that he preferred to take his meals in his room this was accommodated. Small tables are provided within the dining room and were seen to be nicely set with napkins, cruets and flowers. Drinks are served with each meal. Those residents who require a special diet are also catered for. The cook was knowledgeable in relation to the specific needs of residents and ensured that alternatives were provided where necessary. Lunch was observed. Residents appeared to enjoy the meal served with positive feedback was received. One resident stated ‘lunch was lovely’. Choices are also offered with regards to breakfast, tea and supper. Regular drinks and snacks are served throughout the day. Records are made of all meals served. Additional records were made in relation to food temperature and fridge and freezer temperatures. Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Satisfactory arrangements are in place in relation to the protection of service users as well as responding to their concerns. Polices are in place outlining the appropriate response for allegations of abuse. Outstanding training has also been scheduled in this area. EVIDENCE: Clear policies and procedures are in place covering these standards. The complaints procedure was displayed within the home and is contained within the homes guide, which is available in each of the bedrooms therefore accessible to service users and their visitors. A file is in place for recording an issues raised. No concerns have been raised with the home or CSCI since the previous inspection. A copy of the Local Authorities Vulnerable Adults procedure has been accessed. The team have some knowledge in relation to the procedure to follow however staff training in relation to Vulnerable Adults has yet to be undertaken by all staff. Additional policies and procedures are followed by the home in relation to safeguarding the residents. This includes all relevant checks when employing staff including criminal record checks. Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Glenholmes provides safe, comfortable homely accommodation for those living there. EVIDENCE: Glenholmes is a large semi-detached house situated in the Heaton area of Bolton. The home is close to the main road between Bolton and Horwich and is easily accessible to public transport. The home provides pleasant comfortable accommodation for those living there. Accommodation is provided on three floors and comprises of 2 lounges, a dining room, 5 separate toilets, 3 bathrooms, one of which is assisted, 17 single bedrooms and 2 double rooms. Both double rooms also have en-suite facilities. The kitchen, laundry and staff office are situated in the basement. A full inspection of the home did not take place as all the standards were assessed at the previous inspection. The inspector did however see the bedroom of those individuals spoken with. Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 15 Bedrooms had been personalised with individuals’ belongings and pictures etc. One residents spoken with expressed that he was ‘quite content’ and that ‘I have everything I need’. The home employs designated domestic staff and a handy man that undertake all domestic and maintenance tasks within the home ensuring the building is clean and safe for the residents. The home was found to be clean, tidy and odour free. It was noted that in one of the ground floor toilets the handles had been removed from the taps preventing individual from washing their hands. This had been done due to the behaviour of a resident resulting in damage being caused. Consideration should be given to alternative arrangements so the individuals are able to wash their hands when visiting the toilet. Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 to 30 Sufficient staff was seen to be provided ensuring the needs of service users are met. On-going training takes place providing staff with the knowledge and skills needed in meeting the needs of the residents. Information required in relation to the recruitment of new staff has been gathered including criminal records checks therefore ensure the safety and protection of the service users. EVIDENCE: The home is registered for up to 21 people. At the time of the visit there were 3 vacancies. Staffing levels and rotas were looked at. Based on current occupancy sufficient staffing levels were found to be on duty during the day and evenings with 2 wake-in staff provided at night. The home also provides an on-call facility should additional support be required or escort to hospital. In relation to recruitment and selection a random sample of files were seen for both existing and new staff. Information was seen to include a completed application form including full employment history, references, health questionnaire, copies of identification and photograph. Evidence in relation to the Criminal Records Checks was not available within the home. The manager is advised to record details of the check on individual files. The Proprietor is registered with the Criminal Records Bureau, as a Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 17 signatory for checks required therefore application is easily made when employing new staff for either Glenholmes or their second home, Glenbank. Recent training has been held and included moving and handling and adult protection. Further courses have been planned in relation adult protection, food hygiene, NVQ’s and dementia. One of the senior staff also needs medication training. Attendance at all courses is to be recorded with the supervision discussion so that training can be monitored and where up dates are required the appropriate arrangements can be made. Copies of all certificates are held within staff files. The home has also developed a training feedback questionnaire for staff to complete following all training. This will enable the management team to monitor whether the training provide is effective and meeting the development needs of the team. In relation to NVQ qualifications the home has been very progressive in providing the training. Ten of the care staff have gained the level 2 and two staff have gained the level 3. A further 3 staff have now signed up for level 2, 6 have signed up for level 3, with senior staff to complete the level 4 in the care. One of the managers is also to undertake the Registered Managers Award. The home has a structured induction programme in line with the TOPSS (now skills for care) specification. This had been completed by all new staff as well as formal training. Discussion was held with several member of the team. Feedback received was very positive. Staff felt there were clear roles and responsibilities and that communication was good between managers and carers. Comments included, ‘it’s relaxed and homely’, ‘we have a good team’ and ‘I enjoy the work’. Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35 and 36 The overall management of the home is consistent and reliable for the people living there. Staff are offered and support and guidance ensuring standards of care are maintained. Adequate arrangements are in place to safeguard service user finances. EVIDENCE: The home is owned by Mr and Mrs Hughes. Mr Hughes is the Registered manager of the home and holds qualifications in both general and mental health nursing as well as a Diploma in Management Studies. In line with his responsibility as Manager he has also completed the Registered Managers Award. In relation to the day to day management of the home the Registered Manager is supported by another manager who takes responsibility for up dating care plans and supervising and supporting staff. Training is to be Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 19 completed by the manager in relation to the Registered Manager Award, however overall responsibility will remain with Mr Hughes. With regards to the residents finances, in the main families take overall responsibility for the residents money particularly for those who lack the capacity to do so themselves. The home only holds personal allowances for those who require assistance. Records and receipts are held for all transactions made. Money is held securely and individual records are maintained. The system of staff supervision is currently under review. Previous arrangements have focused on staff being observed undertaking specific care tasks. Opportunity is to be made available for the staff and manager to meet on a 1-2-1 basis so that care practice, training, concerns etc can be discussed more formally. Discussions are also to be recorded and copies held on file. The process of observation will continue with sessions alternating. The manger must ensure that a minimum of 6 sessions are held each year for all staff as outlined within the standard. Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 X 18 2 3 X X X X X X 2 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 X X 3 2 X X Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 21 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. 4. 5. Refer to Standard OP9 OP9 OP26 OP29 OP36 Good Practice Recommendations That a record is made of all medication received at the home. That where changes have been made to the medication record sheets information is dated and signed to confirm when and by whom it was agreed. That the taps are repaired/replaced in the identified toilet providing suitable hand-washing facilities. That evidence is placed on staff files of the Criminal Record Checks. That all staff receive a minimum of 6 supervision sessions per year. Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Glenhomes Residential Home DS0000009286.V263453.R01.S.doc Version 5.1 Page 23 - 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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