Inspection on 19/11/07 for Glenkindie Lodge

This inspection was carried out on 19th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Glenkindie Lodge 14/02/07

Glenkindie Lodge 10/04/06

Glenkindie Lodge 05/01/06

Glenkindie Lodge 29/09/04

Glenkindie Lodge 26/04/04

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

CARE HOMES FOR OLDER PEOPLE Glenkindie Lodge 27 Harborough Road Desborough Northants NN14 2QX Lead Inspector Sarah Jenkins Unannounced Inspection 19th November 2007 07:45 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 Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glenkindie Lodge Address 27 Harborough Road Desborough Northants NN14 2QX 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) 01536 762919 F/P 01536 762919 Premedic Limited Julia Mary Exley Care Home 25 Category(ies) of Dementia (25), Old age, not falling within any registration, with number other category (25) of places Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following catergories of service only: Care Home only - code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is 25 14th February 2007 2. Date of last inspection Brief Description of the Service: Glenkindie Lodge is a privately owned care home providing personal care and accommodation for up to 25 Older People. Within this total number the home is able to provide care for up to 7 People with Dementia. The Home is situated in the outskirts of Desborough close to local shops and the town’s amenities. The premises consist of a two-storey house with an extension in progress. Residents are provided with single bedrooms with en suite facilities throughout the accommodation. Currently extensive building work is on-going to provide more bedrooms and major alterations to the existing main building. The Work has been considerably delayed and remains uncompleted despite the Commission’s expectation that it would be finished by April 2006. The Homes charges range from £348 to £420. In addition extra charges are made for Hairdressing and Chiropody services and newspapers. Any charges incurred for private Dentistry or Ophthalmic services are the responsibility of the Residents. Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements minimum standards of practice, and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting 2 service users and tracking the care they receive through meeting with the service users, a review of their records, discussions with the care staff and observation of care practices. The Inspector visited during the morning to observe practices by staff and to meet with service users. Some service users have various forms of dementia and thereby communication for some is difficult. Establishing Service Users choices and informed decisions is dependant to some extent upon the consistency of staff, service users relationships with staff, and the quality of communication. Feedback obtained from Service Users in this report was in part through observations of their relationships with staff, and also through interpretations of their general levels of happiness with their routines. There was no Annual Quality Assurance Assessment (AQAA, a self assessment document filled in by the Registered person) due or available at this inspection, or feedback comment cards. The history of the home, recent events, and a review of the homes detailed quality assurance processes helped to inform the inspection. The Inspector had a telephone discussion with the Responsible Individual after the inspection to discuss her concerns about the building works and to emphasize the need for environmental issues to be resolved. What the service does well: The management approach is open and inclusive, residents are enabled to exercise choice and autonomy and staff are provided with a clear sense of leadership. The service is being developed positively by a committed and active management team. Staff feel well supported and appropriate training opportunities are promoted. Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 6 Quality Audit is undertaken to a high standard and issues arising are reviewed and addressed. 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. The summary of this inspection report can be made available in other formats on request. Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 is not applicable in this home) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with the information they need to make an informed choice about where they live. A thorough assessment process is in place, and is documented, to ensure that their needs can be met, prior to their admission being agreed. EVIDENCE: The inspector reviewed the records of a recently admitted service users and found that a comprehensive evaluation of the prospective service users needs had been undertaken to ensure that the staff within the home would be able to meet these needs. Detail had been transferred to an initial care plan. Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 9 Service users expressed general content with the admission process and said that they had felt welcomed by the staff at the home. A Service Users Guide pack has been developed and includes the Statement of Purpose and the most recent inspection report for the home. Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The professionalism of the care planning processes leads to good outcomes for service users. Their individual needs and choices are promoted and well met. EVIDENCE: Service users were generally happy with the health and personal care that they received although they did not necessarily remember that they had been involved with their care plans. They thought that staff were generally helpful and treated them with respect and that they had people to talk to including the Manager and her deputy if they had any worries about their care. Staff spoken with, were knowledgeable about the care and support each service user required. Observations of staff interactions with service users showed that they had a good understanding of the individuals at the home. Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 11 Service users files are full of relevant and detailed information, which is likely to enhance the quality of care and understanding, and ensure consistent approaches from staff. The information is generally well organized, making the relevant and up to date details easily accessible for staff. Staff were observed to be caring and responsive to service users needs. Service users healthcare is properly supported and healthcare professionals including Occupational therapists are accessed as needed. Medication management needs review and improvement. The Registered Manager had already picked this problem up as part of her Quality Audit process and had started to address it. Issues include, the adequate labelling and identification of medications in the “nomad” system, poor storage of medications in the trolley and staff procedures. Risk is generally well managed and service users skills and abilities in relation to their daily living activities are properly risk assessed and reviewed. Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Daily routines are made flexible and social activities are meaningful and meet residents needs. EVIDENCE: Service users who were able to discuss their activities with the inspector spoke of their interest in their hobbies and how the staff supported them. One service user showed the inspector the Christmas card she had been making and said that this activity really pleased her. One of the staff members works voluntarily as an activities coordinator and outings are arranged. The Inspector had an opportunity to meet with four visitors to the home, including the visiting hairdresser, at the time of the inspection. All spoke of their views that the home provided a very good quality of care and activity and that staff were attentive and kind. Visitors, including representatives of local churches, are welcomed and offered hospitality. Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 13 Service users are involved in regular meetings at which they discuss their activities and the menu. The meal seen at the time of the inspection was appetizing and nutritious and choice was offered. Service users were generally very happy with the quality of the food provision and were confident that they would be listened to and that their needs would be met if they had any concerns or wishes. Nutritional assessments are undertaken and food and fluid charts were kept for frail service users or where a service users appetite was poor. Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are well protected by a caring and conscientious staff group but some processes could be improved. EVIDENCE: Staff receive training in Safeguarding Adults (Protection of Vulnerable Adults), and some policies and procedures in these areas are available. These are being reviewed and improved as in places they lack sufficient detail for staff to be able to confidently follow the processes. There is no complaints record at the home at present, and although it was evident that the excellent Quality Audit processes are likely to pre-empt complaints, the importance of setting up a record and showing how concerns raised are dealt with, was discussed. The record of finances held on behalf of Service users were good but advice was given on the importance of establishing the detail of service users financial affairs including Powers of Attorney at the time of their admission. Advice was given on records of staff supervisions in relation to any protection issues. Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The evident improvement in the environment has been noted, but the rating above remains since serious Health and Safety issues related to the building work, were identified at this Inspection. EVIDENCE: At the last inspection in February the manager said that the providers were experiencing considerable difficulty with their building contractors and this was the cause of delay to the building work. Some of these problems appear to be ongoing and were the subject of a discussion with the Responsible Individual after the inspection visit. Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 16 At the time of the inspection three Health and Safety issues were noted. These were: a perilously balanced heavy ladder on a stairway in use by staff but not by service users; a toilet area with loose wiring and building materials which was dangerous to service users with dementia, and a room occupied by a service user which was cold due to a radiator problem which was reported to have been forgotten by the builders. These matters were resolved by the time the Inspector left the home. Advice was given to purchase thermometers in order that temperatures around the home can be easily checked before they fall too low. However, a number of improvements in the premises were evident. The side of the home currently occupied by service users is almost complete, with the exception of an upstairs toilet (see above) and a further area (previously the kitchen) that is to be redeveloped as a dining room. Refurbishment including new carpeting has been undertaken. The garden area has been cleared and walkways provided. The other side of the building has largely been redeveloped and is in use only by staff. This area includes the new kitchen, laundry, a staff rest area and staff toilet/cloakroom, and the Managers office and storage cupboards. There are also bedrooms upstairs that have not yet been completed and are not yet registered. Given that the service users side of the building is essentially completed complete with refurbishment, the inspector has judged that the previous requirement made has been sufficiently met. Staff and service users expressed a feeling that although the remaining work was slow there had been considerable improvements since the last inspection. Therefore a new requirement is being made on the timescales for the full completion of the redevelopment, as much of this side of the home is part of the premises that is already registered. The Registered Owner has been advised of the importance of submitting achievable timescales and meeting these. All parts of the home in use by service users, and the kitchen, laundry and offices were very clean, and odour free throughout. Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are well met by a staff team who are experienced and appropriately trained. EVIDENCE: At the time of the inspector’s visit the night staff senior was “handing over” to three day carers. The shift leader was slightly delayed by the snow but arrived shortly, followed by the Registered Manager and her deputy. Catering and domestic staff members were also available through the morning. The Inspector observed that there appeared to be enough staff on duty to meet the current needs of service users, and there were no evident shortfalls in care. Staff spoke positively about their training opportunities and the support they received. Those who had been at the home for a long period commented on the improvements there had been in the last year. These included organization, support and training. Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 18 The Inspector observed interactions between staff and service users and saw that there was a sensitive and responsive understanding of older peoples needs and that staff recognized service users as individuals with individual needs. The Inspector met with a newly recruited staff member who described a professional recruitment process, and staff records demonstrated this. Two staff records and the training matrix were reviewed. Advice was given to the Registered Manager on the need to check any gaps in prospective staffs employment history. Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed in a manner that promotes service users wellbeing and rights. Records are well kept and staff well trained and supported. EVIDENCE: The Registered Manager is well qualified and motivated to provide a high quality service. There have been a number of improvements in the management of the home since her registration. The Registered Manager was observed to have a good understanding of service users needs and had developed a sensitive and caring rapport with them. Service users reported that both the Manager and her deputy were approachable and responsive to Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 20 their needs. The Deputy Manager is properly involved in the management of the home. Staff spoken with found the management approach at the home open and inclusive and said that staff had full access to care plans, policies and procedures. Staff meetings and residents/relatives meetings are held. Quality assurance questionnaires are sent out to staff, residents and relatives. Quality Monitoring and Audit are also carried out to a high Standard. Health and Safety issues are generally well monitored, but the delay in the removal of the ladder on the stairway presented an unacceptable ongoing risk to staff (see under Environment); and staff had not made the Registered Manager properly aware of the problem with the toilet left by the builders. Small amounts of resident’s personal money can be stored securely and records for this are maintained. The providers do not manage the personal finances of residents and do not act as an agent or appointee. Glenkindie Lodge DS0000012786.V354661.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 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 3 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 2 1 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 2 Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Partially met 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 06/01/08 1. OP19 23,13 A detailed plan to show the contracted timescales for the completion of all building and refurbishment work must be submitted to the Commission for Social Care Inspection to provide a safe, fully functional and reasonably decorated environment for service users. Health and Safety issues must be addressed promptly. The environment for service users and staff must be safely maintained and temperatures in all areas of the home at all times must be adequate to secure the safety and wellbeing of service users. (Action was taken to fulfil this Requirement at the time of the inspection) The medication system must be fully checked and reviewed to ensure procedures for the administration and recording of DS0000012786.V354661.R01.S.doc 2. OP19 OP38 13 21/11/07 3. OP9 13 14/12/07 Glenkindie Lodge Version 5.2 Page 23 medicines are safe for service users. 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 OP9 Good Practice Recommendations The Royal Pharmaceutical Society guidance on the administration of medicines in Care Homes should be accessed to ensure the home is following all relevant advice. A complaints record should be set up to evidence how concerns and complaints are responded to Where staff need to be advised on appropriate conduct a record should be kept in their staff supervision notes to detail this. 2 3 OP16 OP18 Glenkindie Lodge DS0000012786.V354661.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG 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 Glenkindie Lodge DS0000012786.V354661.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. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!