Inspection on 11/09/08 for Glenmuir House

This inspection was carried out on 11th September 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Glenmuir House 12/09/06

Glenmuir House 14/11/05

Glenmuir House 17/05/05

Glenmuir House 09/11/04

Extracts from inspection reports are licensed from CQC, this page was updated on 23/11/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Glenmuir House 4 Branksome Road St Leonards On Sea East Sussex TN38 0UA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Deborah Calveley     Date: 1 1 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Glenmuir House 4 Branksome Road St Leonards On Sea East Sussex TN38 0UA 01424430203 01424428017 glenmuir@angelhealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Nicola Anne Pearce Type of registration: Number of places registered: Angel Healthcare Ltd care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Only older people who have been assessed as requiring residential care are to be accommodated. Service users should be aged 65 years or over on admission. The maximum number of service users to be accommodated is 20. Date of last inspection Brief description of the care home Glenmuir House provides residential and personal care to up to twenty older people. The property is a large detached building situated in a quiet residential area of St Leonards. Accommodation is provided on three floors, having a passenger lift that provides level access to all rooms. Glenmuir House has been registered as a care home since 1978 and owned by Angel Healthcare Limited since June 2004. The gardens, surrounding the home, are well kept and readily accessible to the service users. The home is approximately one mile from the town centre and sea front. A bus service runs near to the home. Care Homes for Older People Page 4 of 30 0 Over 65 20 Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Glenmuir will be referred to as ‘residents’. This was a key inspection that included an unannounced visit to the home and follow up contact with resident’s representatives and visiting health and social care professionals. This unannounced inspection was carried out over 6.5 hours on the 11 September 2008. There were 16 residents living in the home on the day, of which four were case Care Homes for Older People Page 6 of 30 tracked and spoken with. During the tour of the premises four other residents both male and female were also spoken with. The purpose of the inspection was to check that the requirements of previous inspections had been met and inspect all other key standards. A tour of the premises was undertaken and a range of documentation was viewed including the Service Users Guide, Statement of Purpose, care plans, medication records and recruitment files. Four members of care staff and the cook were spoken with in addition to discussion with the Manager and registered provider. Telephone contact was made with visiting professionals following the visit and their views and comments are incorporated into the report along with the comments from four resident surveys and two care staff surveys. The information received verbally during the site visit has been incorporated into this report. An Annual Quality Assurance Assessment was received from the Manager completed in February 2008. What the care home does well: What has improved since the last inspection? What they could do better: The home needs to confirm in writing to the prospective resident or their representative that with regard to the needs assessment completed the home can Care Homes for Older People Page 8 of 30 meet the needs of the prospective resident. This ensures that decisions around admission to the home are informed. Some of the documentation in the care plans were not in use and therefore were misleading, E.g bowel charts and residents weights. The care planning system needs to be reviewed to ensure its appropriate for the home. To ensure that the infection control measures are robust the home need to ensure that there is suitable equipment to deal with soiled laundry. The accident records regarding falls and trips needs to be monitored regularly and the outcomes linked to individual care plans and risk assessments to prevent a recurrence. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides prospective residents and relatives with a good level of information about the home, its facilities, services and the costs involved. The admission procedures allow for the needs of prospective residents to be assessed by a competent person before admission, however people are not assured in writing that their needs will be met. Evidence: There is a Statement of Purpose and Service Users Guide in place, which contains a good level of information about the home and the services it provides. A recommendation would be that the section containing staff qualifications include in a clear statement regarding the regular updates and refreshers undertaken by the staff. A copy of the Service Users Guide is in the residents care plan, which is kept in their bedrooms. This is potentially a good idea, however not all the residents spoken with were aware of the care plan in their room, two residents said that they had never Care Homes for Older People Page 11 of 30 Evidence: looked at the folder and thought it was just for the staff. It would benefit the residents if the care plan and service users guide were promoted at the next resident meeting. It was confirmed whilst talking to residents that the contract arrangements and terms and conditions of residency were clear and understood. There is a copy of the terms and conditions of residency included in the homes information documents and in the residents care plan. Four admissions to the home were identified and the records relating to the admission procedures followed were reviewed. This confirmed that pre admission assessments are completed and provide a clear assessment of prospective residents care needs. These are completed by the registered manager and discussion with the manager confirmed that these are used to ensure new admissions to the home are appropriate and that the home have the staff equipment and environment to meet their care needs. Prospective residents are seen either in their home or hospital before admission and the input from relatives and other professionals is used whenever possible. This approach should be more clearly recorded on the assessment documentation to demonstrate the procedure followed. It was however noted that the home does not confirmin writing having regard to the assessment that the home can meet the assessed needs of the prospective resident. This was discussed with the manager, who was advised that this should be completed in writing in accordance with the regulation 14. The manager was able to verbally demonstrate her knowledge and awareness of the different specialities required in the home and ensures that the carers employed have attended relevant courses to deal with the needs of the elderly and also specialised courses for certain diseases. Trial visits to the home can be arranged. The manager confirmed that residents are invited to a trial period to ensure suitability of the home this is clearly stated in the Statement of Purpose and in the statement of terms and conditions. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans provide a framework for the delivery of care, which give guidance to care staff on all the care needs of all the residents. The home was found to be meeting resident’s health and general needs with accessed additional specialist support when needed, practices in the home allow the privacy and dignity of residents to be promoted. Evidence: The care documentation pertaining to four residents were reviewed in depth as part of the inspection process. The majority of residents were found to have care plans specific to their needs, and evidenced in the main regular review. The Care plans included risk assessments for health needs medication reviews and demonstrated that overall the needs of residents are assessed and evaluated on a regular basis, however the weights of some residents have not been recorded regularly. On discussion it was found that the scales are not suitable for many of the residents, suitable scales or a different monitoring system needs to be used. The bowel charts have not been completed since July 2007, it was discussed that if the paperwork is not being used it Care Homes for Older People Page 13 of 30 Evidence: needs to be removed and an alternative monitoring system devised. Discussion took place regarding the format used and the ideas for simplifying the documentation, so important information is not lost within many varying documents. A more accurate way of cross referencing needs to be devised as residents needs change. Whilst these shortfalls did not impact on the positive outcomes of the residents at this time due to the knowledge the staff have on individual resident the home needs to ensure that the shortfalls are addressed to protect the residents and promote their health and well being. A requirement was not made at this time as the manager was aware of the shortfalls in the documentation used. Staff spoken with confirmed that they received a full report on each resident daily. Residents spoken with were satisfied with the care provided at the home one saying that the home is very nice I receive good care and care workers are kind and friendly Staff are efficient and competent Further comments included they look after me very well, I have my own room and the staff let me have my independence but are there if I need them a home from home I came here for a short stay and then realised I could not go home so I chose to stay here. There are policies and procedures in place for staff to refer to regarding the safe administration, storage, disposal and recording of medication. The systems for recording and checking controlled drugs were found to be thorough. The Medication Administration Charts (MAR) were viewed, a few gaps were identified and these need to be followed up by the senior staff. Some poor practice issues were identified and these include: Tippex was found to have been used on the MAR sheets, and staff were signing in red ink, the MAR sheets do not include the codes used by staff for the non administration of prescribed medicines and there are no records kept of dates and reasons for non administration. As discussed during the inspection this needs to be introduced to provide vital information for the G P and for audit purposes. The comparison signatures of staff able to administer medication were also not available and current. There are suitable storage facilities for medication stocks and dressings, a medicine trolley is stored in the corridor when not in use, it is not secured and this was identified and needs to be actioned. From direct observation the morning medications were administered safely and were in line with the homes policies and procedures. Advice is to be sought from the pharmacist regarding the dispensing of medications to residents who then take it later when they wish to. This needs to be supported by appropriate risk assessments to ensure the safety of the resident is not compromised. Feedback from a health professional was positive regarding the home and confirmed that advice was sought as and when required. The district nurse visits the home to see residents who are receiving treatment for leg ulcers, pressure damage and indwelling catheters. There are at present no diabetics living in the home. Care Homes for Older People Page 14 of 30 Evidence: Staff were seen to be respectful and considerate to all residents whilst attending to their needs. Each of the residents were addressed by their preferred term and dressed appropriately in well-laundered clothing. The atmosphere in the home was warm, friendly and the interaction seen was very positive. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals continue to be creative and provide variation and interest for people living in the home. Residents are able to make a range of choices about their lives as well as maintaining links with friends and relatives. Evidence: Activities in the home are provided regularly but not on a daily basis. The activity programme was found distributed throughout the home and residents bedrooms. The september programme offered tai chi, music sessions with outside entertainers, bingo, aromatherapy, motivation sessions, communion and every Sunday sherry and crosswords. The residents were of mixed mobility, and those that are able talked of trips out and walks on the sea front. The activities in the home are enjoyed by the people who live there and only positive comments were received. From talking to residents and visitors the level of support given to residents regarding their wishes of their daily life was appropriate. It was confirmed by staff and the residents that the residents are supported and enabled to join local events and attend the Church Services at a nearby church. Residents are facilitated to maintain their independence for as long as they are able. There are no restrictions on visiting times as long as Care Homes for Older People Page 16 of 30 Evidence: consideration is shown to all the residents. There are communal areas throughout the home that are available to residents and their visitors for private meetings if required. Many of the residents have individualised their bedroom with items from home and residents and relatives spoken with confirmed that they are encouraged to make it homely. It was observed during the inspection that the routines at the home are flexible, residents spoken with confirmed that they were consulted about all aspects of their lives. The home has an advocacy policy in place and the information regarding this is available to all residents. The meals provided by the home are nutritious and well balanced with thought given to residents tastes and preferences. The daily mealtime choices are discussed with residents on the day before, the menu is also displayed on the lounge door. Records are kept of all the meals served, it would be beneficial to also include amount eaten as it identifies appetite trends and picks up problems early. The inspector joined the residents for their mid day meal and the company and the food was most enjoyable. Residents also enjoyed a glass of their own wine with lunch. Fresh fruit and vegetables are readily available. The kitchen has recently been inspected by the Environmental Health Team and the home has acted on their recommendations. The residents comments included, ‘the food is very good’, ‘we get a good variety’, ‘its really very good’. The kitchen was clean and tidy, the head cook keeps cleaning schedules and completes the ‘safer cooking better business’ in accordance with the environmental health agency. Consideration should be given to the provision of fly resistant coverings for the windows in the kitchen and a commercial dishwasher. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a formal complaints system with evidence that residents feel that their views are listened to and acted upon. Staff receive training to protect residents from abuse. Evidence: The complaint policy and procedure is clear and uncomplicated and a copy of this is readily available in the home and the Service Users Guide. A system of recording complaints was demonstrated to the inspector during her visit to the home. The home has not received any complaints since the last inspection. Relatives and residents spoken with confirmed that they were confident that any complaints or concerns that they had would be listened to and responded to effectively. The home has relevant guidelines on the protection of vulnerable adults and staff have now all received appropriate training. The management team has a clear understanding of adult protection guidelines and are aware of how to initiate an investigation if required. Care Homes for Older People Page 18 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Glenmuir provides a comfortable, clean and safe environment for those living in the home and for those visiting. Residents are enabled and encouraged to personalise their room, and rooms are homely and reflect the resident’s personalities and interests. Evidence: The tour of the home confirmed that the home is well maintained and bedrooms are attractive with some being very personalised and all bedrooms have an ensuite facility. Staff enter maintenance issues in a book which is then actioned by the maintenance person who works between all four homes. The layout and location of the home is well suited for its purpose and meets the expectations of the people who live there. The gardens are well maintained and enjoyed by the residents when the weather is suitable, there is a designated outside smoking area for those residents who wish to smoke. There are adequate communal bathrooms and shower rooms in the home with specialist equipment to ensure all residents can have a bath or shower. The home has specialised equipment available throughout the home to promote independence. During the inspection it was noted that staff were aware of good moving and handling techniques. There is a suitable passenger lift which provides level access to all areas of Care Homes for Older People Page 19 of 30 Evidence: the home. Call bells are provided in all areas and staff were seen to be attentive and ensured residents had access to these. The home has access to special mattresses and seat cushions which are used on an assessed needs basis to prevent tissue damage, the staff were able to discuss how they procure special equipment if they should need it. The lighting in the home is of domestic quality and there are above bed lights as well as the main ceiling lights. Water temperatures are controlled and monitored monthly and a record kept. Random temperatures were taken and were of the recommended level. There are systems in place for monitoring safety issues such as fire checks, fire drills, PAT testing, electrical tests and gas and boiler checks and all the rooms are routinely checked for safety and maintenance issues. The manager has this responsibility, and the AQAA received completed by the manager confirmed the records in the home were up to date. The tour of the home confirmed that staff are aware of the fire safety policies, no doors were found inappropriately wedged open. Polices and procedures for infection control are in place and are updated regularly. The home was clean and free from offensive odours on the day of the inspection. The laundry area was clean and well organised, but the home need to purchase an appropriate washing machine that has a sluice cycle for soiled washing. Care Homes for Older People Page 20 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Robust recruitment procedures are in place to protect residents, and staff training ensures they are aware of their roles and are able to provide the support and care the resident’s need. Evidence: The staffing rota was viewed and the staffing levels were seen to be sufficient to meet the needs of the residents at this time. It was confirmed by the manager that there is flexibility of the staffing levels and they are adjusted according to the changing needs of the residents. Care staff spoken with said that the levels of staff on duty were sufficient to give the care required; they also said that the senior staff always helped out. Residents also confirmed that they had no complaints regarding the amount of staff. Comments from residents said that staff were leaving recently to continue their studies which was a shame, but the new staff were very nice. A roster is held giving names of staff on shift. Staffing levels include four care staff on duty each morning and in the afternoon and evening, the carers on duty have the additional tasks of cleaning and the laundry. Discussion took place in respect of ensuring that suitable steps are taken in infection control procedures i.e separate overall to change into as they clean/care. There are two waking care staff on duty at night. In addition to care staff, staff are employed for cooking and maintenance. Care Homes for Older People Page 21 of 30 Evidence: A selection of staff recruitment files were viewed and demonstrate that a robust recruitment process has been maintained to protect residents and contained all the relevant information required, except for a photograph of the employee. There was evidence of health questionnaires, Criminal Record Bureau checks, two references, a resume of previous employment and work permits where necessary. All the paperwork is kept within a locked room. As identified the files need to include an identification photograph of the employee and this was discussed. There is an induction programme in place and has been introduced for all new staff. Files seen confirmed this. New staff are required to complete an initial induction programme and undertake mandatory training, including fire and health and safety. This leads into foundation training, in preparation of National Vocational Qualification (NVQ) training. At present 40 of staff have an NVQ qualification. The induction and foundation training is in line with the Skills for Care guidance. The provider facilitates training sessions and there is a training matrix in place. This evidenced that not all staff have received the necessary updates, however it was confirmed that there is a rolling programme of training, which will ensure that staff receive the training necessary to meet the residents needs and ensure safe practices. As this is being undertaken a requirement has not been made at this time but will reviewed at the next key inspection. Staff spoken with said that training opportunities at the home are good and they are well supported by the fellow staff and the manager. One new member of staff said I love it here. Care Homes for Older People Page 22 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The overall management of this home is good with effective systems in place to protect residents. Evidence: The registered manager has been in post for eighteen months and has worked in the home for twenty years and worked her way up to her current position. She has the relevant experience and is undertaking further NVQ training in Care at level 4 and has two units left to do; she will also be required to complete the Registered Managers Award, within a given timescale, as a condition of registration. There is a clear management structure in the home with staff having designated responsibilities, these could be reflected more efficiently in their job descriptions. Both the residents and relatives spoken with during the site visit spoke highly about the quality of service provided at Glenmuir House. The atmosphere was pleasant friendly and inclusive. Quality assurance measures have been introduced that provide helpful feedback i.e. Care Homes for Older People Page 23 of 30 Evidence: from satisfaction questionnaires, completed by residents, relatives and visitors to the home. These are then audited and action taken to rectify or improve the issue raised.It was discussed the benefit of developing the quality audit to include visiting professionals. The registered manager maintains suitable records of individual pocket monies with receipts, where small personal items are purchased on behalf of residents. The home is part of a larger group, and the registered manager said that she receives support from the organisation, however whilst discussing her role and the support network, it was identified that there is no formal written supervision records kept. This would benefit her development as manager and enable the organisation to monitor her progress. The home has adequate insurance cover, and a current certificate of insurance was on display in the home along with the registration certificate. Staff supervision has commenced and it is acknowledged that not all are yet up to date. this is a continuous piece of work. At present not all staff have received the mandatory training in moving and handling, health and safety and fire safety. However, there is evidence of a rolling plan of training that will address this. The manager confirmed that all staff are appropriately supervised until they have received the necessary training and induction. Glenmuir looked well maintained and systems are in place to report any problems to the maintenance team that need attention. Certificates relating to Health and Safety in the home were reviewed and found on the whole to be full. Full records of hot water checking are kept, there are measures in place to prevent Legionnaires disease, and the health and safety policy is up to date. It was however noted that environmental risk assessments are not fully recorded, this was discussed in full on the inspection visit. The accident book was viewed along with the actions taken to prevent a re occurrence. It was discussed that expert advice be sought regarding those residents that have recurrent falls. These then need to be linked to the residents care file and risk assessments to prevent a recurrence. The first aid boxes need to be spread out throughout the home and they need to be regularly checked and topped up. The kitchen first aid box would benefit from including and an eye wash for immediate first aid. Good practice was observed throughout the inspection in respect of promoting the safety and well being of the residents. Care Homes for Older People Page 24 of 30 Care Homes for Older People Page 25 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 That the registered person 22/11/2008 confirms in writing that having regard to the assessment made on any prospective service user that the home can meet those needs. To ensure that the home can meet the assessed needs. 2 9 13 That the registered ensures that medication practices are safe and promote the health of residents. this pertains to: Tippex and red ink is not to be used in accordance with legal guidelines. Codes on the medication records need to be used correctly and the reasons for non-administration of medicines clearly written. That staff specimen signatures are in place for 22/11/2008 Care Homes for Older People Page 27 of 30 audit purposes. That gaps in the records are investigated. To ensure the residents health needs are met and ensure their safety. 3 26 16 That the Registered person ensures that there are suitable systems in place to control the spread of infection. This pertains to ensuring that suitable equipment for soiled laundry is in place. To protect and promote service users health and safety. 4 36 18 That the registered person 22/11/2008 ensures that all staff including the manager receive the necessary formal supervision. To ensure that all staff are appropriately supervised. 5 38 17 That the registered person ensures that all falls and trips are monitored and expert advice sought regarding repeated falls and that these are linked to the individual service users care plan to prevent a recurrence. To protect and promote service users health and safety. 22/11/2008 11/11/2008 Care Homes for Older People Page 28 of 30 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 That the staff qualifications are updated regularly on the document or contains a statement that states that updates are undertaken on a regular basis. That the shortfalls in the care documentation are reviewed and acted on. That residents weights are recorded regularly or a system devised to monitor their weight effectively. Consideration should be given to the provision of fly resistant coverings for the windows in the kitchen and a commercial dishwasher. It would be beneficial to record the amount residents eat as well as what they eat. This will help the staff identify appetite traits early. That staff training continues to ensure staff have received the necessary training to meet the needs of the service users. 2 3 4 7 8 15 5 30 Care Homes for Older People Page 29 of 30 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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