CARE HOMES FOR OLDER PEOPLE
Glenmuir House 4 Branksome Road St Leonards On Sea East Sussex TN38 0UA Lead Inspector
Mike Flint Unannounced 17 May 2005 09:15 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service Glenmuir House Address 4 Branksome Road St Leonards On Sea East Sussex TN38 OUA 01424 216250 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Wilton Lodge Limited Jenifer Claire Twist Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (OP) 20. of places Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users should not be aged 65 years or over on admission. 2. The maximum number of service users to be accommodated is 20. 3. Only older people who have been assessed as requiring residential care are to be accommodated. Date of last inspection 09 November 2004 Brief Description of the Service: 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 Leonard’s. 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 has been under the ownership of Wilton Lodge Limited since May 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. Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out, over 5 hours during a day in May 2005, when there were seventeen (17) residents. The registered manager assisted with the inspection. The deputy manager and each of three senior carers were spoken with in private, as were five of the residents. The full-time cook and maintenance manager were also spoken with. A selection of records were inspected and found to be in order. These included care plans, day and night logs, medicines administered, menu plans and maintenance book. The physical environment was also inspected and found to be very clean, fresh and tidy. This inspection was unusual in as much as two representative Inspectors from Albania attended during part of the visit. Accompanied by an interpreter, they expressed their positive impressions regarding the quality of care and quality of the environment to be found at the home, as part of a fact-finding visit they were undertaking to this country. What the service does well:
A high quality of care is provided at the home and the residents spoken with expressed their contentment with their lives at Glenmuir House, where a relaxed, homely atmosphere is apparent. In meeting with residents, the Inspector was informed of the variety of social activities that are organised by a senior staff member. At the time of the inspection, a dozen residents were taking part in a crossword activity. The activities organiser said that she was employed for several hours each day to promote individual interests and group activities for the enjoyment of residents. The staff spoken with said they enjoyed working at the home. Regular staff meetings are held and staff said they felt well supported by management. Their interactions with residents were observed as being attentive and friendly, with discreet assistance being provided for those who needed support with their personal care. Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 Page 6 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 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 standard(s) 1 - 6 People who are referred to the home are fully assessed, enabling decisions to be taken in respect of the home’s ability to meet individual resident’s needs. EVIDENCE: A suitably detailed Statement of Purpose and Service User Guide is available to prospective, or newly admitted residents to inform them about the home and of the services and facilities that are to be provided. All residents receive a copy of the Terms and Conditions of their residency; a contract is also provided if care is to be purchased privately. Pre-admission assessments are completed for all potential users of the service, referred to the home, prior to a trial period being offered. Visits are arranged to assist people in reaching a decision about whether to move in for a trial period. Each of the residents spoken with was able to confirm that they felt their needs were being met. The home does not offer intermediate care, or rehabilitation services. Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 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 standard(s) 7, 9 and 10 Personal support in this home is offered in such a way as to promote and protect the residents’ privacy, dignity and independence. EVIDENCE: A satisfactory system of care planning and assessment has been introduced. Care plan summaries are located in residents’ bedrooms, ensuring that they are aware of the care they will receive and how it should be delivered. Daily progress notes are used and the care plans are kept regularly updated. The home has a monitored dosage system, which the deputy manager has responsibility for. The administration of medicines in the home is well managed promoting good health. The deputy confirmed that only staff, who have received training, have responsibility for dispensing. Residents may manage their own medicines, subject to risk assessment. Staff seen in the course of their duties, were courteous and respectful towards the residents. The majority of rooms have telephone points and each of the residents seen had their own phone fitted and commented on how much they valued this. Appropriate measures are taken by the home to ensure privacy e.g. where double rooms are to be shared. Though at the time of the inspection each of the three double rooms was being used for single occupancy.
Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 Page 10 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 standard(s) 12, 13, 14, 15 The home provides a relaxed and supportive environment that enables residents to pursue their interests and autonomy within a socially orientated setting that is beneficial to their wellbeing. The meals in this home are of good quality, offering both choice and variety and catering for any special dietary needs. Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 Page 11 EVIDENCE: A varied range of activities is offered, including exercise classes, local walks, quizzes and gardening as well as various social events that take place from time to time. Regular church services are held at the home. A senior staff is employed as an activities co-ordinator, to arrange and oversee the various activities. Residents are encouraged to retain their individual interests; records of any special interests are kept within the care notes. It was apparent that the routines of daily living were flexible to suit the residents’ needs. Many of the residents have regular contact with family and friends. Visitors are welcome to the home at any reasonable time; visiting arrangements are clearly stated in the information provided, upon a resident’s admission Glenmuir House. On entering residents’ rooms it was clear that many bring personal items with them on admission, including furniture. The home has little involvement in residents’ finances. The manager said that encouragement is given for residents to maintain this responsibility and, where this is not possible, relatives are asked to assist. The menu plan is varied and provides an appealing, nutritious and wellbalanced diet. Daily mealtime choices have been introduced into the menu and these are posted up. Records are kept of all meals served. Residents spoken with stated that all their meals are of good quality and nicely presented. The Inspector sampled the midday meal and found it to be tasty, nourishing and of good quality. Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 Page 12 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 standard(s) 16, 17 and 18 Any matters of concern are handled appropriately, reassuring those involved that they are being listened to and that action will be taken, as necessary. EVIDENCE: There have been no complaints recorded, or received by the CSCI since the last inspection. The home has a written procedure that advises residents, or visitors to the home how to make a complaint; a copy of this is displayed in the hall. Residents said that the owners and manager were very approachable and responsive, should issues arise that required action. Residents’ legal rights are protected and all their names are included on the electoral register; postal voting forms are available for those who wish to take part in local, or general elections. Those who do not retain responsibility for their own affairs have a next-of-kin, or other person acting for them. There are detailed policies and procedures in place relating to adult protection and abuse; staff have received training in these areas of their work. Police checks are carried out for all staff employed in the home. Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 Page 13 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 standard(s) 19, 20, 24, 25, 26 The home provides a pleasing environment that is accessible, safe and well maintained, meeting residents’ individual and collective needs in a very comfortable, homely style. Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 Page 14 EVIDENCE: Since the last inspection, a maintenance manager and assistant have been employed by the Proprietor to work between the four homes owned by Wilton Lodge Limited. The home appears to be well maintained; considerable redecoration and refurbishing of resident’s private rooms has recently taken place. The standard of décor, lighting and furnishings throughout the building is domestic in character and of good quality. The choice of communal areas includes a spacious lounge, a seating area in the hallway and a dining room. The garden with lawns and borders is kept safe and tidy by an employed gardener and is readily accessible to residents. Residents’ private accommodation is very comfortably furnished. Residents may furnish their own rooms and many do so. The manager confirmed that as far as possible any adaptations, or equipment would be provided, should this be required, following a review/ re-assessment of any individual resident’s needs. All areas, accessed by residents are kept very clean, hygienic and free from any odours. Appropriate policies and procedures are displayed e.g. infection control and COSHH procedures. The fire safety arrangements meet the requirements of the fire brigade and are routinely inspected. An electrical survey has been recently been carried out throughout the house. The manager confirmed that a report has not yet been received. Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 30 The staff have a good understanding of the residents’ support needs, evident from the positive relationships, which have been formed between staff and residents, observed during the inspection. EVIDENCE: The duty rota showed that staffing arrangements during the day and at nighttime are satisfactory. Some necessary shift changes, carried out since the change of ownership last year, have resulted in some staff turnover. The home has carried vacancies for several months, during which time the existing staff provided relief cover, some working long hours. The manager confirmed that several new staff have since been appointed and only a small number of vacancies remain unfilled. Each of the three senior staff, including deputy manager spoke enthusiastically about their work in the home, though two had reduced their hours, since the changes made to the shift pattern. The home provides a home-specific induction to ensure that all new staff are aware of their roles and responsibilities. Additional to this, induction and foundation training that meets the TOPSS specification has been introduced. However, additional to the two current NVQ candidates, there have been no new candidates for NVQ training in the current year; some of the trained staff have left and this places the home at a disadvantage, when endeavouring to meet the target of 50 trained care staff. The manager said that newly appointed staff were signing up to commence this training in the autumn. Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 38 Staff shortages over a prolonged period of months have resulted in some issues, concerning health and safety, remaining outstanding. The manager is qualified and competent, providing the home with stability, during a period of change. Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 Page 17 EVIDENCE: The manager has been working long hours, covering duty care shifts; as a result, some administrative tasks had been left unattended to. She confirmed that the situation continues to improve with new staff being appointed and that the employment of a gardener and the maintenance men has helped to ease the situation considerably. Routine health and safety/ fire safety checks are being carried out, though staff training in safe working practices remains outstanding. This includes moving and handling and infection control, which training is necessary to ensure the safety and welfare of all those who live and work in the home. Some staff have recently trained in food hygiene. First aid training was booked and to be delivered to staff imminently. Checking the hot water, heating systems and general environmental safety around the home is being carried out by the maintenance staff, in conjunction with the manager. Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 x x x 3 1 3 STAFFING Standard No Score 27 3 28 1 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 x x x x x x 1 Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 Page 19 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 38 18(1)(c,i) That a programme of training in safe working practices is delivered to all care staff. (Timescale from previous inspection unmet) 01.11.05. 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. Refer to Standard Good Practice Recommendations Glenmuir House H59-H10 S61434 Glenmuir House V220578 170505 Stage 4.doc Version 1.20 Page 20 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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