CARE HOMES FOR OLDER PEOPLE
Glenthorne Care Home 126-128 Reads Avenue Blackpool Lancashire FY3 9GA Lead Inspector
Wesley Cornwell Announced 7 June 2005 9:30 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. Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Glenthorne Care Home Address 126-128 Reads Avenue Blackpool FY3 9GA 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) 01253 626722 Miss V Tyler CRH Care Home 18 Category(ies) of OP Old Age 18 registration, with number of places Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 18 October 2004 Brief Description of the Service: Glenthorne Residential Care Home is registered to provide personal care for 18 people of both sexes over the age of 65 years. The home is situated close to the town centre and comprises of the following accommodation. The ground floor comprises of a dining room at the front of the home and a large lounge leading into a conservatory at the rear of the home. Resident accommodation is located on the ground and first floors and comprises of fifteen single bedrooms. En suite facilities are available in fourteen rooms. A chairlift facilitates access between the ground and first floor. Services provided by the home include a laundry service and social activities to provide motivation and stimulation. Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was announced and started at 9.30am and took place over 5 hours. The Inspector spoke to three staff members, three residents, two visitors, a healthcare professional and the owner. Comment cards were completed by nine residents, four relatives/visitors and one General Practitioner providing their views about the home. Staff and care records were also examined. A full tour of the premises was undertaken with the owner. What the service does well:
This is a care home where residents are well looked after. The staff team work well together and show a good understanding of the needs of the people living at the home. Those residents spoken to said they liked living at the home and felt they were being well cared for by the staff. One resident said, “I like living here. Great food, great staff and I want for nothing. The location of the home is ideal for me as it’s close to my relatives and I can walk to the pub”. One healthcare professional visiting the home said staff communicate clearly and work in partnership with them and are able to demonstrate a clear understanding of the care needs of residents. One General Practitioner who completed a comment card prior to this inspection said, “ We often have to visit our patients in this home, the staff are always helpful and the care provided is often above rest home requirements. If the staff have any concerns they will always contact us”. Meals are varied with an alternative available if required. pleased with the choice and variety available. Residents were The assessment and ongoing review of care is thorough ensuring residents care needs are being met. Visiting arrangements at the home are informal and family and friends of residents are encouraged to maintain contact. Two relatives said they visited the home every week and are always made welcome. One visitor said, “I visit my relative daily and I look forward to the visit. The staff are so friendly”. The staff team are well trained and supervised. Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 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 Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 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) 3 The admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: The records of two residents admitted to the home had full assessment information. Staff members confirmed they had access to this information and could describe in detail the care needs of residents. Staff members involved in the preparation of meals confirmed they are informed about residents who have special dietary needs. Residents confirmed they had been involved in their assessment and were happy that their needs were being met by the home. Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 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) 7,8 and 9 Promotion of health is taken seriously. Residents welfare is closely monitored and health needs were met. EVIDENCE: Individual records are kept for each resident with a plan of care setting out in detail the action that needed to be taken by care staff to ensure all aspects of health, personal and social care needs of the residents were met. Significant events had been recorded and daily entries made setting out the care given. The records of two residents were looked at and these clearly described their healthcare needs. Discussion with staff members confirmed they were fully aware of the healthcare needs of residents and these are monitored and kept under review. Entries made on care plans showed good communication between the home and healthcare professionals. The records of one resident confirmed they were receiving regular visits from healthcare professionals to monitor their health. One healthcare professional visiting the home said staff communicate clearly and work in partnership with them and are able to demonstrate a clear understanding of the care needs of residents.
Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 Page 10 The healthcare professional said, “ The staff at this home provide good care and are very patient with the residents”. One General Practitioner who completed a comment card prior to this inspection said, “ We often have to visit our patients in this home, the staff are always helpful and the care provided is often above rest home requirements. If the staff have any concerns they will always contact us”. Medication practices observed were safe and good records had been maintained. Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 and 15 Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. Visiting arrangements at the home are informal and family and friends of residents are encouraged to maintain contact. EVIDENCE: Residents spoken to confirmed they enjoyed the food provided by the home. One resident spoken to said, “ I really enjoy the food and get plenty to eat. Where else would you get breakfast in bed every day”. One visitor spoken to said, “The food provided by the home is excellent and my relative enjoys the meals on offer. Good home cooking and it always smells good”. Meal times were served in a relaxed and unhurried manner. Residents spoken to were very happy with the arrangements in place for social activities. One staff member had a keen interest in arranging activities for residents. These were varied and arranged individually and in groups. Residents spoken to said they were happy with arrangements in place for receiving their visitors. The Inspector was able to observe throughout his visit relatives and friends visiting the home. Two relatives said they visited the home every week and are always made welcome. One visitor said, “I visit my relative daily and I look forward to the visit. The staff are so friendly”.
Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 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 and 18 Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. Procedures for dealing with and reporting abuse were satisfactory ensuring people are adequately protected. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents on admission to the home. Residents spoken to were aware of how to make a complaint and felt these would be listened to and acted upon. People visiting the home also said they were aware of the complaints procedure but hadn’t had any cause to make a complaint about the home. The home has a procedure in place for dealing with allegations of abuse. The manager and staff spoken to had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. One staff member on duty informed the Inspector abusive practices and how to recognise these had been covered during their NVQ training. Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 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) 19,20,21,22,23,24,25 and 26 The home has a planned maintenance and renewal programme for the redecoration and refurbishment of the home to ensure residents live in a comfortable, homely and safe environment. EVIDENCE: Since the last inspection the homes owner has started to make improvements to the environment. A number of residents bedrooms have been redecorated and new carpets fitted. The hallway and stairs have had a new carpet fitted and a new chairlift has been installed. The owner informed the Inspector the refurbishment of the home is on going and there are plans to redecorate and refurbish more residents bedrooms. Residents spoken to were very happy with the improvements being made to the home. Lounge and dining areas have been decorated and furnished for the comfort of residents.
Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 Page 14 One resident said, “I like living here. Great food, great staff and I want for nothing. The location of the home is ideal for me as it’s close to my relatives and I can walk to the pub”. Three residents spoken to said they were happy with their rooms and were provided with the choice of spending time on their own or in the lounge area’s. A recommendation from previous inspections was for the home to provide at least two accessible double electric sockets in all residents bedrooms. The owner of the home informed the Inspector there are no immediate plans to implement this work. Toilet and bathing facilities are located on the ground and first floor and are easily accessible for residents. The home has a chairlift to provide access between the ground and first floor. The Inspector observed residents using the chairlift independently during the visit. Radiators throughout the home are guarded or have guaranteed low temperature surfaces to protect residents from the risk of burning. Hot water temperatures throughout the home were checked and found to deliver water at a safe temperature in line with health and safety guidelines. The Inspector discussed with the owner of the home a fire safety report recently produced following an inspection by Lancashire’s Fire and Rescue Fire Safety Department. The owner informed the Inspector she was still considering recommendations made in the report and intended to liaise further with the Fire Safety Department about the recommendations. It was observed during the visit the home was clean and hygienic. Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 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 Staff are well trained to ensure they have the competencies to meet residents needs. The deployment of staff throughout the day is sufficient to meet the needs of residents. EVIDENCE: Staffing levels were sufficient for the number of residents living at the home. Residents said they were happy with the care they receive from the home and were well treated by the staff. One resident said, “The staff are very kind. I like living at the home and feel safe. There is always plenty of staff on duty and they are always there when you need them”. One visitor said, “I am very satisfied with the level of care and attention provided. The staff are very caring and understanding and cannot be faulted in any way what so ever”. Staff spoken to said they were clear about their role and work well as a team to ensure the individual and collective needs of residents are met. Records show four staff members have gained National Vocational Qualifications (NVQ). The owner of the home informed the Inspector she is encouraging other members of staff to undertake NVQ training. Discussion with staff and examination of records confirmed training had been provided for staff members to ensure they had a clear understanding of the specific care needs of residents accommodated at the home. Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 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) 31,33,36 and 38 The home is well managed and run in the best interests of residents. EVIDENCE: The owner of the home has many years experience in caring for the elderly and is presently working towards achieving relevant management and care qualifications. Records seen confirmed the owner undertakes periodic training to ensure her knowledge and skills are updated. Residents spoken to were very positive in their comments about the owner of the home. One resident said, “I find the owner to be very thoughtful and approachable. I am very happy living at the home and have no complaints about my care”. Visitors spoken to said they found the owner to be approachable, supportive and helpful. Staff members said they found the owner was supportive and provided a clear sense leadership.
Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 Page 17 The home has good systems in place to gather staff, residents and relative’s views as part of the monitoring of quality. Staff spoken to had a clear understanding of their role and what is expected of them during their shift. Inspection of records for residents were comprehensive, well written and up to date. Staff members spoken to confirmed they receive formal supervision and value the support of management. Inspection of maintenance records confirmed facilities and equipment was being maintained as required. Records were available to the Inspector to verify that training on health and safety issues had taken place. Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 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. 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 2 3 3 3 3 2 3 2 STAFFING Standard No Score 27 3 28 2 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 x 3 2 x 3 x x 3 x 3 Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 Page 19 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 19 Regulation 23 Requirement The registered person must ensure recommendations made by the fire authority are implemented. Timescale for action 7th September 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 24 26 Good Practice Recommendations At least 2 double sockets should be provided residents accommodation. The registered proprietor should ensure a hand washing facility is prominently sited in the laundry area for staff members who have handled infected material and/or clinical waste. 50 of the care staff team should achieve NVQ qualifications The registered manager should an NVQ level 4 qualification in management and care. 3. 4. 28 31 Glenthorne Care Home CS0000009759.V169074.R01.doc Version 1.30 Page 20 Commission for Social Care Inspection Area Office, Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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