Inspection on 19/06/06 for Glentworth House Nursing Home

This inspection was carried out on 19th June 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Glentworth House Nursing Home 21/01/09

Glentworth House Nursing Home 25/07/08

Glentworth House Nursing Home 21/08/07

Glentworth House Nursing Home 23/11/05

Glentworth House Nursing Home 31/05/05

Glentworth House Nursing Home 14/01/05

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

CARE HOMES FOR OLDER PEOPLE Glentworth House Nursing Home 40-42 Pembroke Avenue Hove East Sussex BN3 5DB Lead Inspector Elizabeth Dudley & Linda Boereboom Key Unannounced Inspection 19th June 2006 10:00 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 Glentworth House Nursing Home DS0000062476.V296737.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. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glentworth House Nursing Home Address 40-42 Pembroke Avenue Hove East Sussex BN3 5DB 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) 01273 720044 Whytecliffe Limited Vacant Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33), Physical disability (33) of places Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service Users should be sixty-five (65) years or over on admission. The service can provide up to thirty-three (33) nursing place and thirty-three (33) social care places. The maximum number of service users to be accommodated is thirtythree (33). 23rd November 2005 Date of last inspection Brief Description of the Service: Glentworth House nursing home consists of 6 double and 21 single rooms and comprises a detached house with a purpose built extension. It is situated in a residential area of Hove, close to local shops and public transport. Parking is on-road and in a restricted parking area. The home has a well-maintained garden, which is easily accessed from the ground floor lounge by service users, and all parts of the home are served by a shaft lift. It has recently changed ownership and the new providers are undertaking a refurbishment of the home, which is of a high standard. The local authority have contracted five beds for Transitional and Interim care The fees currently charge range from £460.90- £600 per week and does not include extras such as hairdressing, chiropody or newpapers. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 19th June 2006 over a period of seven and a half hours. Two inspectors undertook this inspection in order to fulfil the ‘Inspecting for Better Lives’ which includes in-depth conversations with residents and staff. The inspection was facilitated by Mrs A Redwood, the registered provider and at present the acting manager of Glentworth House. During the course of the inspection a tour of the home was undertaken, various documentation which included care plans, personnel files, training plans, health and safety and catering records were examined. Six residents, several members of staff and the two visitors at the home that day were spoken with. Six residents were ‘case tracked,’ a process which includes examining the residents care plans, their medication charts, talking with the resident and ensuring that the quality of care meets the expectations of the residents, their families or the local authority. Much information was also gained from comment cards received from relatives, residents and health care professionals. Telephone discussions were also held with some relatives. The home provides a good quality of care and makes efforts to ensure that residents and relatives are happy with the care and service provided. Comments from residents included ‘the staff are very kind’, ‘they make visitors welcome’ and ‘the new decoration around the home looks nice’. Thanks are extended to all the providers, staff, staff and residents for their help, courtesy and hospitality in this inspection. Thanks are also extended to all persons who returned questionnaires forwarded to them by the CSCI. These include relatives and visitors, GPs, staff and residents. These make a very positive contribution to informing the inspection process and are valued. What the service does well: Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 6 The home provides a good quality of care to residents, with staff being encouraged to undertake ongoing training. All staff take part in induction training regarding the expectations and ethos of the home when they commence employment. There is a quality-monitoring programme and the home sends questionnaires to residents asking for their views on various aspects of living in the home, the information gained from these informs the care and policies within the home. The majority of residents and resident representative made positive comments about the home, both in person and on questionnaires sent back to the CSCI, one resident saying ‘Some staff are terrific, and visitors are made welcome, they can have a cup of tea on request’, ‘my medication always arrives on time ‘I can always speak with the manager when I need to’, ‘The home is always clean’ and ‘There is a good standard of cleanliness’. What has improved since the last inspection? What they could do better: Comments from residents stated that they were not always aware of the choice of meals and those that were aware said that the choice was often just a baked potato with filling, at one time the home used to offer a choice of two different cooked meals at lunchtime. This is especially important with the liquidised meals, on this day liquidised sausage meat and winter vegetables were being offered. Two residents stated that they wished there were more fresh vegetables. Residents were also not aware that they could ask for a snack at any time. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 7 Some residents stated ‘the food is alright but it is often cold’, ‘the food is not very hot when I get it’. Some residents stated that they had to wait a long time for their bells to be answered and this was apparent on this day. Some call bells had not been left within residents reach. The quality of care within the home is good, however some of the care plans do not show this and these need to be revised. The provider was aware of this. The home has a closed-door policy to protect residents in case of fire. However some doors were wedged open. Some residents were not aware of what to do in case of fire. Most rooms only have one chair and this was discussed with the provider. Staff appeared very busy, especially in the morning, deployment of staff must be reviewed, especially now that the home is contracted to provide transient and interim care. 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. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 8 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 Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5 Quality in this outcome area is good; this is based on the available evidence including a visit to this service. The home provides the necessary information for prospective residents to allow them to decide whether the home meet their expectations and needs. EVIDENCE: The statement of purpose and service users guide reflect the changes which have recently taken place within the home and meet the standards. Residents receive a statement of terms and conditions following their admission to the home and evidence was provided to verify this. All residents are assessed by the manager prior to being admitted to the home. This assessment confirms that the home can meet the needs of the prospective resident and ensures that the resident has information about the home and the opportunity to make an informed decision over whether they wish to live there. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 10 Pre admission assessments include physical, psychological and social assessment; this forms the basis of the care plan. The manager takes a brochure, which contains the statement of purpose and service user guide when she assesses the resident. All prospective residents and their relatives can visit the home prior to them making a choice over whether to live there. Staff have sufficient training to enable them to meet the needs of the residents admitted into their care. Registered General nurses provide 24 hour cover and carers are encouraged to undertake training which includes the NVQ Level 2. Nine members (30 ) of care staff have achieved either NVQ level 2 or 3 in care. Registered nurses receive training updating, including palliative care training, to enable them to meet the needs of the residents. Some residents are now being admitted for transitional and interim care, physiotherapists are being provided by the local authority and advice from specialist staff is also being provided. Specific rooms have been designated for this care and there is lounge space available. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is adequate, this is based on the available evidence including a visit to this service. Care plans do not always identify the care to be given to a resident and this could affect the quality of care that they receive. The length of time taken to answer bells could impact upon residents dignity and safety. EVIDENCE: The home provides a good quality of care but this is not being reflected in, or informed by, the care plans. A sample of six care plans were examined, two of these belonged to residents recently admitted to the home. There was no evidence in the care plans of those recently admitted to the home that their care plans had been discussed with either the resident or their relative. The basic care plan of one of these residents was not complete. The consent form for the bedrails was not signed, and several basic details in the care plan were not filled in. There was not sufficient detail in the care plan to allow a nurse that was unfamiliar with the resident to give all the care required. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 12 In another care plan the daily notes indicated that the resident required the use of a hoist, this was not identified in the care plan, there was no moving and handling plan, there was indication of involvement of the wound care nurse but no information about the wound. There were no nutritional notes in either care plan. The information provided was insufficient to inform care. Other care plans were variable in detail, most care plans could evidence the involvement of the resident or their relative, some had nutritional and social care plans and some were quite comprehensive relating to the care to be given. Two relatives confirmed that they had been involved in the care planning and one resident said that she is informed of any changes of treatment that the nurses may think necessary. However one resident said that she hasn’t been involved in the care planning at all and is not aware of what medication she is on. The daily notes in other care plans showed that needs had changed in respect of residents change in condition, but in some cases the care plans had not changed to reflect these needs. Not all risk assessments had been updated in the past few months. All residents appeared well cared for and evidence was seen that advice was sought from other healthcare professionals, including the wound care nurse, GPs and the Older Persons Nurse Specialists. A key worker system is being commenced. Staff are participating in the Liverpool care pathway and Gold standards framework for palliative care. Residents stated that they were well looked after and that staff were kind and attentive. One relative, responding by questionnaire, said that the ‘home made appropriate changes to my father’s care as he deteriorated.’ Two residents said that they had to ask to see a doctor, whilst another said that she sometimes has to remind people when she needs a doctor. Comments from residents were ‘the staff are kind but I do have to remind them to do even the basic care sometimes, and remind them of what I have said’ and ‘Sometimes I get cramps from sitting in the chair so long’. Care plans showed that residents were taken to hospital appointments as required and that a dentist visits the home. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 13 A new clinic room is in the process of being provided, with work almost finished on this. However the present storage of medications is good, these are in locked cupboards in resident’s rooms and those examined corresponded to the medicine administration records. All controlled drugs were stored and recorded correctly although there was a discrepancy in one area; the manager was already aware of this and was addressing this. The majority of the recording of the medication following administration was, in general good, however there were some medications where the records had not been signed following administration. Medication was observed to be administered at the correct times and residents confirmed this. The drug fridge was kept locked and there was evidence of records of drug fridge temperatures and maintenance of equipment. Due to the infrequency of the use of syringe drivers, all registered nurses receive updated training in these whenever they are required to use them Medication charts should include the photograph of the resident to ensure safety of residents. Residents stated that in some instances they had to wait for some time before their call bell was answered, with one resident saying that she found this difficult at times because of her ‘water tablets’, whilst another one said that she had to wait almost an hour before her call bell was answered. One resident stated that her bell took a long time to be answered at night. During the inspection it was seen that not all call bells were answered promptly, and in some instances the bell was ringing for a long time, especially during the morning, but this improved in the afternoon. Some call bells were not left within easy reach of the resident. One visitor stated that she has seen less cognitively able residents hoisted without explanation being given to them. Some concerns were raised about the quality of the laundry service, with clothes not always being ironed properly and laundry ‘going missing’ at times and this was discussed with the provider. Nurses have attended some study days in palliative care and are to undertake study on the Liverpool Care Pathway and Gold Standards Framework. Some residents were seen that were being nursed in bed, they appeared comfortable and were in receipt of the appropriate analgesia. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is adequate, this is based on the available evidence including a visit to this service. Some activities are now in place, which have enhanced the quality of life of some residents. Some residents are unaware of the availability of choices and availability of food outside recognised meal times, and this could affect their perception of their quality of life. EVIDENCE: An activities programme is now in place and two part time activities carers are responsible for doing these. Two carers are responsible for the activities in the home and undertaking one to one activities with residents in their rooms. Several residents said that they took part in the activities but some said that they preferred not to join in, and this was respected. One resident stated that the lounge was too crowded to accommodate all the residents and ‘the high dependency of residents make it difficult to stimulate any person sitting endlessly in the lounge when people need extra attention’. Residents spoken with said that they were aware of the activities on offer but ‘that do not always proceed as listed, due to staff training or staff taken away to care for residents’. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 15 It was seen that staff were happy to take staff into the garden and took out drinks etc for them and brought them back in as soon as the resident was ready to come into the garden. Staff are trying to arrange outings for residents. Residents stated that they have choice in what time they get up and go to bed and in most activities of daily living. There is an open visiting policy and a minister of religion visits the home. Visitors were seen to be welcomed into the home and they stated they were offered tea. They said that the staff were very friendly and welcoming and that they were informed of any concerns that the staff may have about the resident if appropriate. The home provides a menu which appears well balanced, the cook visits all residents on a daily basis and tells them what is on the menu that day. However several residents said that they were not aware of the choices that were available and these were not evident on the menu seen. Formal choices should be shown to avoid residents being offered limited choices. Most of the residents spoken with said that they enjoyed the food provided. The menu on this day was sausage and onion pie, leeks, carrots and mashed potatoes, followed by mandarin flan or ice cream. The liquidised meal was liquidised sausage meat and vegetables. A discussion was held with the cook regarding the suitability of this. However three residents said that the meals were ‘cold’ or ‘not very hot’ when they arrive. Another resident stated that they had too much ‘processed food and would like more fresh meat and vegetables’. The cook stated that vegetables in season were used, but none were seen on this occasion. Fruit is always available, with this being put in the rooms and in the lounges, cold drinks are available in the lounges and rooms, but residents said that they could have a cup of tea when they wished. Breakfast commences at 0700—0900 and a cooked breakfast is available. One resident stated that it was a long time between breakfast and supper, and was not aware that sandwiches and snacks were available. The home undertook a food survey and this showed that the majority of people were happy with the food provided. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 16 Residents either have their meals in rooms or on small tables in the lounge, there is no room for dining tables within the lounge area. Fridge and freezer temperatures and have been recorded and all kitchen staff have their food hygiene course. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17 and 18 Quality in this outcome area is good, this is based on the available evidence including a visit to this service. Residents can feel confident that any complaints or concerns they may have will be taken seriously and dealt with in a fair and competent manner. Staff training in the protection of vulnerable adults further protects the residents. EVIDENCE: The home has a complaints policy, which is displayed, both in the home and in the service users guide. Staff also receive guidance about how to handle complaints. The home recently undertook a survey of residents asking if the resident was aware of the complaints policy, the response from residents indicated that 90 were aware of this. This was also reiterated in responses received by the CSCI. The majority of residents spoken with or returning questionnaires were aware of how to make a complaint and to whom, and suggested that they would not be worried about making a complaint. There have been no complaints received by the CSCI apart from one concern which was relayed to the manager. It has been seen that complaints have always been dealt with in a fair and transparent manner. It is recommended that the provider consider keeping complaints in a specific file in a secure place rather than in the care plans or in personnel files. This will ensure confidentiality both to the complainant and to any persons mentioned in the complaint. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 18 There was a concern relating to medication. This, and the way that the RGN had dealt with it, were written as a note in the care plan. The manager was not aware of this. It is recommended that formal notes must be made of all such concerns, in a confidential file, in order to inform any judgements at a future date if necessary. All staff have received training in the Protection of the vulnerable adult, with staff being aware of their role in this and how they would follow the reporting protocols. Residents are further protected by the homes robust recruitment policy. The home has no involvement in resident’s finances. Residents can take part in the political process by postal votes. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26 Quality in this outcome area is good, this is based on the available evidence including a visit to this service. Although parts of the home are in disarray due to refurbishment, this is being completed to a good standard, and when finished will provide a very pleasant home for residents. EVIDENCE: The home has been under new ownership for eighteen months; during this time a tremendous amount of refurbishment has taken place and is to a very high standard. Bedrooms are now completely refurbished as they become vacant and many of the corridors have been redecorated and have new carpets. Bathrooms also are part of this process and one has been turned into an assisted shower room. The kitchen has been completely renovated. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 20 Although this has taken place with a minimum of disruption to residents and staff, some has been inevitable and there is still much work to be done. The owners state that they anticipate another 12 months work is needed. Residents and staff stated that they are very pleased with all the work that has been done and stated that ‘it looks nice’ and ‘what a difference’. The CSCI received plan of work prior to this commencing. The gardens to the front and rear of the home are well maintained with all residents able to access the secluded rear garden, which includes a patio and seating. There is one main lounge and two very small lounge areas on the first floor. There is insufficient space in the main lounge to accommodate all residents and three residents remarked on the lack of space available, there is not room for a dining room table. Bathrooms are in the process of refurbishment at present with one having being turned into a shower room. Most rooms have ensuite bathrooms consisting of washbasin and WC. Those that do not have en-suites have washbasins in the rooms. A new clinic room is in the process of being completed. The home has been assessed by a qualified occupational therapist and has hoists, manual handling equipment and assisted bathing facilities. The resident’s personal accommodation is still in the process being refurbished, again to a good standard. There were locks on all doors but some residents did not have risk assessments in their care plans to show whether they were able to keep a key or whether they wished to have one. All residents have a lockable facility for their valuables. One resident stated that they would like an extra chair in their room for visitors to sit on as they have to sit on the bed at present, and other rooms were seen not to have a second chair. This was discussed with the provider. All rooms have radiator guards, and water temperatures to resident’s outlets have been monitored on a regular basis and within the recommended parameters. The home was clean, but two rooms were malodorous; this was discussed with the provider. A new washing machine has been provided and soiled laundry is put into red bags prior to washing. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 21 There is a range of infection control policies and staff receive ongoing training in this. Catering staff have their food hygiene training. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate, this is based on the available evidence including a visit to this service. Staff deployment at certain times of day may adversely affect the care of residents. A planned induction and training programme allows residents to benefit from the provision of informed care. EVIDENCE: The off duty rota identified that there were sufficient staff on duty to meet the number of people resident in the home at this time, but all staff in the morning appeared to be very busy and rushed. Many of the residents are highly dependant, and two members of staff stated that they were very rushed in the morning and there was a need for an extra member of staff at times. There are usually two registered nurses on duty for the main part of the day with one registered nurse being on at night Some residents had also stated that their bells took a long time to be answered, with one resident stating that this happened at night. Conversely, the afternoon staff seemed more relaxed and able to spend more time with residents, although one resident had said that staff were called away from activities to attend to residents’ care. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 23 The management must consider whether the deployment of staff for the level of need of residents, is adequate, and make adjustments should this appear necessary. The recent contract for transitional and interim care will stretch the existing staff even further and therefore it is essential that this is reviewed in order to ensure quality of care, completion of relevant documentation and staff morale. Eight staff have left since the last inspection, and 9 new members of staff employed. Personnel files for these staff were examined and all were found to include the necessary documentation to meet the regulations. The home does not undertake checks on registered nurses PIN numbers but does keep copies of their NMC cards. Some staff were working whilst waiting for their full CRB, their POVA First, (Protection of vulnerable adults first check) had been received, but were not always working under the supervision of a specific member of staff. Wherever possible the member of new staff must work under the guidance and monitoring of a specific allocated member of staff. All new staff had received induction training. There is a training programme and records in place and staff receive ongoing training including encouragement to undertake their NVQ 2. All staff have received POVA (Protection of the Vulnerable Adult) training. Training includes Manual handling, control of infection, fire safety, food hygiene and health and safety training. There are staff meetings on a regular basis. All staff have been given copies of the GSCC handbook. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 and38 Quality in this outcome area is adequate, this is based on the available evidence including a visit to this service. There is no permanent management structure within the home at present, but this is not affecting resident’s welfare. Whilst the majority of the health and safety practice within the home ensures the safety of residents some practice is not in line with the home’s policies and may adversely affect the residents safety. EVIDENCE: There is no permanent manager in post at present; the provider is now acting as manager. The provider, Mrs Anita Redwood is the manager of the sister home. The ethos within the home appears to be open with staff meetings being held. The provider says that she tries to talk with all residents, staff and relatives at intervals. There has been an amount of staff turnover since the last Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 25 inspection. The home, under present ownership, is in its infancy and is still evolving. There are several quality monitoring processes in place, with questionnaires having been given to residents about the food and the complaints procedure. A full quality monitoring exercise took place earlier this year. Results from these questionnaires are collated and inform practice. It is recommended that views from stakeholder including GP’s and other health and social care professionals take place. No residents meetings are taking place, however possibly only very few residents in the home at the present time would benefit from this. Staff supervision is taking place at the intervals as dictated by the standard. The business plan and other financial records were seen prior to the home being purchased and insurances were in place. All records are kept in a secure environment and are up to date. Staff have undertaken mandatory training including moving and handling, fire training and health and safety training. Certificates relating to the servicing and maintenance of utilities and equipment were up to date and in place. A fire risk assessment is in place and the home has a ‘closed door policy’ for residents, however some doors were wedged open. The provider stated that some automatic door closures have been purchased but they have not been put in place yet. Some residents were not aware of what to do in case of fire, although this is in the service user guide. The providers must continue to risk assess and be aware of the possibility of residents safety being compromised during the refurbishment. Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 26 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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 3 3 3 3 3 2 Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation Reg 15(1)(2) (3) Requirement That the service user plan of care includes all details of the care required by the service user and that will be needed to inform care, including social needs. The initial care plan completed on or shortly after admission. That it is reviewed regularly and evidences changing needs and can evidence consultation with the service user and their representative. That the risk assessments and moving and handling plans are completed and kept under review. That all medications are signed following administration. That the standard of personal laundry and ironing within the home is of a good standard. That call bells are left within reach of service users and are answered promptly. That service users are made aware of the choices available including those relating to variety and availability of food and drink and activities of daily living. DS0000062476.V296737.R01.S.doc Timescale for action 30/07/06 2 3 4 5 OP9 OP10 OP10 OP38 OP14OP15 Reg 13(2) Reg 12 (4)(a) Reg 16(e) Reg 12(4)(a) Reg 13(4) Reg 12(3) Reg 16(i) 30/07/06 30/07/06 30/07/06 30/07/06 Glentworth House Nursing Home Version 5.2 Page 28 6 7 OP27 OP38 Reg 18(1) Reg23 (4) 8. OP38 Reg23 (4) That the registered person reviews the deployment of staff within the home. That measures are taken to ensure protection in the case of fire for present service users who wish their doors to be kept open. (This was a previous requirement May 2005, December 2005) That practice is informed by the current policy in the home. That service users and visitors to the home are made aware of what to do in case of fire. (This was a previous requirement May 2005, December 2005) 30/07/06 19/07/06 19/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP9 OP16 OP15 Good Practice Recommendations That Photographs of service users are put on all MAR charts. That a record of all concerns and complaints made including details of investigation and any action taken is kept in a secure, confidential manner. That the provider reviews the menu that is offered to those service users requiring liquidised food and that the choice of a second available meal is formalised on a daily basis on the menus. That residents’ rooms are provided with two chairs. 4 OP24 Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection East Sussex Area Office 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 © 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 Glentworth House Nursing Home DS0000062476.V296737.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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