Inspection on 23/11/05 for Glentworth House Nursing Home

This inspection was carried out on 23rd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 19/06/06

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 Unannounced Inspection 10:00 23 November 2005 rd 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.V262338.R01.S.doc Version 5.0 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.V262338.R01.S.doc Version 5.0 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.V262338.R01.S.doc Version 5.0 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). 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. Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 23rd November 2005 over a period of four hours, this forms part of the annual inspection programme for this home. The inspection was facilitated by Mrs Donna Hardie, home manager. During the course of the inspection a tour of the home took place, ten residents, six members of staff and two visitors were spoken with. Very positive comments were received from all those spoken with. Documentation, which included care plans, personnel files, catering and health and safety records, was examined. Thanks are extended to the manager, residents, staff and visitors for their help, courtesy and hospitality during the course of the inspection. What the service does well: The home is in the process of refurbishment, which is being undertaken to a high standard, providing a lovely environment, sympathetic to the age of the home, for residents to enjoy. The recently appointed manager appears to have a management style, which benefits both staff and residents. Residents and staff spoke positively about the life within the home, staff that they ‘felt proud’ to be working at this home, and “ its now such a happy place to be”. Residents in the lounge appeared to be alert and happy with the new décor and also responding to the lively atmosphere, particularly those residents who had been previously seen not taking much notice of what was going on around them. This is possibly due to the provision of activities and the manager says she has noticed much improvement since these have been introduced. The home has always had a good standard of catering and this continues, with homemade cakes and puddings being provided. The present owners and manager show a strong belief in and commitment to staff training and staff stated that they are grateful for this. Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 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. Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 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 the following standard(s): 1,2,3,4,5. The home provides adequate documentation to inform prospective residents about the home. All residents are assessed prior to admission and can visit the home to reassure them that the home can meet their needs. EVIDENCE: The home produces adequate documentation, which includes a service users guide and statement of purpose, to ensure that prospective residents are fully informed about the home. All residents receive a copy of the service users guide and the manager takes this and the statement of purpose along when she goes to assess prospective residents. All residents have a preadmission assessment before being considered for the home, this also ensures that the home can meet their needs. They and their representatives are invited to visit the home prior to making the decision whether to make Glentworth House their home. Residents are initially admitted for a month’s trial period and receive a copy of the terms and conditions on arrival at the home. All documents seen complied with these standards and the regulations. Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 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 the following standard(s): 7,8,10,11 The care plans thoroughly address the assessed needs of the residents and ensure that residents receive a comprehensive standard of health care. EVIDENCE: A percentage of care plans were examined and these were seen to address the physical, psychological and social needs of the residents, had been reviewed on a monthly basis and had been signed by the resident or their representative to show that they were aware of the contents of the care plan. Risk assessments relating to bed rails and the possession of door and drawer keys were included in the care plans and consent forms for the use of bedrails were also present. There was evidence that health care professionals including GP’s, the wound care nurse, dentist, opticians and physiotherapists visit the home as required. A dentist was visiting the home at this time and he stated that he comes in regularly, and the majority of dental treatment required is carried out within the home. It was apparent that some residents are very frail and that some require a large amount of nursing input. It is recommended that the manager tries to Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 Page 10 admit residents with lighter needs when undertaking assessments in the future in order balance the care needed. The home has a range of pressure relieving equipment with no residents having pressure damage at present. Residents spoken with felt that they were treated with dignity and respect and visitors stated that they were ‘impressed’ with the staff and the way they spoke to all the residents. Those residents that were poorly were seen to be comfortable and the care given appeared good. Staff have attended some training at the hospice and registered nurses receive updating on the use of syringe drivers and analgesic patches, although one registered nurse stated that they use syringe drivers so infrequently that she would need a review should they be using them again. The manager is aware of how to contact bereavement counsellors and ministers of religion, and relatives can stay with the dying resident. Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 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 the following standard(s): 12,13,14,15 The home provides a range of activities and catering. The home has done much to improve the quality of life for residents. EVIDENCE: The day of the visit to the home was very cold, but on entering the home two residents could be seen in the garden, well wrapped up against the cold enjoying their cigarettes and coffee. Staff were seen to be going out at regular intervals to check on these residents, who, when they came back into the house, stated they really enjoyed being allowed to go out for ‘a smoke’ and were always well clothed and taken out there at their request. One said ‘ the girls make sure we are warm enough and keep running in and out to make sure we are not getting cold’. All residents in the lounge were alert and taking an interest in the conversation and activity around them. Activities are provided within the home and these include music therapy days, a visiting magician, gentle exercise to music and reminiscence. During the morning the attendant from the local library brought in a large delivery of books, which were exchanged for those already in the home. Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 Page 12 It is recommended that an activities programme be placed where residents can see it to give a visible reminder of what is planned in the home. A record of which residents take part in the various activities should also be kept. Residents spoken with said that they were able to make choices around their activities of daily living, including their times of going to bed and getting up, they had a choice of food and that they could have a cup of tea whenever they wished. Some residents stated that they had difficulty in understanding some of the staff in the home at times. The manager stated that only those who wish to get up early between 06000800 do so and no residents spoken with said that they felt they were getting up to early. Visitors stated that they were made very welcome whenever they came in and that there was no restriction on the times that they visited. The manager can access ministers of religion and one resident has regular visits from a member of her church. The kitchen has recently been refurbished and a good range of fresh, dried and frozen food was seen. All catering staff have undertaken food hygiene training and all records for temperature testing, including food probing were up to date and within recommended parameters. A cleaning schedule is in place and the kitchen was seen to be very clean. The cook, who has been at the home for a number of years, visits every resident to ascertain what they would like for meals, including breakfasts, and provides homemade cakes and puddings. Liquidised meals were seen to have their components served separately and food was well presented. The meal of the day was smoked haddock, fish cakes or chicken, mashed potatoes and vegetables followed by banana custard. The supper for that day was to be corned beef hash, soup, sandwiches and ice cream. All residents said that they could ask for a cup of tea or a snack whenever they want it. One resident said that he gets hungry in the evening. This was reported to the manager who has now arranged for sandwiches to be given to him with his late evening drink. This was already arranged for one other resident. Residents stated “ The food is lovely”, “ We always get enough to eat”, “The cook makes nice cakes” and that fruit was available. Discussions were held with the manager regarding the possibility of a dining room table and encouraging some residents to use this. This would encourage Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 Page 13 social interaction as well as relieving pressure on the skin by the movement. She stated that she would like this to happen and will address this possibility. Residents can take meals in their rooms if they prefer. Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The home has shown that it deals with complaints in an open and robust manner. Staff have received training in the protection of the vulnerable adult therefore ensuring that residents can feel secure within the home. EVIDENCE: The home has a complaints policy which meets this standard. Only one complaint was received by CSCI and was unsubstantiated. All staff have received training in the protection of the vulnerable adult and were aware of their responsibilities in the protection of those in their care. Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. Extensive refurbishment is being completed to a good standard providing a very pleasant home for residents. The home provides a good standard of cleanliness and staff have a knowledge of infection control therefore ensuring the protection of frail residents. EVIDENCE: The home is in the process of refurbishment and this will be on going for the next two years. Work completed at present includes the outside of the home, some corridors and residents rooms and the lounge and kitchen areas. Not only has this been completed to a high standard but the décor chosen is in keeping with the style of the house and the colours chosen, especially within the individual bedrooms give a sense of warmth and light. Residents stated that they were ‘very impressed’. Staff who have been working at the home for several years said that “ the improvement is tremendous”, “who would have thought it could look like this” and “it makes you feel proud to work here”. Visitors also commented on the attractiveness of the home. Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 Page 16 Some areas are still to be commenced, and in those areas being worked on, efforts have been made to ensure residents safety. The lounge area is finished and has new carpets and curtains, this has made a light, attractive room, and residents stated that they found it very nice to use. Maintenance has also been undertaken in the garden and this looks very good, both at the front and back. Due to intended refurbishment some of the bathrooms are not being used at present. One bathroom has already been refurbished and the manager states that this one, and the en-suite bathrooms, provides sufficient facilities for the needs of the residents. The majority of resident’s rooms now have a lockable facility and the new furniture being purchased includes these, all doors have locks, keys for these being issued under the auspices of a risk assessment. Residents can bring in their own possessions to personalise their rooms. All hot water outlets in resident’s accommodation are thermo regulated and records evidence that these are within recommended parameters. There are sufficient aids and equipment for use of residents and the home has now been assessed by an occupational therapist whose recommendations will be followed alongside the refurbishment. The home is clean and not malodorous. Staff were seen to be wearing blue aprons on entering the kitchen. Kitchen staff must refrain from keeping cleaning utensils under the kitchen units, as this will hamper the floor cleaning. The home has a range of infection control policies and staff receive training in the prevention of cross infection. Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The commitment of the home towards staff training ensures residents receive a good quality of care. EVIDENCE: Staff spoken with stated that there were normally sufficient staff on duty to meet the needs of the residents and that the only time that they felt rushed was if someone called in sick and they could not be replaced from the nurse bank. The duty rota evidenced that there were sufficient number of staff rostered, but the manager is reminded to be aware of the high needs of the residents in her care. The home has recently recruited some new staff including registered nurses. Newly employed staff undertake induction training, and those spoken with stated that they had a “ good induction programme”, the trainer was seen giving training sessions to a new member of staff on this day. There are ten members of staff at present undertaking NVQ2 and three s studying for NVQ 3. Other training courses are also offered by the home and the provider shows a commitment to providing staff training. Registered nurses confirmed that they are encouraged to maintain their professional development. A selection of personnel files were examined, including those of new staff. All documentation was found to be present in line with the requirements of Reg 18,19 and Schedule 2. Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 Page 18 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): 31,32,33,34,35,36,37,38 The management of the home provides a secure and happy atmosphere for residents and staff. Some policies to ensure resident’s safety in case of fire must be put in place. EVIDENCE: The manager, Mrs Donna Hardie, has been in post for eight months. She is a registered nurse who prior to this employment was the senior sister in a home in Brighton. The home owners, Mr and Mrs Redwood also are the owners of another home in the area. Mrs Hardie intends to apply for registration with the CSCI and to undertake a management course. Staff stated that “ this is now such a happy home” and said that the manager and providers were very approachable and easy to work for. All staff spoken with said they enjoyed coming to work and a resident stated, “ staff here always seem happy, makes such a difference to our lives”. Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 Page 19 Accounts and business planning for the home were seen prior to the new registration of the owners and was in order. The manager or provider do not act as appointee for any resident or deal with resident’s money. A quality monitoring system has been put in place and this has included thorough collation of questionnaires sent to residents and relatives. This is a substantial piece of work, which was undertaken by the manager shortly following her arrival at the home. This will also include risk assessments, ongoing quality management and questionnaires to health care professionals and other stakeholders. Action has been taken on matters arising from the questionnaires. All policies and procedures were recently reviewed. Supervision of staff at times dictated by this standard now takes place, and the provider makes monthly Regulation 26 visit reports available to the CSCI. There has been compliance with the majority of the requirements made at the previous inspection. Staff meetings have been taking place every two months; these have been split into registered nurse meetings and other staff meetings, at times, although joint meetings are also held. All staff records and confidential resident records are kept in a locked office; care notes being kept in the manager’s office. All certificates relating to the servicing of utilities and equipment were in place and in date, and there were no health and safety issues that needed attention. At the last inspection the home was required to address the issue of safety in the event of fire in the case of those residents who preferred their doors left open. This has only been partially complied with at this stage insomuch that new residents will be told that the home has a ‘closed door’ policy. Should this be put into force it must be put into the Statement of Purpose and Service user’s guide. However the issue of present residents that prefer their door open must be addressed and it was noted that the door to a new resident’s room had been wedged open. This must now be addressed as a matter of priority. Likewise a simple statement to inform residents of what their actions (if any) should be in the case of fire must be put in resident’s rooms. It is advised that this should be short and to the point and in large print Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 Page 20 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 2 Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 Page 21 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 2 Standard OP12 OP38 Regulation Requirement Timescale for action 01/02/06 20/12/05 Reg16 (m That a programme of activities is n) displayed. Reg23 (4) 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) Reg23 (4) 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) 3 OP38 20/12/05 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 OP15 Good Practice Recommendations That the manager considers encouraging those service users who are able, to sit at a dining table for meals. Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 Page 22 2 OP27 The manager ensures that all staff employed and in contact with residents have an acceptable standard of spoken English to facilitate their contact with residents. Glentworth House Nursing Home DS0000062476.V262338.R01.S.doc Version 5.0 Page 23 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. 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