Inspection on 08/01/09 for Glenwood Nursing Home

This inspection was carried out on 8th January 2009.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Glenwood Nursing Home 09/01/07

Glenwood Nursing Home 16/11/05

Glenwood Nursing Home 02/08/05

Glenwood Nursing Home 22/12/04

Glenwood Nursing Home 21/06/04

Glenwood Nursing Home 26/02/04

Glenwood Nursing Home 23/12/03

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

CARE HOME ADULTS 18-65 Glenwood Nursing Home Liverpool Road Widnes Cheshire WA8 7HJ Lead Inspector Anthony Cliffe Unannounced Inspection 8th January 2009 09:15 Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 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 Glenwood Nursing Home DS0000005144.V373439.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 Adults 18-65. 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. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glenwood Nursing Home Address Liverpool Road Widnes Cheshire WA8 7HJ 0151 420 5945 0151 420 5945 ashwood@c-i-c.co.uk www.c-i-c.co.uk. Community Integrated Care 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) Care Home with nursing 12 Category(ies) of Learning disability (12) registration, with number of places Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2007 Brief Description of the Service: Glenwood is a care home with nursing providing care for 12 people with learning difficulties and physical disabilities. Glenwood is owned and managed by Community Integrated Care, which is a non-profit making organisation. The home is located in the Ditton area of Widnes, near to shops, pubs, post office, and other local amenities. It has a small parking area and a garden area with patio to the rear of the property. The home comprises of two purpose built dormer bungalows with link corridor and office facilities on the first floor. All the bedrooms are on the ground floor and all have fitted furniture and a wash hand basin. Six bedrooms have overhead fixed hoist tracking fitted. There are no en-suite facilities, but there are 4 assisted bathrooms and separate toilets on the ground floors. Also on the ground floor are two large lounge / dining rooms, two kitchens and utility rooms. Both lounges have fixed overhead hoist tracking fitted. The home is in a local bus route and close to two local railway stations. Fees range from £500 to £100 per week. Information about Glenwood can be obtained directly form the home or from the owners website. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is a two star. This means that the people who use the service experience good quality outcomes. References to we or us represent the Commission for Social care Inspection. This unannounced visit took place on the 8th January 2009 and lasted over seven hours. One inspector carried out the visit. As part of the inspection we were accompanied by an expert by experience who is someone who has experience of using care services. The expert by experience helps us get information to make judgements about the quality of life that people that use services have when using a care service. This visit was just one part of the inspection. Other information received was also looked at. Some weeks before the visit the manager was asked to complete a questionnaire called an Annual Quality Assurance Assessment (AQAA) telling us what they thought they did well, what they needed to do better and what they had improved upon since the last visit, to provide up to date information about the service provided. This helps us to determine if the management of the home see the service they provide in the same way we do and if our judgements are consistent with homeowners or managers. We provided questionnaires for people that use services, staff employed at the home and social and healthcare professionals involved in their care to find out their views about the service the home provides. During the visit various records and the premises were looked at. A person that uses services was spoken with and gave their views about the service. We also received questionnaires from staff that said the home had good recruitment procedures and staff received support and training. In January 2007 we did an annual service review of the home, which told us the home was still providing a good service. An annual service review is a summary of our knowledge about how a service that has not had a visit in the last year. It is also how we decide if a service is still as good as we thought it was since the last visit or annual service review. What the service does well: Glenwood provides a homelike, calm and welcoming atmosphere for people that use services. The expert by experience said the home was very relaxed and calm. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 6 People that use services received a very good standard of care and comments from a person using the service said, it’s a nice place to live, I like to dust, help staff with the laundry and tidy my bedroom. Care staff practices were good and staff were very patient and were seen to take time to ask people that use services questions and rather than making decisions for or deciding for them. People that use services were encouraged to join in activities if that was their wish. People that use services were comfortable and confident in their home and were experiencing a good quality of life. People that use services were seen to move freely around the home and decide on their daily activities. The provider had a commitment to training and staff said that training was very good. This means that staff are fully trained and competent to meet the needs of the people living at Glenwood. An experienced manager has been appointed to manage Glenwood and this was reflected in how the manager approached her job and upheld the philosophy of the home. What has improved since the last inspection? What they could do better: Provide relevant information in the statement of purpose and both the statement of purpose and complaints procedure in formats that adults with learning difficulties can understand. So they have information about the facilities and services at Glenwood and understand how the complaints procedure works so they will have confidence their concerns or views are listened to and acted upon People that use services’ support plans should include information on their personal and lifestyle routines, details for staff on how agreements and choices are decided with people that use services and how they communicate their needs. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 7 Glenwood should provide additional private visiting facilities for people that use services to use so they can have facilities to meet with their families and visitors. 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. The summary of this inspection report can be made available in other formats on request. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People have their needs assessed before they move into Glenwood so they know their needs can be met. Current information available about Glenwood does not assist people in making a decision to move into the home. EVIDENCE: Glenwood accommodates mainly people from the Halton area but is welcoming to anyone with a disability, different ethnic or cultural needs or sexual orientation. Information about the home is not routinely given to people that use services due to their different needs associated with their physical and learning difficulties but information was available for them at the home with the previous inspection report available and some information on facilities and services provided. The information available called the ‘service users’ handbook provided information on all the facilities and services available to people wishing to live at Glenwood and provided information on moving into the home, what people could take with them and what the arrangements were for arranging their care. Since the home changed the name to Glenwood care home in 2008 the service user guide had not been amended to include this information and information about the change in the manager. Information on the care home can be made Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 10 available on request in different formats but as recommended at the last visit the provider had not produced information in a format that adults with severe learning difficulties could understand. We examined the files of two people that use services who had moved into Glenwood since the last visit. The home had gathered information on their needs. Information gathered about people was seen and it covered information about maintaining their safety, managing finances, health, social and psychological care, housing needs, decision making, dreams and aspirations and the support that people that use services needed. Gathering information about people that use services involved their families, advocates and health and social care professionals. People that may want to use the service can visit the home before decisions are made about choosing Glenwood. Moving in usually involved a period of time where people that may want to live at Glenwood visiting the home to get to know the other peole that lived their to see if they developed relationships so they could live together. People that use services were provided with a contract with information about what the costs of their care covered. Information was obtained about their life histories so staff had information about their lives before they moved into the home. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People are supported to live their preferred lifestyle, however information held about them does not support that they are directly included in the decision making process. EVIDENCE: We examined the person centred plan of two people that use services and the expert by experince sought and was given permission by people that use services to look their personal support plans. Person centred planning is a really good way for people to take control of their lives. Person centred thinking helps staff that care and support people that use services to listen to them and then to get what they want. A person centred plan contains information on what is positive about people that use services for example what people like and admire about them and their gifts and talents. Information should be included about what and who is improtant to peole that ue services from their viewpoint, as well as what people want for the future. A person centred plan should have information about how people that use services wante to be supported so stay healthy, safe and well. This is called a support plan and should be detailed enough to provide a living description of Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 12 how people want to be supported, how they make decisions and says who will do what by when. The support plans seen and conversations with a person that used the service and staff demonstrated that the health and personal needs of people living at the home were consistently met and their privacy and dignity always respected. We could see that the home had gathered a lot of information on people that use services. The information included copies of the local Primary Care Trust person centred plan, health action plan and hospital passport. These documents provide information about people that use services and gave information on what was improtant to them, what was improtant for them and information that they neede to know and what other people caring for them needed to know about them so consistent information was shared and appropriate care provided. For example how they commuicated and understood information and what may cause them to become distressed. This information was not included in the support plans written by the home. The information the home had about people that use services contained information about their needs, routines and lifestyle choices. Support plans written by the home that we examined did not consistently reflect the level of information that had been gathered about them. Support plans contained important information about their needs and this reflected a person centred approach to care, but support plans were not written as person centred plans so did not reflect the personalisation of their care. A staff member said, The person centred plans could help but theyre not person centred plans they are all the same and not personal to each resident. Residents are not involved in them and they are very black and white in what they say, impersonal and task orientated. What we use here isnt person centred planning. We use the thinking but not the plans. Plans should include more information about and from the residents, like their own pictures, drawings or things they understand and are interested in. How can you understand your own plan about yourself if you cant read or write. The expert by experience looked at some support plans of people that use services. He said they were big files with lots of information in them. He said a daily routine for each person was a good idea, but the plans were not accessible to the people they were about and did not include individual information about them and he could not see that people that use services were involved in how their support plans were put together. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People that use services are supported to maintain personal relationships and make choices about lifestyle and leisure activities in keeping with their age, wishes and choices so they receive appropriate social care and have a healthy diet based on their personal choices. EVIDENCE: People that use services had access to a variety of leisure activities and the home had its own minibus. The home had also supported people that use services to access local day care facilities so people that use services did things they enjoyed. The activity staff members spoken with said they worked flexibly during the day, evenings and weekends. Before the visit people that use services returned surveys to us. One person that uses services said, I always make decisions about what I do each day. I go out in my wheelchair and on the bus. I enjoy being out and doing things. I can do what I want during the day, evenings and at the weekend. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 14 Another person that used services said, my key worker and colleagues take me out regularly and I join in activities. I get up and go to bed when I am ready. A person that used services said she had got up out of bed because she did not want a lie in and was waiting for staff to assist her with a shower. Other people that use services were still in bed until after 10:00 am which was in keeping with their personal routines, while other people that use services had gone to day care or out with staff into the local community. Later on some of the people that use services chose to go out for lunch with the activities staff. The home had a menu based on the choices of people that use services, which offered a variety of choices including a cooked breakfast. People that used services could choose when they had their meals and did not have to keep to the regular mealtimes. A person that used services said, I have weetabix and toast for breakfast thats what I like and have. Meals were agreed with people that use services and they could eat together if they wished. Each bungalow had its own kitchens so people that could help prepare meals. Staff was seen serving people that use services their breakfast but we did not see people that use services involved in preparing their meals. The expert by experience said that the people that used services could have been more involved in making their meals for example instead of staff just serving breakfast people that use services could go in to the kitchen and be involved. The staff told the expert by experience that people that use services went to various activities like swimming, shopping and going out for walks. While the expert by experience was at the home some people that use services went out for a walk and others were getting ready to go out for lunch. The expert by experience saw that people got up at different times which he said was good but there did not seem to be much activities in the bungalows in which people that use services were involved in. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People that use services’ personal, physical and emotional needs are met. Management and administration of medicines ensured people that use services received their prescribed medicines safely. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) stated that people that used services’ preferences was central to the home’s philosophy and this was reflected in the attitude of staff and could be seen in their approach to people living at Glenwood. Support plans gave details as to the personal care required by people that use services but did not always reflect the preferences and routines of people around how they wanted their personal care to be arranged. For example care records did not specify personal routines and choices around bathing. Care records included details from the appropriate professionals involved in their health and social care and daily records showed that staff acted on recommendations from professionals. Examples of this were advice given from speech and language therapists, physiotherapists and psychiatrists. People that use services were supported to attend hospital visits and to see their doctor. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 16 People that use service had health action plans and hospital passports provided by the local primary care trust. Hospital passports provide staff in the NHS with important information about people that use services. The hospital passport and health action plan provided personal information about the physical, psychological and mental health of people that use services and their routines and lifestyles so consistent care could be provided to them. Before the visit a health care professional returned a survey to us and said the home does well as it Provides a stable safe, caring environment, giving their clients support and stability in their daily lives Medication policies were comprehensive. Both bungalows have the same under stair storage for medication. A medicine fridge is located in one of the bungalows with daily records for the operation temperature maintained. Each storage area contained the policies and procedures for medicine administration with specimen signatures for the staff responsible for the management and administration of medicines so staff was aware of their responsibility and accountability for managing and administering medicines. We looked at the arrangements for the ordering, receipt, administration and disposal of medicines and found some minor errors, which were rectified during the visit so people that use services received their medicines safely. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People that use services are protected by the safeguarding adults procedures in place but information needs to be made available in a style they can understand and use so will be confident their concerns are taken seriously and acted upon. EVIDENCE: The home had received one complaint. This had been dealt with under the local council safeguarding adults procedure and not through the homes complaints procedure. We had not received any complaints about the home. The complaints procedure is not made available at the home to people that use services in a format they can use so they may not understand the complaints procedure in place. Prior to the visit people that use services returned surveys and said they knew who to talk to if they were unhappy and that there was a complaints procedure. People that use services said about the complaints procedure, I will let the staff know in various ways that I am not happy. I cannot communicate a complaint directly but the staff know me well enough to know when I am complaining. Another person said, If I was unhappy I would talk to everyone. Policies and procedures were in place in relation to safeguarding vulnerable adults in line with Department of Health guidelines. Staff employed at Glenwood had either received training on or had training arranged on safeguarding vulnerable adults and managing challenging behaviour, which helped them to respond appropriately to suspicions and ensure people, were Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 18 protected. The home had a copy of the local council’s safeguarding adults policy and procedure. Staff confirmed that during the corporate induction programme they completed training on safeguarding adults. Certificates for training were in staff files examined. Information provided during the visit confirmed that safeguarding training was ongoing. Following safeguarding referrals to the local council the manager and locality manager cooperated with the local authority in the investigation of allegations made. Since all staff were reissued with the local council guidance No secrets abuse, neglect or mistreatment, information for workers in the community or care homes. As part of the locality managers monthly visits she discusses with staff their understanding of the safeguarding adults procedure and how to report any allegations or suspicions of abuse or neglect. The safeguarding procedure is how the local council and other agencies involved respond to and manage allegtaions of abuse against vulnerable adults. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People that use services live in a safe, comfortable and well-maintained environment, which is equipped to meet their needs. EVIDENCE: The home is being redecorated and new fixtures and fittings being fitted, which commenced in the summer of 2008. Both bungalows had new kitchens fitted and all the inside corridors were redecorated. The bedrooms of people that use services have started to be decorated and one had been completed at the time of the visit. New curtains and blinds will also be fitted. The manager said the home is going to purchase new dining, lounge and where necessary bedroom furniture, including flat screen televisions. Under stair storage had been provided for the storage of medicines belonging to people that use services. As recommended at previous visits additional facilities to provide privacy for receiving visitors has not yet been made available to people who use services. The only additional facilities that could be used are on the first floor of the building but these are not accessible to people that use wheelchairs. The only facility to receive visitors in private is using the Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 20 bedrooms of people that use services so people that use services are not able to receive visitors or attend meetings about their care. The two bungalows accommodate physically disabled adults. Facilities included overhead tracking so the mobility needs of people that use services can be comfortably met when accessing living and bathing facilities. The expert by experience had a look around and thought the bedrooms were individualised with personal touches. The bungalows had personal photographs and ornaments, which helped to make it homelike. Before the visit people that use services returned surveys to us and said their home was always fresh and clean. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The recruitment and training programme provides a skilled workforce so people that use services are protected and in safe hands at all times. EVIDENCE: Staffing levels seemed more than adequate. Surveys sent to us by staff before the visit said that staff always received up to date information on the needs of the people they were providing care and support to. The expert by experience said the staff were trying their best but they had a lot to do, Staffing levels seemed ok with both care staff and activities staff employed. The expert by experience said staff seemed to know how to deal with situations were people that use services showed difficult behaviour and dealt with the behaviour in a gentle way. The manager said that people that use services were involved in the recruitment of staff as potential employees were invited to Glenwood to meet them so people that use services were involved in deciding who would care for them. The manager said of the recruitment process, recruitment is a mindful process as we are inviting someone to come ad work in someones home and we have to get it right. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 22 Thirty one care staff were employed. Nine had an NVQ level 2 and four wereing toward NVQ level 2. An NVQ qualification in social care is a recognised qualification in the social care sector. We examined the records of three staff employed at the home. Recruitment procedures were robust and adhered to and included staff having to complete an application form, a full employment/education history, and two references inclusive of the current or last employer and Criminal Records Bureau (CRB) disclosures being completed. Staff were issued with job descriptions, contracts of employment and the General Social Care Council code of practice for care staff so people that use services were protected by the providers employment policies and procedures. The information sent to us by the manager before the site visit told us that there had been a lot of agency staff used at the home to cover staff absence. The manager said that agency staff were used to cover staff vacancies. The agency staff supplied where from one agency and the same regular staff worked at the home so people that use services were familiar with them. Since then the use of agency staff has lessened as more staff have been recruited so people that use services have consistency of care. The providers e learning package, which is learning by using a computer over the Internet was introduced into the home in December 2008, which means that new and existing staff will complete their training mainly via the Internet and at the providers head offices. Staff had attended training in podiatry, moving and handling, safeguarding adults, food hygiene, non violent crisis intervention, health and safety, risk assessment and medication administration so people that use services benefited from competently trained staff. During induction staff had supervision and there were records of staff having ongoing supervision arranged so staff have opportunities to discuss how they do their jobs and their personal development. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Regular quality assurance and monitoring of staff practice is completed so the welfare of people that use services is maintained. EVIDENCE: The manager has been in posts since the spring of 2008. We were told about her appointment when she was recruited and appointed as the manager. The manager has previous experience as a deputy manager of a large care home. We have not yet received an application from the manager to register as the registered manager for the home so we cannot yet confirm her suitability. We have completed her CRB documents so we are confident we will receive and application within the future. The manager completed quality assurance audits as part of the quality assurance system. These were checked externally during visits by the providers’ representative and by the provider’s quality assurance team. The manager audits records weekly within the home and check that the records Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 24 and support plans of people that use services were completed and medicine administration and management policies and procedures were followed. The manager had to produce a plan to improve any shortfalls identified as part of the quality assurance process. Staff spoken with during the visit and staff surveys returned before the visit said that communication from the manager and between the staff team had improved and always or usually worked well. A staff member said, Management has improved, the new manager is easy to talk to and I would say that since she has been here communication in the staff team has got better. We are a more integrated staff team. Another staff member said, She is a great manager. She leads the team well and knows what direction shes going in. I think its great to work here with a good philosophy of focusing on peoples rights and choices. Prior to the visit staff surveys were returned and said the manager was supportive and met with them on a regular basis to provide support. The AQAA confirmed that all the required maintenance and health and safety checks had been completed as required. We looked at the fire records for the testing and maintenance of equipment and found that these had been completed so people that use services live in a safe home. Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA1 Good Practice Recommendations The statement of purpose should be revised to include information in a style people can understand so they can decide if their needs can be met before they make a decision about moving in. People that use services’ care records should include information on their personal and lifestyle routines, details for staff on how agreements and choices are decided with people and how they communicate their needs. The complaints procedure needs to be made available in a way that people that use services can understand and use so they will be confident their concerns or complaints are taken seriously and acted upon. Additional private visiting facilities should be provided for people that use services so they can have a comfortable place to receive visitors, attend meetings about their care and have additional quiet space. 2. YA6 3. YA23 4. YA28 Glenwood Nursing Home DS0000005144.V373439.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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