Inspection on 14/11/05 for Glynn Court

This inspection was carried out on 14th November 2005.

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

Glynn Court 11/06/07

Glynn Court 03/05/06

Glynn Court 04/05/05

Glynn Court 21/12/04

Glynn Court 30/06/04

Glynn Court 04/02/04

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

CARE HOMES FOR OLDER PEOPLE Glynn Court Fryern Court Road Tinkers Cross Fordingbridge Hampshire SP6 1NG Lead Inspector Pat Griffiths Unannounced Inspection 14th November 2005 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 Glynn Court DS0000012344.V261840.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. Glynn Court DS0000012344.V261840.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Glynn Court Address Fryern Court Road Tinkers Cross Fordingbridge Hampshire SP6 1NG 01425 652 349 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) Glynn Court Limited Mrs Sally Crook Care Home 31 Category(ies) of Dementia (31), Dementia - over 65 years of age registration, with number (31), Mental disorder, excluding learning of places disability or dementia (31), Mental Disorder, excluding learning disability or dementia - over 65 years of age (31), Old age, not falling within any other category (31) Glynn Court DS0000012344.V261840.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category MD and DE referred to above are not to be admitted under the age of 55 years. 4th May 2005 Date of last inspection Brief Description of the Service: Glynn Court is a care home providing personal care and accommodation for up to 31 service users who require support due to old age, dementia or a mental health need. The home is owned by Glynn Court Ltd; Mrs Sally Crook is the registered manager and one of the directors. Glynn Court is located in a rural area on the outskirts of Fordingbridge in the New Forest. The accommodation is in two separate buildings. The main building accommodates 23 service users on two floors, in both single and shared bedrooms, none of which have en-suite facilities. The second floor can be accessed using stairs or a stair lift. There is a communal sitting room, dining room and conservatory. The second building can accommodate eight service users; one bedroom has an en-suite bathroom. The second floor is accessed using a stair lift. The building also contains a kitchen with seating for four and a sitting room. There is a bathroom upstairs. Day and night staff are based in the main building. The home has a large garden, which is used by the service users in the summer. Glynn Court DS0000012344.V261840.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over five hours and was the second statutory unannounced inspection of the inspection year 2005/2006. The inspector was able to tour both buildings and saw the sitting rooms, dining room, conservatory, kitchen and most of the resident’s bedrooms. The inspector was assisted by the owner/manager and was able to talk with residents, staff, and visiting relatives. What the service does well: What has improved since the last inspection? All the residents now have a personal care plan in place, and most are reviewed every month. The care plans are used to ensure that residents are looked after in a way which meets their individual needs, and ensure that staff know what those needs are. Harmful cleaning fluids have now been locked away, and are not accessible to people who are confused or otherwise vulnerable; meeting a requirement that was made at the last inspection. A complaints procedure, which meets the standard, has been produced and has been given to all service users; it is attached to the back of every bedroom door. Glynn Court DS0000012344.V261840.R01.S.doc Version 5.0 Page 6 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. Glynn Court DS0000012344.V261840.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 Glynn Court DS0000012344.V261840.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 and 6 Prospective residents do have the information they need to make an informed choice about where to live. Standard 6 does not apply to this service EVIDENCE: The matron, as the residents address the manager, has compiled a Statement of Purpose, which contains all relevant information regarding the home. This was requirement made to ensure that all potential residents were able to make an informed choice before moving into the home. The Service User Guide has now been given to the residents. The home occasionally offers respite care, depending on bed availability, but does not provide intermediate care. Glynn Court DS0000012344.V261840.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 and 10 Personal plans of care for each resident do not always ensure that their needs are met. Arrangements ensure that resident’s health care needs are met. Privacy and dignity appears to be upheld for the residents. EVIDENCE: The inspector looked at three personal plans of care, they provide a simple but comprehensive guide to the care needs of the individual residents. It was apparent that not all plans are being reviewed regularly. There appears to be a list of plans that are being reviewed, but entries have not been made on all of the care plans themselves. Risk assessments appear to have been undertaken for the residents, but only the results are available in their plans of care. There is no documentary evidence to support the conclusions that are written in the care plans. The inspector discussed the need to use nationally recognised risk assessment tools, which should be used to assess risks and care needs such as pressure area care, nutritional needs and levels of mobility. The care plans are kept in a cabinet in the kitchen, which means that day and night care staff can access the information; this was a requirement from the Glynn Court DS0000012344.V261840.R01.S.doc Version 5.0 Page 10 last inspection. Service users do not wish to access their plans of care and do not wish to keep them in their bedrooms. Residents that spoke with the inspector were quite dismissive about the care plans and saw them as “something for the staff to take care of”. During the tour of the home a district nurse was providing care for a resident in their own bedroom and staff and residents confirmed that this was the usual practice. During the course of the day, staff were seen to knock on bedrooms doors before entering. The manager/matron and the inspector discussed the ‘bath rota’ and the inspector was advised that the residents were always assisted in and out of the bath and were ‘left to soak’ or were assisted with bathing as necessary or as they requested. Glynn Court DS0000012344.V261840.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 and 14 Residents experience a varied and stimulating life at the home, their visitors are encouraged and they are helped to make choices and exercise control over their lives. EVIDENCE: Several residents get out and about, taking walks in the gardens or in the local lanes. Residents that spoke with the inspector said that they could do as they wished within the home, that they got up and went to bed at times that suited them and could have their meals in their rooms if they wished. The manager/matron advised that an outside entertainer visited every six weeks to provide musical sessions for the residents. Staff also spend time chatting with the residents and undertake passive exercises with them; one staff member also plays the piano for singing sessions. A local group of Brownies runs Bingo sessions and groups of carol singers visit the home at Christmas. Several residents were seen reading newspapers and books and explained that they enjoyed their own company in their bedrooms. Books can be obtained from the local library, which is close to the home. Ministers from local churches attend regularly to provide communion for the residents. Glynn Court DS0000012344.V261840.R01.S.doc Version 5.0 Page 12 Visitors were seen at different times during the visit, those that spoke with the inspector said that they were happy with the care provided for their relatives and they were always made welcome when they visited; especially at afternoon tea time when there were always homemade cakes available. Several of the bedrooms seen by the inspector had been personalised with the resident’s own possessions. Small pieces of furniture, pictures, photographs and ornaments were seen and some collections of potted plants were being kept; all making the rooms appear individual, personal and homely. Glynn Court DS0000012344.V261840.R01.S.doc Version 5.0 Page 13 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 and 18 Arrangements ensure that the complaints procedure is available to all residents. Arrangements do not ensure that service users are fully protected from abuse. EVIDENCE: The complaints procedure is available to all residents and their visitors; the inspector noted that it is displayed on the back of every bedroom door. The manager/matron advised that there had been no complaints since the last inspection. Training regarding adult protection has been made available, but not all staff have attended. Staff that spoke with the inspector were not able to demonstrate any real knowledge about adult protection or types of abuse, indicating their need for training on the subject. The home does not have copies of the Hampshire Abuse Procedure or the Department of Health guidance, ‘No Secrets’. The manager advised the inspector that these would be obtained and efforts made to obtain information handbooks on the subject for each member of staff. Glynn Court DS0000012344.V261840.R01.S.doc Version 5.0 Page 14 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 and 26 Arrangements ensure the home is safe and well maintained. The home is clean and hygienic. EVIDENCE: The home is accessible to residents in wheelchairs, there are ramps at every external door and a stair-lift is available at each set of stairs. The home looked clean and the décor was in a good state of repair. The manager/matron advised that the home has ‘rolling programme’ of re-decoration. The handyman undertakes all maintenance work, the gardening and odd jobs around the home. The home was clean and free from any offensive odours on the day of the visit. The laundry has been refurbished and the mats on the floor have been thrown away. The home has cleaning staff, one of whom has completed an NVQ in Domestic Hygiene Studies (National Vocational Qualification). Glynn Court DS0000012344.V261840.R01.S.doc Version 5.0 Page 15 Glynn Court DS0000012344.V261840.R01.S.doc Version 5.0 Page 16 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): 29 Recruitment arrangements do not always protect the residents. EVIDENCE: The manager/matron advised that all staff have undertaken a structured induction programme, which is started within six weeks of starting work in the home. A senior staff member has responsibility for this programme. The inspector and manager/matron discussed the changes in this training, which is now called ‘Skills for Care’. The inspector looked at three staff files; they contained application forms and references but none of them contained proof of the staff members identity. The inspector advised the manager/matron of the need for a robust recruitment procedure. Staff files are required to contain proof of identity, such as a copy of a birth certificate, current passport or driver’s licence. This information must have been available for CRB disclosures to have been completed (Criminal Records Bureau) so evidence could have been included in the staff files. Glynn Court DS0000012344.V261840.R01.S.doc Version 5.0 Page 17 and that staff files are required to contain this information. which clearly had been available when CRB disclosures had been completed (Criminal Records Bureau). Glynn Court DS0000012344.V261840.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, 33, 35, 37 and 38 Arrangements for gathering resident’s opinions do not always ensure that the home is run in the best interests of the residents. Resident’s financial arrangements are safeguarded. The home’s record keeping is not always in the resident’s best interests. Arrangements are in place to protect the health, safety and welfare of the residents and staff. EVIDENCE: The home is run by Mrs Crook, who is a trained nurse with many years experience in running this care home. A requirement has been raised at the previous three inspections with regard to formal consultation with the residents about the care that is provided. The manager/matron has created a survey, which has now been completed. The Glynn Court DS0000012344.V261840.R01.S.doc Version 5.0 Page 19 results have not been collated or made available to interested parties or the commission. Hazardous substances, such as cleaning fluids, were seen to be locked away; which was a requirement made at the last inspection. The manager/matron advised that the home does not look after any of the resident’s money. Several of the residents look after their own finances, but most have nominated a family member or solicitor to manage their affairs. During the tour of the home a resident was seen with severe bruising to her face, apparently as a result of a fall in the home. Several accident report forms were seen in the Accident report Book on the day of the inspection, but a Regulation 37 notice has not been received by the commission regarding this accident. The commission has not received any Regulation 37 notices this year. Regulation 37 notices are required to be sent to the commission when there is an incident, accident, death or adverse event in the home. A requirement regarding formal supervision sessions for the care staff has been raised previously. The deputy manager has responsibility for supervising the staff, but has not yet started a supervisory skills course, so has not yet undertaken any formal supervision sessions for the staff. The inspector was advised that supervision was being done in the same way as it has always been done, informally and ‘at the bedside’, which does not meet the standard. Also, whilst some staff do receive a form of supervision, it is not the required minimum of six sessions a year. The need for supervision and the expected content of supervision sessions was discussed. The inspector and the manager/matron discussed the role and responsibilities of the deputy manager. There is a large staff team and whilst she is often ‘extra’ to the rota, she sometimes has to cover shifts due to staff sickness. It is suggested that she has a more clearly defined role, with time allocated for her management responsibilities. The inspector was advised that the home has service contracts for services such as the boilers, the fire safety equipment and the stair-lifts and all are serviced regularly. The handyman undertakes the weekly fire alarm tests and monthly visual checks of fire extinguishers, whilst all other fire safety equipment is serviced and maintained by external contractors. The manager/matron advised that the staff are aware of the need to lock outside doors in the home at night; currently there is no policy in place to ensure that the home is locked and secure at night; the need for a policy was discussed. Glynn Court DS0000012344.V261840.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 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 1 1 2 Glynn Court DS0000012344.V261840.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 Standard OP7 Regulation 15 (2b) Requirement The registered person must ensure that all of the residents personal plans of care are reviewed on a monthly basis and the reviews documented on the care plan This is a repeated requirement from 30/07/05 The registered person must ensure that risk assessments are undertaken as part of the residents care plan, using nationally recognised ‘risk assessment’ documentation The registered person must ensure that all staff undertake training in Adult Protection to ensure that they are all aware of the Adult Protection procedures This is a repeated requirement from 30/07/05 4 OP18 13(6) The registered person must obtain copies of the ‘Hampshire Abuse Procedure’ and the Department of Health guidance, DS0000012344.V261840.R01.S.doc Timescale for action 28/02/06 2 OP7 13(4) 31/12/05 3 OP18 13 (6) 28/02/06 28/02/06 Glynn Court Version 5.0 Page 22 ‘No Secrets’. 5 OP29 19 Schedule 2 The registered person must operate a thorough recruitment procedure and obtain and complete the information and documents specified in Schedule 2 The registered person must ensure that all staff receive formal supervision at least six times a year This is a repeated requirement from 30/07/05 7 OP36 18 (1)(i) The registered person must 28/02/06 ensure that the deputy manager (or any other person undertaking the supervision of care staff) undertakes a supervisory skills training course. A suitable course should be booked within the given timescale. This is a repeated requirement from 28/02/05 and 30/07/05 8 OP37 37 The registered person must ensure that Regulation 37 notices are sent to the commission when there is an incident, accident, death or adverse event in the home. 30/11/05 28/02/06 6 OP36 18 (2) 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Glynn Court Refer to Good Practice Recommendations DS0000012344.V261840.R01.S.doc Version 5.0 Page 23 1 2 Standard OP38 OP38 The deputy manager should have a more clearly defined role, with time allocated, and taken, for her management responsibilities. The manager/matron should review the need for a policy or procedure to ensure that the home is locked and secure at night. Glynn Court DS0000012344.V261840.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Glynn Court DS0000012344.V261840.R01.S.doc Version 5.0 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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