Inspection on 04/05/05 for Glynn Court

This inspection was carried out on 4th May 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 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

Glynn Court 11/06/07

Glynn Court 03/05/06

Glynn Court 14/11/05

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 SP6 1NG Lead Inspector Beverley Rand Unnannounced 4.05.05 10:30am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Glynn Court Address Fryern Court Road Tinkers Cross Fordingbridge Hampshire SP6 1NG 01425 652349 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Glynn Court Limited Mrs Sally Crook CRH 31 Category(ies) of Dementia - DE - 31 registration, with number Dementia, Over 65 - DE(E) - 31 of places Mental Disorder - MD - 31 Mental Disorder, Over 65 - MD (E) - 31 Old Age - OP - 31 Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category MD and DE referred to above are not to be admited under the age of 55 years. Date of last inspection 21.12.04 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 and Mrs Sally Crook is the registered manager as well as 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 rooms, none of which have en-suite facilities. The second floor can be accessed using stairs or a stairlift. There is a communal sitting room, dining room and conservatory. The second building can accommodate eight service users, and one bedroom has an en-suite bathroom. The second floor is accessed using a stairlift. 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 H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over five hours and was the first statutory inspection of the year. Five residents, five staff, two relatives, one healthcare professional and the manager were talked with. Please note that the summary only takes into account standards which were assessed, so for example, the heading, ‘what the service does well’ will not include everything that the service does well What the service does well: What has improved since the last inspection? What they could do better: Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 6 The Service User Guide, Complaints procedure and survey need to be given to all residents, to ensure that residents are fully aware of the home’s services, the way to complain and to be consulted regarding the running of the home. Requirements about these issues have been raised again. Not all the residents had a careplan in place, and those that were in place were not reviewed every month. The careplan should be used to ensure that people are looked after in the way which meets their individual needs. Staff need to be clearer about what would happen if there were allegations or suspicions of abuse, because the way this would be investigated can have implications with regard to the outcome. Staff should have formal supervision regularly, as this identifies how the worker may improve their practice, access further training, and generally discuss issues which affect their work and the home. The person doing the supervision has not yet accessed a training course which would benefit them greatly in meeting this standard. Harmful cleaning fluids were found to be not locked away, but could be accessible to people who are confused or otherwise vulnerable, and a requirement has been raised to lock them away. Recommendations have been made about the deputy manager having more time to look after careplans and do supervision, careplans should show that the resident has been involved, the bath rota should be reviewed, the staff should ensure that they always knock on bedroom doors and staff working in the laundry should be able to use a sink designated for hand washing only. 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 H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 3 Prospective service users do not have the information they need to make an informed choice about where to live, although they do move into the home after their needs have been assessed. EVIDENCE: Following a requirement raised at the last inspection, the manager has compiled a Statement of Purpose which nearly meets the standard and Service User Guide. The Statement needs to contain information about consultation with service users, e.g. survey, how careplans will be reviewed and the number of rooms, including an indication as to the size/whether they meet the standards. The Service User Guide has not yet been given to service users. A pre-admission assessment was seen for someone who was moving to the home the day after the inspection. The assessment was provided by health/social care professionals and contained detailed information. Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9 & 10. A lack of a care plan and regular reviews of care planning for each service user means that service users needs may not be consistently met. Medication procedures are followed correctly ensuring service user’s safety. Privacy and dignity seems to be upheld inconsistently within some areas. EVIDENCE: The inspector asked to see four careplans of people who had moved into the home since the last inspection, but there was not one in place for these people. The deputy manager is responsible for careplans and said that they were not being reviewed on a monthly basis. The deputy manager is also responsible for supervising the care staff and this is discussed in further detail below. Careplans are kept in a locked cabinet, which meets a regulation regarding the security of records, but means that care staff and night staff cannot access the information. Careplans are dynamic documents, and are necessary to ensure that residents get the care according to their plans. They also contain information which may be necessary at times when there is noone available to unlock the cabinet. Additionally, careplans should be made available to service users and could be kept in their rooms. The inspector spoke with staff about the medication procedures and observed lunch time Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 10 medication being given appropriately. The record sheets accurately showed the medication given. Service users said that they saw healthcare professionals in their own bedrooms, and a discussion with a visiting nurse also confirmed this. One resident said staff would always knock on the door before entering the bedroom, another said not all staff do so, and the inspector witnessed someone opening the door, seeing someone was in the room, apologising and closing the door. Residents spoke of having a weekly bath, on a rota system. One said that they would like more time to soak, another said that they were asked if they would like to spend longer. Both said that two staff assisted them at bath times and stayed in the room all the time, although they did not know why this was necessary. Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 Residents do receive a varied diet, and can choose where they wish to eat. EVIDENCE: Although residents said that there was not a choice of meal at lunchtime, they also said that the cook knew what they liked or did not like. One resident gave an example about not liking fried fish, so it was cooked a different way. There was a choice at teatime. The food was described by one person as being, ‘out of this world’. Others said the food was good and varied. A relative said that visitors were provided with tea and cake, as well as lunch, if they were visiting at that time. The inspector saw a staff member taking a tray of puddings to people who choose to eat in their rooms, and heard them discussing the size of pudding the person would like, thereby showing that they were aware of their preference. Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Not all service users or relatives have been given a complaints procedure, and they do not know how to make a complaint. A lack of awareness as to procedures regarding adult protection means that service users can not be fully protected from abuse. EVIDENCE: A requirement was raised at the last inspection for a complaints procedure to be in written to include timescales and details as to how a complaint can be made. This has been done, although a change is necessary as the wrong legislation was cited. The manager said that some people had been given a copy, but four people who were asked by the inspector, did not have a copy. Two visitors said they would feel happy to verbally complain without having the procedure. However, not everyone would feel comfortable using this approach. This part of the requirement is therefore raised again. A training course regarding the protection of vulnerable adults is planned for the near future. Staff were aware that if there was an allegation or suspicion of abuse, they should report straight away to the manager. However, they were less clear regarding the procedure thereafter, generally believing that the manager would undertake her own investigation. On further discussion, they agreed that Social Services would probably do the investigation. The inspector did not view the written procedures. Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 26 The home is clean, however, attention to the laundry floor would promote hygienic practices with regard to infection control. EVIDENCE: The home was clean. Following two requirements the laundry has been refurbished to ensure the walls are readily cleanable and the floor is impermeable. However, there are two carpet mats on the floor, which results in the flooring not being impermeable. Dirty, (although not soiled) laundry is put on the mat whilst it waits to go into the machine. This is an infection control risk and they must be removed. There is a sink in the laundry, but this is used for soaking soiled laundry, (although there is a sluice programme on the machine). This means that there is not a separate handwash facility and staff have to use the basin in the staff toilet, which again, is an infection control risk. Staff should be able to wash their hands in the laundry, in a sink which has not been used for sluicing. Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 & 30 The procedures for the recruitment of staff are not robust and do not provide the safeguards to offer protection to people living in the home. All staff have undertaken core training so they are competent to do their jobs. EVIDENCE: Three recruitment files were sampled for new staff. Two references were in place, and Mrs Crook confirmed that she had taken a verbal reference from a previous care employer. Mrs Crook was advised that written record should be kept of verbal references. Criminal Record Bureau and/or Protection of Vulnerable Adult, (POVAFirst) checks were not in place prior to staff beginning work, although staff worked with other staff for a few weeks. All staff have undertaken training in Fire Safety, Moving and Handling, First Aid and Risk Assessment. The inspector was advised that it was difficult to encourage staff to attend training, even though they were paid for their time. Staff who give medication are currently undertaking a training course. A senior staff member has responsibility for the structured induction programme, which is started within six weeks of starting work. Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 36 & 38 The home is not able to evidence that it runs in the best interests of all of the service users because of the lack of a formal quality assurance programme. The home does not ensure that staff are appropriately supervised. The health and safety of residents would be enhanced by keeping hazardous substances locked away. EVIDENCE: These standards were not fully assessed but have been referred to here due to previous requirements as well as the inspector finding a health and safety risk on the day. A requirement has been raised at the previous three inspections with regard to formal consultation with service users about the care provided. The manager has now created a survey but has not yet distributed it. The manager said that this would be done when she got round to it. Therefore the Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 16 requirement is raised for a fourth time. Hazardous substances were found in the kitchen and laundry which were not locked away. Behind the kitchen sink there was Flash bleach spray, Milton steriliser and Cif cream. In the laundry, the cleaner’s trays were stored, which included polish, air freshener, Neutrodol, Vanish, Cif creams etc. Although spare cleaning fluids are locked away, all hazardous substances must be kept securely. A requirement regarding formal supervision sessions has also been raised at the three previous inspections. The deputy manager has responsibility for supervising the staff, but although she had been booked on a supervision course, (following a previous requirement), this had been cancelled by the course provider. There is no follow up date as yet. The inspector was told that supervision was being done in the same way as it has always been done, which does not meet the standard. Additionally, the supervision sessions do not happen six times a year. The inspector is concerned as to the amount of work which is the responsibility of the deputy manager. There is a large staff team and she is also responsible for careplans, however, she invariably finds that even when she is ‘extra’ to the rota, she has to cover the shift due to sickness of others. This means that she is trying to undertake hands on care and management responsibilities. Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 x 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x x x 2 STAFFING Standard No Score 27 x 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x 2 x x 1 x 2 Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 18 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard OP1 OP7 Regulation 5 (2) 15 (1)(2) Requirement The Service User Guide must be given to all residents (or their families if appropriate) After consultation with the service user, every service user must have an individual written plan which details how their needs in respect of their health and welfare are to be met. Service user plans (careplans) must be reviewed on a monthly basis Service user plans must be accessible to all care staff including night staff, and service users. Each service user must be provided with their own copy of the Complaints procedure and to any person acting on behalf of a service user if that person so requests. This part of the requirement remains outstanding from the previous two inspections All staff must be aware of the Adult Protection procedures, beyond reporting any suspicions/allegations to management. Timescale for action 30/07/05 30/07/05 3. 4. OP7 OP7 15 (2b) 12 (1a) 15 (2a) 22 (5) 30/07/05 30/07/05 5. OP16 30/07/05 6. OP18 13 (6) 30/06/05 Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 19 7. 8. OP26 OP33 13 (3) 24 (1-3) The mats on the laundry floor 30/07/05 must be removed The manager must formalise a 30/08/05 quality assurance system, and must supply to the Commission a report in respect of any review conducted, and make a copy available to service users. This requirement remains outstanding from the previous four inspections. Staff must receive formal 30/07/05 supervision six times a year The deputy manager (or any 30/07/05 other person undertaking the supervision of care staff) must undertake a training course regarding the supervision of staff. The timescale given is for a suitable course to be booked by. Previous timescale of 28/2/05 was not met. All hazardous substances must be locked away. 9. 10. OP36 OP36 18 (2) 18 (1)(i) 11. 12. 13. OP38 13 (4)(a)(b) 30/06/05 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. 2. Refer to Standard OP7 OP10 Good Practice Recommendations Service users should sign their careplans to show their involvement. The manager should review the consistency with which staff knock on bedroom doors. The manager should also review the bath rota, establishing whether one bath a week is really what people want, and whether two staff are always needed at all times for all service users having a bath. The laundry should have a designated hand wash area. H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 20 3. OP26 Glynn Court 4. OP27 The deputy manager should be given the amount of management time, (i.e. not as part of the hands on shift) commensurate with the level of management responsibilities bestowed upon her. Glynn Court H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 H54 S12344 Glynn Court V222583 040505.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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