Inspection on 16/10/08 for Golborne House

This inspection was carried out on 16th October 2008.

CSCI found this care home to be providing an Good service.

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

Golborne House 26/09/06

Golborne House 10/02/06

Golborne House 15/07/05

Golborne House 14/10/04

Golborne House 06/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 17/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Golborne House Derby Road Golborne Wigan Greater Manchester WA3 3JL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Judith Stanley     Date: 1 6 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Golborne House Derby Road Golborne Wigan Greater Manchester WA3 3JL 01942726945 01942276686 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Karen Ann Alford Type of registration: Number of places registered: CLS Care Services Limited care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The registered person may provide the following category of service only: Care home only: Code PC, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP Physical disability over 65 years of age: Code PD(E) (maximum number of places: 8). The maximum number of people who can be accommodated is: 40. Date of last inspection Brief description of the care home Golborne House is a two-storey building with pleasant garden areas, situated in the middle of a housing estate, half a mile from Golborne town centre. It is close to shops and other local facilities and is well served by public transport. The Home is spacious with several lounges and dining areas. All bedrooms are single and five have an ensuite toilet facility. There are ample communal toilets and bathrooms situated Care Homes for Older People Page 4 of 25 0 0 Over 65 40 8 Brief description of the care home throughout the home. Golborne House provides personal care and support for forty people over the age of sixty-five years. The home is owned and managed by CLS Care Services Limited who have 40 plus homes around Cheshire and the Wigan area. A standard fee of 420:00 pounds per week is charged. Additional charges are made for hairdressing, toiletries, hairdressing, newspapers, clothes and transport. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was unannounced and included a site visit and was carried out over a period of 5.75 hours on one day. Part of the time was spent in the office looking at information the home holds on residents (care plans) and other records the home needs to keep to ensure the home is being run properly. Throughout the course of the day we (The Commission) spoke with residents, staff and a visitor, we also looked around the home. Prior to the inspection the manager was sent an Annual Quality Assurance Assessment form (AQAA) to complete. This tells us how the home meets the National Minimum Standards, what they do well at and in what areas they feel they could improve and develop. Comment cards were sent to staff and residents asking them what they Care Homes for Older People Page 6 of 25 thought about the home. Two residents returned comment cards, one said, The staff could not be any better. We had no replies from any staff members. The CSCI have received no complaints made about the home or the services provided. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides residents and their supporters with up to date information about the home that helps them in making a decision about moivng in to the home and the services provided. A full pre admission assessment is carried out prior to admission to ensure the home can meet the needs of the individual. Evidence: The home has a statement of purpose and a service user guide, which informs people about the services and facilities available at the home and the management and staffing structure. The information is available to prospective residents and a copy was seen in some of the residents bedrooms. We selected four residents files (care plans) to work with during the course of the inspection. All four residents had a contract in place regardless of how their care was purchased. Care Homes for Older People Page 10 of 25 Evidence: On examination of the care plans all four had a pre admission assessment in place. The assessment format is a company, pre printed document which covers all areas of care including: residents well being, areas of risk including falls, mobility, continence, personal care needs, nutrition, medication etc. The assessment is carried out at the most convenient place for the prospective resident either at their own home or in hospital. The assessment provides staff with the information they need to ensure that the individuals care needs can be met and provides the base line for the drawing up of the care plans. Some of the residents living at the home had a diagnosis of a dementia related illness. To ensure that their needs can be met all staff had undertaken training in dementia awareness. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and care needs were in the main met, however some records had not been completed in detail, which could result in residents care needs not being met. Residents were treated with dignity and respect and thier right to privacy was upheld. Evidence: The care records for four residents were examined. Care plans are drawn up from the initial assessment and include personal details, personal care, social care, nutrition, mobility and communication etc. Risk assessments covering areas such as moving and handling, bathing, nutrition, and risk of pressure sores were in place. Supplementary information, includes personal care records such and bathing and weighing. In one file looked at it was noted that there were gaps in the recording of the residents weights. In another residents file was a food and fluid chart. Some of the charts were not dated, therefore making it difficult to follow. The information recorded was not specific, such as few mouthfuls of pie and vegetables. The record must be a detailed of how much food has been eaten and not what was on the plate and how much fluid had been taken not what had been offered. On one day no hot or cold drinks were Care Homes for Older People Page 12 of 25 Evidence: recorded on the chart and this gives the impression that no fluids had been taken. The care plans were written in a person centered way for example, I would like you to call me, I have good short term memory and I need help and support with. A life profile was also available which provided staff with some background information on the person they are caring for, this included: family members, school days, work experiences, place of interests and hobbies. Daily progress notes are kept and were seen in residents files. Feedback from residents and from those who returned comment cards was complementary about the staff and the care provided. One resident wrote, The staff could not be better, I feel comfortable talking to any staff. One resident spoken with said, I am very happy here, the food is good, the staff are good and I have some nice friends. There was evidence in the files to demonstrate that the services of doctors, chiropodists and the district nurse team were accessed either at the home or in the community. We checked the medication and records for the four residents whose files we were working with. Residents had received their tablets correctly and this was documented on the individuals drug sheet. There were no errors noted. Observation throughout the inspection showed that the personal care needs of the residents were being met. Attention was given to personal grooming, residents clothes were seen to be clean and nicely laundered. Residents spoken with indicated that staff respected their privacy and dignity. During the inspection, staff were observed to treat residents with respect and consideration. It was evident that good relationships had been formed between residents and staff. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are offered a wide and varied range of activities to meet their capabilities and expectations. Evidence: On the day of the inspection, the routines of daily living were observed to be flexible. Residents were seen to be getting up in morning at times that suited them and choosing where and how to spend their day. Some residents preferred to spend time in their own room, where others were in the lounges with other people to chat with. The home has an activities coordinator, who with the help of the residents plans and delivers a wide range of indoor and outdoor activities. These included, trips out on a canal barge, Blackpool, shopping trips, local walks, involvement with the local church group and the Rotary Club, bingo, quizzes, reminiscence, themed days, entertainers etc. There are photographs displayed in the corridor of different events. One resident likes to help in the garden and is currently growing tomatoes. Visitors are welcome to visit the home, although are requested to avoid meal times. However staff are aware that sometimes this is not possible. One visitor spoken with Care Homes for Older People Page 14 of 25 Evidence: was very happy with home, the staff and with the care her relative received. The winter menus were to be introduced at the end of October. The existing menus were available for inspection. Staff and residents spoken with said that in the main the food was good, however there were some things on the menus they were not to keen on. Whilst the menus are corporate menus, it may be beneficial to involve residents more, asking for their preferences and choices of meals. A flexible breakfast is served and residents were offered a range of hot and cold dishes including: fruit juice, porridge, choice of cereals, eggs on toast, toast and preserves and tea and coffee. A lighter lunch of soup and sandwiches was served followed by dessert. The main meal of the day is served in the evening and residents were offered roast pork, potatoes and vegetables, followed by dessert. The menu board needs to be more informative for example what sort of soup and what fillings in sandwiches and what alternative is available. The same applies to the evening meal, what sort of potatoes and what vegetables and what alternatives are available. Hot and colds drinks and snacks were available throughout the day and suppers are available before residents retire. Most residents dined in the main dining room which was comfortable. Tables were set with appropriate crockery and cutlery. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their supporters, can have confidence that residents will be protected from abuse and have the right to complain, protected by effective staff training and procedures. Evidence: A complaints procdure is in place and the home had a complaints file. Information provided by the manager prior to the inspection told us there had been one complaint made to the home within the last year. Any complaints made to the home are suitably dealt with and the details and outcomes recorded. No formal complaints have been received by the CSCI. There have been four safeguarding adult referrels made within the last year. All staff at the home have undertaken training in the protection of vulnerable adults. Staff spoken with were aware of the correct procedures to follow in the event of any adult protection concerns. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the home was clean and there was evidence of improvements, the home must continue with a rolling programme of maintenance to ensure that the home does not fall below acceptable standards. Evidence: From a tour of the premises there was evidence of improvements. The dining room had been refurbished, a new carpet in the conservatory had been fitted, the downstairs corridor decorated and the garden area re flagged making it accessible for people who use wheelchairs. There is still some work that needs to be addressed. Some of the bedrooms are in need of decorating and the paintwork needs attention. It was discussed with the Homes Service Manager that three rooms had a odour of urine. This must be eradicated as it is unpleasant for residents living in those rooms and for residents whose rooms are in close proximity and for visitors coming in to the home. Two of the bathrooms were out of action and must be fixed as soon as possible. From one of these bathrooms permeated a stale, musty odour. In one of the bedrooms looked, the nurse call buzzer was out of reach, this was brought to the attention of staff. In one area of the home there had been a leak which brought off the wallpaper and plaster. On checking the plaster was now dry and the area should be re-papered as soon as possible. Communal areas were seen to be warm and comfortable and well equipped. Several bedrooms were looked at and were clean and tidy. Some of the Care Homes for Older People Page 17 of 25 Evidence: duvet covers put back on the beds were very creased and would have benefited from being ironed. Most residents had personalised their rooms with their own possessions brought with them from home. The laundry was looked at and all equipment was in working order. The laundry floor requires attention as this was seen to be cracking in places and could harbour bacteria. The home would benefit from a drying room to air clothes in that cannot go in the tumble dryers. These were seen airing on the hand rail on the downstairs corridor and looked unsightly. Infection control procedures were in place and staff were seen wearing different protective clothing for different tasks. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are satisfactory ensuring consistency of care for people living in the home. Evidence: On the day of the inspection staffing levels were sufficient to meet the needs of the residents. A written rota is maintained and corresponded with the staff on duty. Domestic and catering staff support care staff. Two members of staff cover a waking night shift. The manager should regularly review the night staff arrangements and extra staff brought on shift should the need arise. Staff spoken with indicated staffing levels were satisfactory. Some of the staff had worked at the home for a number of years and from the inspectors observations seemed genuinely happy to be working at the home. The atmosphere in the home was friendly and relaxed. Interactions between staff and residents were frequent, natural and warm. During the visit staff were observed to respond speedily to requests for assistance made by residents. The employment files of three staff members were looked at. In the main the necessary checks had been carried out. In the last persons file to start working at the Care Homes for Older People Page 19 of 25 Evidence: home there was evidence of a written application form, two written references, Criminal Records Bureau (CRB) check, interview questions and verification of identification. The other two files contained most of the same information, however only one reference in each case could be found. These members of staff had worked at the home for a number of years when therefore it would not be feasible to request another reference. A staff development programme is in place and records of training are maintained. New members of staff complete a full induction programme on commencement of work. The home meets the standard of having at least 50 of care staff qualified to NVQ level 2 or above. All staff had completed mandatory training, which is updated as and when required. There was evidence of training certificate in files. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and staff can be sure that their health, safety and welfare will be promoted and protected. Evidence: The manager of the home was registered in May 2007 and had provided staff with leadership, support and guidance. The manager was not on duty at the time of the inspection as she had worked the previous night shift. Staff and residents were happy with the way she managed the home. She has continued with her own professional development and undetaken a range of courses. Internal and external quality assurance systems are in place. Regular resident and staff meetings take place and are minuted, CLS representatives visit the home to audit records and speak with residents and staff. A written report is then produced of their findings. These reports were available for inspection. Care Homes for Older People Page 21 of 25 Evidence: Some of the residents at the home had handed over small amounts of money to manager for safe keeping. We checked the monies for the four residnets whose files we had been working with. One of the residents family dealt with her finances, therefore no money was on site. The other residents money was kept in individual wallets with a corresponding balance sheet. On checking no discrepancies were found. Receipts of any transactions made were kept. Health and safety policies and procedures were in place. Equipment and systems used in the home are serviced and maintained, and records were kept and easily accessible. With the pre inspection materials, the manager provided a list of maintenance and associated records. A sample including the gas, water testing, hoists and electrics certificates were checked and all were up to date. Accidents had been suitably recorded and the CSCI are kept informed as required. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The recording on the food and fluid charts needs to be more detailed to inform staff of the intake of food and fluid the resident has had on each shift. Residents should be weighed on a regular basis, unless they refuse, as is their choice and information should be recorded. 2 3 19 19 To continue with repairs and refurbishment to ensure standards are maintained. You must ensure that the home is free from offensive odours. Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!