CARE HOMES FOR OLDER PEOPLE
Gleneagles Nursing Home Pexton Road Sheffield South Yorkshire S4 7DA Lead Inspector
Janice Griffin Unannounced 21 April 2005 07:00 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. Gleneagles Nursing Home CS0000021780.V218776.R01.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Gleneagles Nursing Home Address Pexton Road Sheffield S4 7DA 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) 0114 244 1223 0114 244 1224 none Gleneagles (Yorkshire) Ltd Mrs Maureen Parr Care Home with Nursing 56 Category(ies) of Old Age 38 registration, with number Physical Disabilities 18 of places Gleneagles Nursing Home CS0000021780.V218776.R01.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 02 February 2005 Brief Description of the Service: Gleneagles is a purpose built home providing accommodation on three floors, all floors are serviced by a lift. The home is sited in a residential area in the North of Sheffield, close to local shops and a bus route to the city centre. Parking is located at the front of the building. The garden which has level access is attractive, well maintained is situated to the rea of the buildingr. Gleneagles Nursing Home CS0000021780.V218776.R01.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over eight hours from 7:00 to 15:00 Opportunity was taken to make a partial inspection of the home and examine a sample of records and policies and talk to staff and residents. The inspector spoke to six staff on duty, four visiting relatives and seven of the fifty-six residents. What the service does well: What has improved since the last inspection?
Some areas around the home have been redecorated providing a more pleasant environment for the residents. The manager and staff have been working hard to improve the care planning system. Detailed information is now obtained before any new staff are recruited to work at the home. All residents are now admitted with a detailed needs assessment. Gleneagles Nursing Home CS0000021780.V218776.R01.doc Version 1.30 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. Gleneagles Nursing Home CS0000021780.V218776.R01.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 Gleneagles Nursing Home CS0000021780.V218776.R01.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) 3 and 6. Residents needs had, been assessed this ensured that the home were able to meet their needs. Specialist medical and nursing staff were regularly consulting with the staff at the home and advising good practice Intermediate care is provided in a dedicated area of the building, some refurbishment has commenced to provide specialist facilities to promote activities of daily living. Specialist services from relevant professionals including occupational therapists and physiotherapist were provided for residents to promote good health care for residents EVIDENCE: Copies of full needs assessments were contained in resident care plans. The information from the full needs assessment had been incorporated into the resident care plans. The staff said the home had little equipment to enable residents with disabilities to take part in stimulating activities.
Gleneagles Nursing Home CS0000021780.V218776.R01.doc Version 1.30 Page 9 Details of medical/nurse specialists who had been consulted with regard to the residents care were recorded in the care plans. The qualified nurses said that they were trained to use techniques for rehabilitation including treatment and recovery programmes. The care assistants interviewed said that they had not received any specialist training. Gleneagles Nursing Home CS0000021780.V218776.R01.doc Version 1.30 Page 10 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) 7,8,9 and 10. Three care plans checked contained a good range of information, although one had insufficient detail to fully confirm that the residents needs could be met. All were untidy, poorly organised, making information difficult to retrieve. Problems were noted with the safe storage and administration of medication. Residents said that they were satisfied with the care they were receiving and that the staff are friendly, helpful and polite This was confirmed by the inspectors observations EVIDENCE: Care plans had been regularly reviewed by the staff. Residents or their relatives were involved in drawing up of the plans. Information in the plans was in a variety of places and the care plan folders were untidy. Several medication charts had not been signed on several occasions, it was unclear whether medication had been given or not. Medication was noted to be insecurely stored and the labels on three containers had been partially removed, this is not safe practise, as the wrong dose could be given to the wrong resident.
Gleneagles Nursing Home CS0000021780.V218776.R01.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) 12,13 and15. Some residents said they were bored and had nothing to do but sleep for long periods. The residents with physical disabilities were not involved in any activities that would promote independence. The catering at the home needs to be improved as residents said that the meat was often under cooked. EVIDENCE: Six of the residents interviewed were very critical of the social and leisure activities provided at the home. Very little specialist equipment was provided for those residents with disabilities, this did not allow them to get involved in stimulating activities. Relatives said that visiting times were flexible and that they could see the residents in private. Residents confirmed that staff helped them to maintain contact with their family/friends and that they could choose who to see and who not to see. Meals could be served in the service users own rooms. The lift at the home was out of order and food was noted to be served warm to the residents on the lower ground floor, this could present a risk of food poisoning for the residents. Gleneagles Nursing Home CS0000021780.V218776.R01.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 and 18. The homes arrangements for protecting service users and responding to their concerns were satisfactory. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home. Complaints procedures and an ethos is in place to enable residents and relatives to feel confident that any concerns they voice will be listened to. EVIDENCE: Relatives and residents said that if they had any concerns that they would feel comfortable in talking to the manager. Staff had received information on adult abuse and some staff had received some training. This will help to ensure that residents are protected from abuse. Discussions with residents confirmed that their only complaints were about the food and leisure activities, they said that were happy and looked after well. Gleneagles Nursing Home CS0000021780.V218776.R01.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) 19,21,22,24,and 26. On the day of the inspection the home was clean but some areas had damaged/stained decoration and carpets. All the residents said their rooms and the home in general was well maintained and kept clean. More attention needs to be paid to the hygiene standards at the home. EVIDENCE: Some bedroom doors were not fitted with suitable door locks and lockable facilities were not provided in all the bedrooms, this does not allow resident privacy. The home had an appropriate amount of sitting, recreational and dining space and there were sufficient rooms for a variety of activities to take place, creating a comfortable environment. Service users could see visitors in private. The dining areas were large enough to cater for all service uses.
Gleneagles Nursing Home CS0000021780.V218776.R01.doc Version 1.30 Page 14 There were smoke free sitting rooms offering choice to non- smokers. Outdoor space and all areas of the home were accessible to people in wheelchairs. Some of the lounges had stained decoration and stained /damaged carpets. Equipment was noted to be stored in the bathrooms this could be a trip hazard fro residents. The home provides intermediate care but there were no specialist facilities provided to promote activities of daily living, restricting choice and independence. Soiled pads were noted to be stored in some bins with no lids, placing the residents at risk from cross infection. Gleneagles Nursing Home CS0000021780.V218776.R01.doc Version 1.30 Page 15 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) 27,28 and 29. Staff are employed in sufficient numbers to meet the needs of service users in accordance with agreed staffing levels. The service users said they felt safe and that the staff are competent and knowledgeable. EVIDENCE: The staff rota identified agreed staffing levels had been met. This assists in making sure that residents needs are met. Staff said that staff numbers were adequate to meet the needs of residents. Residents said there was always a member of staff available when they needed them. Fifty per cent of care staff had not achieved their level 2/3 NVQ qualification, records showed that eight staff were undertaking the course. Staff said that they had not had any training on caring for people with physical disabilities. This does not allow the staff to ensure they meet the individual assessed needs of residents. Staff recruitment files were satisfactory and Criminal Record Bureau (CRB) checks had been completed for staff offering protection for residents. Gleneagles Nursing Home CS0000021780.V218776.R01.doc Version 1.30 Page 16 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) 31 and 38. The manager has the necessary skills and experience to run a care home. A safe environment is not provided in all parts of the home these could affect the wellbeing and safety of service users. EVIDENCE: The manager is a state registered nurse with experience in the management of nursing homes. She has commenced NVQ level 4 in management. The manager had had an enhanced CRB check which the inspector saw. The lift had been broken down for one week and engineers were on site attending to it.
Gleneagles Nursing Home CS0000021780.V218776.R01.doc Version 1.30 Page 17 Staff on the lower ground floor were noted to be washing pots on the floor in two bowls because of the difficulty in transporting equipment around the home. Staff spoken to had an understanding of the home’s fire procedures; they had received training on moving and handling, food safety and infection control. The manager stated that there was a programme for the regular servicing and maintenance of gas appliances. Fire exits were clear but hazardous substances were noted to be insecurely stored placing residents at unnecessary risk. Gleneagles Nursing Home CS0000021780.V218776.R01.doc Version 1.30 Page 18 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 x x 3 x x 1 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 x 15 2
COMPLAINTS AND PROTECTION 1 x 3 2 2 2 x 2 STAFFING Standard No Score 27 3 28 2 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x x x x x x 1 Gleneagles Nursing Home CS0000021780.V218776.R01.doc Version 1.30 Page 19 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 19 Regulation 16 Requirement Carpets that are badly stained or damaged must be cleaned or replaced.This as been outstanding since 2004. Areas around the home with stained/damaged decoration must be redecorated.This as been outstanding since 2004. Suitable provision must be made for the storage of aids and equipment.This as been outstanding since 2004. Locks on their bedroom doors and a lockable facility must be provided.This as been outstanding since 2004. Rehabilitation facilities must be provided for those service users with physical disabilities, and include equipment for therapy and treatment, as well as equipment to promote activities of daily living and mobility.This as been outstanding since 2004. Care plans must be tidy so information can easily be retrieved.This as been outstanding since 2004. Service users must be given the opportunity for stimulation through leisure and recreational
CS0000021780.V218776.R01.doc Timescale for action 1/7/05 2. 19 23 1/7/05 3. 22 23 1/7/05 4. 24 12 1/7/05 5. 6 23 1/7/05 6. 7 15 1/6/05 7. 12 16 1/6/05 Gleneagles Nursing Home Version 1.30 Page 20 8. 38 12 9. 9 13 10. 11. 12. 13. 9 9 26 15 13 13 23 16 14. 15 16 15. 28 19 activities in and outside of the home which suits their needs, preferences and capacities.This as been outstanding since 2004. Hazardous substances must be kept in a secure place at all times.This as been outstanding since 2004. Medication administeration sheets must always be signed to show whether medication has been given or not. Medication must be kept in a secure place at all times. Mledication containers with damaged labels must be returned to the pharmacist. Bins for soiled pads must be fitted with secure lids. Investigation into the quality of meals served must be carried out,action to improve the quality must be taken. Residents must be asked if they are satisfied with the outcome. The Environmental Health Departmentmust be asked for advice regarding the storage of food and washing of pots during the period the lift is out of order. Staff must be provided with training on caring for younger people with physical disabilities. Immediatel Immediatel Immediatel Immediatel Immediatel 1/6/05 Immediatel 1/7/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 18 Good Practice Recommendations Training is required for staff regarding adult protection Gleneagles Nursing Home CS0000021780.V218776.R01.doc Version 1.30 Page 21 Commission for Social Care Inspection Ground Floor, Unit 3 Waterside Court Bold Street Sheffield, S9 2LR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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