CARE HOMES FOR OLDER PEOPLE
Preston Glades Care Home Miller Road Preston Lancashire PR2 6NH Lead Inspector
Lillian McMullen Unannounced 4 August 2005
th 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. Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Preston Glades Care Home Address Miller Road Preston Lancashire PR2 6NH 01772 651484 01772 651514 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) Four Seasons Healthcare (England) Limited Mrs Valerie Francis Care home with nursing 64 Category(ies) of DE Dementia (33) registration, with number OP Old Age (31) of places Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Registered Numbers to include one (1) named person under 65 years of age The home is registered for a maximum of 64 service users to include: Up to 31 service users in the category of DE (Dementia) Up to 33 service users in the category of OP (Old Age over 65 years) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 23rd February 2005 Brief Description of the Service: Preston Glades Nursing Home is owned by Four Seasons Health Care. The Home is registered with the Commission for Social Care Inspection to provide nursing and personal care to elderly people of both sexes over the age of 65 years. This comprises of 33 service users with dementia and 31 service users with old age in need of nursing and residential care. Preston Glades is a purpose built two-storey building and care is provided in two areas of the home for the two categories of service user. Those needing care regarding dementia are cared for on the first floor of the home, and those needing nursing and personal care on the ground floor of the home. There are 62 single bedrooms of which 16 have ensuite facilities and 1 double room. There is a passenger lift to each floor of the home. The home is situated in its own grounds and there is an enclosed garden area at the rear of the home with a pleasant a sitting area. There are parking areas available at the side and front of the home. Preston Glades is located in a residential area of Preston and it is close to local shops and amenities. It is situated on a bus route into Preston town centre. Service users are encouraged to return to their links with the surrounding community and visitors are welcome at anytime. Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 10.45am. It took place over five and half hours and was carried out by two inspectors. The inspectors spoke to five residents, three relatives, three members of staff and the manager. Part of the inspection was spent on looking at care documentation in respect of the assessment procedure and care plans. What the service does well: What has improved since the last inspection?
The care planning process and risk assessments have improved since the previous inspection. The resident’s files are now well constructed making the location of relevant information easy. To ensure that a consistent standard is being maintained in the maintenance of records the manager conducts a monthly audit by examining a random sample of care plans. There have been a number of improvements to the environment over the past twelve months, a number of areas have been decorated and radiator covers are fitted to all radiators. Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 Page 6 A maintenance man is employed together with a gardener, which has improved the appearance of the exterior of the home. 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. Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 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 Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 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 There is a good assessment procedure in place, which ensures the needs of the residents can be met. EVIDENCE: The records of six residents were examined all had full assessment information. Also on file was information about the specialist needs required by residents all of which was acquired prior to admission. There was also evidence of social work assessments being carried out to supplement the homes assessment. Minor omissions on some of the standard forms were noted and the manager was asked to reaffirm to staff the importance of fully completing documentation. In addition to the manager or senior staff member visiting prospective residents in their own home to carry out an assessment of need, prospective residents are invited to Preston Glades with their relatives to meet the staff and view the facilities. A relative spoken to at the time of the inspection
Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 Page 9 confirmed that he had viewed three homes prior to choosing Preston Glades for his wife. He stated that he has not been disappointed and that in his opinion his wife is well cared for and that the staff are very good. Staff members confirmed they had access to all information and could describe in detail the care needs of residents. The majority of residents presently accommodated at Preston Glades are extremely frail and unable to communicate however relatives spoken to said they were happy that the residents needs was being met by the home. People are not admitted to Preston Glades solely for intermediate care. Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 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 and 10 Each care plan is regularly reviewed, which ensures that changing needs are responded to. Resident’s welfare is closely monitored and health needs are met. EVIDENCE: The care planning process has improved since the previous inspection, a care plan for each resident was in place and was reflective of needs, all care plans examined had been reviewed on a monthly basis. It was also pleasing to note that some care plans contained a signature of the relative also on file was a copy of a letter inviting relatives to the care plan review meeting therefore providing evidence that were possible relatives are involved in the care planning process. The care plans take into account the health, personal and social care needs of each resident. Whilst the care plans contained good information and were very informative at present two different styles of this document is being used. The inspector advised that one style should be used in order to avoid any possible confusion. The inspector also expressed concern regarding the management of
Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 Page 11 challenging behaviour and aggression displayed by residents. The care plan did not fully direct staff in techniques on how to manage such situations. Whilst it is acknowledged that staff receive training in dementia care, which incorporates managing aggression, the inspector advised that all staff should receive specialised training in this area. Risk assessments accompany the care plan and are reviewed also on a monthly basis. In addition to risk assessments also on file is a nutritional assessment and weight charts are maintained for each resident. Daily records show that health care is monitored and good contact with health professionals is maintained. Relatives stated that staff are very good and that everyone works really hard. Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 Page 12 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) 12,13,14 and 15 Social activities and meals are well managed to suit both the individual and group. Contact between residents and their families are encouraged to help them maintain relationships. EVIDENCE: An activity organiser has recently been employed which will enhance the lives of the residents and promote social interaction. Following discussion with this member of staff it was evident that she is enthusiastic and looking forward to arranging a programme of activities. Unfortunately until her CRB clearance has been returned she in unable to work directly with residents therefore she is currently undergoing supervised induction training. Visitors are welcome at anytime and residents are encouraged to retain relationships with family and friends. A relative spoken to at the time of the visit confirmed that she could visit at any time for as long as she wishes and that she is always made to feel welcome. Daily dairy notes provided evidence that residents can exercise choice over how they live their lives, entries confirmed that residents could get up and go to bed when they please and have their meals were they wish.
Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 Page 13 A number of residents were spoken to and all commented that the food was good and that they looked forward to mealtimes. Fresh produce from local suppliers is used and menus inspected were found to be balanced and varied. Bowls of fresh fruit was placed around the home. During the visit the inspector spoke to the chef and he confirmed that the budget was adequate and that produce is delivered daily. The kitchen facilities are generally good and some new equipment has been purchased since the previous inspection, however the floor covering is in need of replacing as one area could pose a health and safety hazard. Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 Page 14 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 Residents are protected by a robust complaints procedure. EVIDENCE: A robust complaints procedure is in place, which is given to residents and their relatives upon admission. The complaints procedure is also on in the entrance to the home. Staff confirmed that should they have any concerns they would inform the manager and stated they were confident that these concerns would be acted upon. Relatives spoken to felt that the home is well managed and should they have any concerns they would raise them with the staff on duty, one relative stated “that there had been times when she had been unhappy about certain aspects of her husbands care, but I talked to the staff and they took it on board”. Since the previous inspection there have been two complaints received by the Commission for Social Care Inspection both of which were referred to the manager of Preston Glades for investigation. Following investigation one complaint was upheld and the other was not upheld. On both occasions the Commission for Social Care Inspection was satisfied that the investigation had been carried out thoroughly and objectively. Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 Page 15 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) EVIDENCE: None of the above standards were assessed at this inspection. Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 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 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) EVIDENCE: None of the above standards were assessed at this inspection. Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 Page 17 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) EVIDENCE: None of the above standards were assessed at this inspection. Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x x Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 Page 19 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. 3. 4. Standard 29 Regulation 18 Requirement All staff must be CRB cleared prior to commencing employment. Timescale for action 3/8/05 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. 3. 4. 5. 6. Refer to Standard 7 7 3 7 15 Good Practice Recommendations One type of care plan should be used. All documents should be fully completed and signed A designated pre assessment document should be used Specific training should be provided for managing challenging behaviour. For reasons of health and safety the flooring in the kitchen should be attended to Preston Glades Care Home F57 F09 S6072 Preston Glades Care Home V211115 040805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Unit 1, Tustin Court Portway Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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