Inspection on 16/10/06 for The Glade

This inspection was carried out on 16th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Glade 18/12/08

The Glade 23/05/08

The Glade 09/11/07

The Glade 08/12/05

The Glade 01/06/05

The Glade 12/10/04

The Glade 20/04/04

The Glade 27/11/03

The Glade 15/07/03

The Glade 18/02/03

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Glade, The 32 Lancaster Road Southport Merseyside PR8 2LE Lead Inspector Mrs Margaret Van Schaick Unannounced Inspection 16th October 2006 9:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glade, The Address 32 Lancaster Road Southport Merseyside PR8 2LE Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01704 566699 01704 569288 Mr David Winston Jackson Mrs Susan Jackson Mrs Antonia M Gillett Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 25 in the category of OP The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection 8th December 2006 Date of last inspection Brief Description of the Service: The Glade is an older property that has been converted into a care home and is registered to provide personal care and support for up to 25 older people. It is situated in a leafy part of Southport close to public transport and within easy reach of the amenities that serve the area. The home provides accommodation over four floors and has lift access. The communal space contains one large dining room and one large sitting room. Toileting and bathing facilities are located throughout. The home has had adaptations such as handrails, hoists and ramps to suit the needs of the residents. There is a call-bell system throughout the home. The front garden is accessible via a ramp and suitable garden furniture is available for the residents and their visitors. The Glade is part of a small group of homes privately owned by Mr and Mrs Jackson and is managed by Antonia Gillette. Weekly fees range from £355-£410. Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two days lasting 11.75 hours. This was the key unannounced inspection to be carried out as part of the regulatory requirements. As part of the inspection process all areas of the home were viewed including most of the residents bedrooms. Care records and other residential home records were inspected also. Discussion took place with the registered manager, deputy manager and cook. One to one conversations took place with 3 staff. Several residents were also spoken with. Three residents were interviewed in private and their views obtained on how the home was run and the care and support provided. Relatives were spoken with and a visitor hairdresser also. Residents views were also obtained through Have your say about…. questionnaires, which were sent to the home prior to inspection. Some of these were returned to the Commission prior to the inspection. The views of which were positive. Three residents care plans were ‘case tracked’ (looking at all information with regard to care for the individual resident) and three staff files were examined, which included the training file. What the service does well: Many of the residents, relatives and visitors to the home describe the home as having a ‘lovely homely atmosphere’. Many of the comments included in the report evidence how caring and kind staff are towards the residents. Families interviewed confirmed that their relative was happy with the choice of home and were very happy with the service provided. Residents interviewed confirmed this, stating, “I like it here, staff are lovely, and it’s nice, isn’t it?” The Glade provides a caring, inclusive and ‘homely’ environment, which ensures residents settle down to a routine that is suited to them. The manager audits the controlled drug medication on a regular basis with records kept, which is good practice. The homes policies and procedures ensure that residents are protected from abuse. Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The home need to improve the assessment process to ensure all prospective residents care needs are identified, this ensures residents care needs are met. The residents are being placed at risk because of the difficulty in exiting all fire doors. The fire escape was viewed during this inspection. During this visit the inspector and staff had difficulty in opening some of the fire doors. One door was unable to be opened, therefore compromising resident and staff safety. The fire escape was viewed and showed signs of neglect. The inspector asked for the fire officer to offer advice, as she was concerned that they had been unable to open one of the fire doors. The fire officer attended the home early the next morning and has made some recommendations therefore the inspector strongly recommends that the recommendations are acted on. Since the inspection visit the home have had a builder out to assess the work needed and work is to commence mid November 2006. The fire escape has been jet sprayed in preparation for painting. This shows that the home are addressing the issues raised. The basement area has been tidied a little but there is still quite a lot of clutter remaining including an old washing machine Access to the rear garden is restricted due to the steep ramp in place. Garden rubbish is still prevalent in many black bin bags at the rear of the garden and needs clearing. Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 7 All residents contracts should show a breakdown of fees so that they and their relatives understand the fees payable and by whom. Families interviewed are concerned about being asked to pay for the care of their relative some time in advanced. Families interviewed stated, “our family are not happy as they are being invoiced for the fees 2-3 months in advance”. It would benefit residents if they could have a shower facility in the home. This would give residents a choice of how they wish to maintain their personal hygiene. Families interviewed stated, “I think that the ground floor bathroom should be upgraded to include a shower”. One of the residents care files does not evidence that their previous medical history has been recorded. This needs to be addressed as the resident’s healthcare needs may be compromised. Some of the residents are not accessing all healthcare professionals that they are entitled to. This would ensure that optimum care is available where needed and includes areas such as dental, optical and hearing assessments. Residents need to agree and sign their care plan. The home needs to make sure that all pre employment checks are in place to ensure residents are protected by the homes recruitment procedure and that all staff has an employment contract in place. The home needs to ensure that all staff have a full induction and up to date mandatory training. 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. The summary of this inspection report can be made available in other formats on request. Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home need to improve the assessment process to ensure all prospective residents care needs are identified, this ensures residents care needs are met. Standards 2 and 3 were assessed. OP6 is not applicable EVIDENCE: Residents and relatives interviewed confirmed contracts were in place. Some of the resident contracts were viewed during this visit. Not all contracts evidenced a breakdown of fees as required therefore this needs addressing. Prior to being admitted to the home prospective residents are assessed by the manager. Documentation with regard to assessment of residents is in place and confirmed the pre admission assessment is carried out. Not all areas of care are assessed therefore this needs addressing. Some of the information gathered during the assessment process has excluded prospective residents’ Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 10 optical, dentist and hearing needs. The previous medical history of one of the residents who was case tracked is absent therefore this needs to be addressed. Prospective residents and their families are encouraged to visit the home where possible prior to taking up a place. Relatives interviewed stated “my sister and her husband viewed the homes in Southport on my mothers behalf, we had a choice of two rooms (at the Glade) and there was a probationary period”. Families interviewed confirmed that their relative was happy with the choice of home and were very happy with the service provided. Many of the residents have lived at the Glade for some years. Residents interviewed confirmed this, stating, “I like it here, staff are lovely, and it’s nice, isn’t it?” Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Not all healthcare needs are identified therefore this may compromise residents’ health. Medication is not always signed for therefore the assumption is that the medication was not given as prescribed placing residents at risk. Standards 7, 8,9,10 EVIDENCE: Three residents care plans were case tracked. Some of the residents have signed to agree the care planned. This needs to include all residents and where they are unable to sign, their relative could do so on their behalf. The three care plans viewed contained detailed information regarding most of the residents’ healthcare needs and how staff are to meet them. It is evident that in most areas the home have addressed the needs of the residents but there are some areas in some of the care plans viewed that have not been looked at including, dental, optical and hearing assessment. One of the residents care records does not evidence any previous medical history and the home has Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 12 been advised to access this from the GP practice. One resident case tracked has difficulty in communicating with staff therefore the home reviews the care of this resident on a regular basis throughout the year with the specialist social worker and family representatives. This is good practice. The feedback from the resident is that they are happy with the care provided. This resident was at risk of isolation but because of improved communication this has now been reduced. The inspector was able to communicate with this resident and their views including others are included in this report. Care plans viewed have been reviewed on a monthly basis to August/September this year. One resident who has comprehensive care needs evidences detailed care and intervention where needed from various health professionals. The chiropodist visited the home during the inspection and residents interviewed confirmed that he visited on a regular basis. Residents interviewed stated, “I like it here, staff are lovely”, “staff are very nice and kind” and “we are well looked after”. Families interviewed were happy with how the home delivers care and support to their relative, stating, “we think the home is very good, they are very thoughtful, very caring, mums bed is turned back and following a hospital stay staff were so welcoming”. Comments received from relatives also included, “we are kept well informed, any problems they let us know, the ‘physio’ has been out to assess mum as she is very unsteady on her feet and the supervision has been increased due to her falls”. Some of the families advised the inspector that they visit the home on a regular basis and are able to confirm that they are happy with the care provided. The home has a new pharmacy service, which is satisfactory. Blister packs are the main format for the administration of medication with bottles of medication where needed. The manager orders the medication on a monthly basis and checks all completed prescriptions prior to the pharmacy collection. The person in charge checks in the medication shortly after delivery. The medication trolley is tidy and organised with up to date medication in place. Some of the Aberdeens (medication records) were viewed and all showed clear instructions and records of medication entering the home, including dates and signatures. The returns book evidences regular entries. There are still isolated incidences of staff not signing to say that medication has been administered. This can compromise resident safety, as it would be assumed that the resident had not received their prescribed medication. The manager advised that the staff responsible for forgetting to sign the medication sheets has been identified and is now attending further training with regard to the management of medication. The manager audits some of the stronger medication on a regular basis. This is good practice. Care files evidence how staff supports the residents to maintain their personal hygiene. Through discussion with residents it is apparent that they are happy with the assistance provided. Families interviewed confirmed that staff provide Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 13 support where needed to ensure their relative is well groomed. Relatives stated, “we can’t fault the staff on anything”, my sister files mum’s nails and staff do also, mum always looks nice”. During the unannounced inspection the inspector met with many of the residents and observed that all were well groomed. All of the residents, relatives and visitors spoken with agreed that staff were respectful and supportive in their approach with all of the residents. During the inspection visit a visiting heath professional was observed to be applying treatment/dressing to a resident in the front hallway. The manager is advised to ensure that this does not recur, as it is undignified for the resident concerned and also increases the risks of contamination to the wound. Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Glade provides a caring, inclusive and ‘homely’ environment, which ensures residents settle down to a routine that is suited to them. Standards assessed OP 12, 13, 14, and 15 EVIDENCE: Activities are displayed in the hallway and are varied to suit the residents. Activities set up in the afternoons include beauty therapy, (including a foot spa), trips out, quizzes, reminiscence, music, bingo, crafts, and various videos. Feedback from the ‘have your say about …’ surveys show that some residents wished to have more activities whilst others were happy with what was available. Residents were also very keen on a new gardening activity, which involved a person coming into the home to assist the residents in planting flower pots that they are now able to view from the sitting room windows and some of the resident bedrooms. On regular occasions ‘outside’ entertainment is brought into the home including film shows. Some residents are able to go into town shopping or visit friends. One resident is a regular weekly visitor to their local club and attends the club for functions also. One resident Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 15 interviewed stated, “I’m very happy here, the food is lovely. Staff are very nice and kind. I like my room, it’s recently been decorated”. “ I am able to out when I want and am out a lot, I sometimes use the buses to get about when I need to as I’m not as fit as I was”. Local churches visit the home on a regular basis to provide Holy Communion with residents confirming this. Most of the residents have regular contact with their families and friends. This was observed during the inspection visit and confirmed during discussion with relatives and residents. The local advocacy service contact details are available for residents use. Residents interviewed confirmed that they were able to live their lives as they pleased. Residents are able to retire to bed and get up when wished. Where restrictions are in place because of the health and welfare of residents this is identified in care plans. There are no restrictions on visiting times and relatives confirmed this. Residents and their relatives confirmed that they receive visitors in the privacy of their own bedrooms. Occasionally the home receives other visitors from the local community including the local brownie pack at Christmas time. Four weekly menus are set up and the daily menu is displayed in the front hallway for resident to see. Alternative meals are available each mealtime. Home baking is available. The cook speaks with all the residents to ensure they are happy with their meals. A separate dining room is available and specialist cutlery and diets are available for residents who need them. Residents interviewed stated, “I’m very happy with the food” and “the food is lovely”. Relatives interviewed stated, “Mum enjoys the food and eats more cakes and desserts”. Fridge and freezer temperatures are recorded daily with records kept. Hot food temperatures are also recorded with records kept. Staff were observed to be courteous and kind in their approach with residents and residents and relatives interviewed confirmed this. Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes policies and procedures ensure that residents are protected from abuse. Standard assessed OP16, 18 EVIDENCE: Relatives and most of the residents interviewed knew how to make a complaint. The residents that where interviewed felt they had no need to complain as they were very happy in the home. Minutes of residents/relatives meeting showed that a copy of the complaints process was given out to all who attended. A copy of the complaints procedure is also available at the rear of residents’ bedroom doors. A comments book is on display in the hall but as yet none are included. The home has a complaints process and record in place and this was viewed during the visit. The record shows any investigations with regard to complaints and the outcomes. A whistle blowing policy is in place. Many of the staff has attended training with regard to abuse. Staff interviewed confirmed this. The inspector discussed the issue of abuse with some of the staff and they displayed a good understanding of this area. Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 17 Financial records are in place documenting all financial transactions including invoices to families for payment of chiropody/hairdressing. Receipts and records were viewed. Most of the residents have the assistance of their family or solicitor. One resident interviewed advised the inspector that they regularly received a personal allowance, which they signed for and had a savings account for when they needed larger sums of money. Records evidence the resident’s signature. The resident also stated, “I have a solicitor”. Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The residents are being placed at risk because of the difficulty in exiting all fire doors. Standards assessed OP 19, 21, 26 EVIDENCE: An action plan for the maintenance of the building was viewed. This covered all areas identified at the previous inspection. A maintenance book is in place and as each ‘job’ is complete, it is ‘ticked off’. A brief audit has been carried out by the manager but has yet to be formalised. There are areas in the home that do need attention and therefore a detailed audit needs to be carried out so that areas of concern are prioritised and action taken sooner. Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 19 The last environment health visit in October 2005 made some recommendations, which were acted on. The basement area still needs to be tidied up and cleared of items such as an old washing machine. The laundry is untidy and needs to be cleaned out regularly as there is no laundry assistant. Relatives interviewed expressed a wish for the home to provide a shower facility for residents use. This would enable residents to have a choice of how they wish to maintain their personal hygiene. One relative interviewed stated, “I think that the ground floor bathroom should be upgraded to include a shower”. Feedback from the September residents’ meeting identified the request for a shower had been raised then also. The garden has many mature shrubs and some pots of plants for residents to enjoy but the rear garden grounds still have many black bin bags of garden rubbish. The rear garden is not accessible to many of the residents as the ramp is too steep. Steps at the front entrance to the home show wear and tear with some of the tiles and brickwork loose. Residents, staff and visitors who enter/leave the front door could be at risk of falling if it deteriorates further. Other areas discussed with the manager during the inspection visit included, the toilet window next to the fire escape is in need of repair, a bath panel needs repainting, a bedroom window needs replacing, the window is cracked in two places and bedroom 8’s carpet is burnt in many areas due to the occupant smoking. A waste pipe leading from the toilet next to room 19 is damaged as when the toilet flushes, the water cascades down the outside of the brickwork. The rear wall of the home shows substantial gaps between bricks, forming a large crack close to one of the fire exits therefore this needs urgent attention. The fire escape was viewed during this inspection. During this visit the inspector and staff had difficulty in opening some of the fire doors. One door on the second floor was unable to be opened, therefore compromising resident and staff safety. The fire escape was viewed and showed signs of neglect. The inspector asked for the fire officer to offer advice, as she was concerned that they had been unable to open one of the fire doors. The fire officer attended the home early the next morning and has made some urgent recommendations therefore the inspector strongly recommends that these are taken up as a matter of priority to ensure resident and staff safety. Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home needs to make sure that all pre employment checks are in place to ensure residents are protected by the homes recruitment procedure and that all staff receive a full induction with up to date mandatory training. Standards assessed OP 27, 28, 29, and 30 EVIDENCE: The staff rota evidences all staff employed in the home. Staff interviewed stated, “some days staffing is a problem”. Other staff interviewed confirmed this, as each day at 4pm one carer has to work in the kitchen leaving the floor short. Also as there is no laundry assistant in the home care staff has to manage this. It may be that staffing levels and residents dependency levels need to be looked at to ensure sufficient staff are available at all times of the day. Residents and relatives interviewed acknowledged staff were busy but there is no evidence to suggest that the care of the residents is compromised. Relatives comments include, “I am happy with the care provided” and “staff are so lovely”. One staff member interviewed stated, “I enjoy working with the residents at the Glade and staff are a good team at the moment”. The response from staff, residents and relatives indicates that although the home is busy, staff work hard to provide good care. A visitor to the home stated, “what I really like about here is how kind the staff are towards the residents, Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 21 I’ve been coming here for some weeks and staff are lovely with all the residents, it’s very pleasant, it’s a lovely home”. 56 of care staff has an NVQ qualification in care. Staff files examined evidence Criminal Record Bureau checks (CRB), Protection of Vulnerable Adults (POVA first) checks and most other pre employment checks are in place. One staff file evidences only one written reference for a carer who commenced employment earlier this year. Evidence of mandatory training is on file but for some staff is now out of date. Two staff files had no contract of employment in place. The manager has carried out a training audit and identified staff training needs therefore this needs to be followed up ensuring that staff are then booked for the mandatory training needed to ensure residents and staff are safe. Not all care staff are able to take up the government sponsored induction course and this is discussed in standard 38. There is documented evidence on some of the staff files showing some induction is in place. One carer interviewed stated, “I can’t remember an induction” therefore the manager needs to ensure that the new staff member signs and dates the training schedule as it progresses. This verifies that the induction has taken place. Other care staff confirmed that they had an induction period on commencement of work. The induction should be based on the NTO (National Training Organisation) training targets within six weeks of appointment and the foundation training within the first six months of employment. Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. That all staff attends all mandatory training on a regular basis so that the health and welfare of the residents and staff are promoted and protected. Standards assessed 31,33,35,38 EVIDENCE: The registered manager has several years experience working in the home as a senior carer prior to taking up the position of manager. The manager has the NVQ Level 3 qualification in care and is at present completing the (RMA) Registered Managers Award. The manager has since taking up this post continued with attending further training including mandatory training. The home is privately owned along with two others and all three managers meet on a regular basis to offer support to each other and discuss any issues including Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 23 training needs. This is good practice. Through discussion with the manager it is apparent that she has a good understanding of the needs of the older people that she is caring for. She is aware of her own limits and when necessary seeks the advice of other health care professionals. The manager distributed relatives and residents questionnaires prior to setting up the most recent relatives and residents meeting in September. The results of the questionnaire are published and displayed on the residents’ notice board. Positive feedback was gained from the questionnaires. Residents’ views were also obtained through the resident/relative meeting. The minutes of which have been published. This information has provided the home with the opportunity to look at the residents’ views on how the home is run. It is now important that now that residents’ views have been ‘listened’ to that where possible they be acted on. Most of the residents have the assistance of family or in some cases solicitors in dealing with their finances. One or two residents deal with their individual finances. Documentation is kept for all financial transactions and was available for inspection. Not all mandatory training is up to date therefore this needs addressing to ensure safe working practice. Overseas staff are unable to take up the government sponsored induction course until they have been resident in Britain for a minimum of three years therefore the manager and her deputy carry out the induction. There is documented evidence available on the individual staff files showing some of the induction that has been attended. The manager needs to ensure that the new staff member signs and dates the training schedule as it progresses. This verifies that the induction has taken place. Hot water temperatures are recorded regularly in varying areas of the home and documented. Bathing temperatures are measured and recorded prior to residents having their bath. The manager has advised that an appraisal of the water systems in the Glade has taken place with regards to a proposal for the Legionella control programme. A copy of which was faxed to the Commission. Servicing to all boilers, electrical and gas appliances is up to date and certificates are in place confirming this. Emergency lighting checks, fire testing and extinguishers are up to date with records kept. The lift and hoists are serviced and up to date. The most recent fire drill was in June 2006. Fire procedures have not been reviewed since 2005 and therefore need updating including fire risk assessment documentation recommended by the Fire Brigade. One resident who smokes in their bedroom has a fire blanket and fire retardant apron in place but the carpet is marked with many small burns therefore this needs to be addressed to ensure resident and staff safety. Some of the senior staff has attended the ‘fire marshal’ training last month. Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 24 Therefore the information gained from this training will help when updating the policies and procedures with regard to fire procedures/practices. The maintenance book has regular entries for the attention of the maintenance person. When work is carried out this is logged. Accident records are detailed and kept on file. New safety notices are in place throughout the home where needed. Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 26 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 OP2 Regulation 5 Requirement The registered provider must ensure that each residents contract includes a breakdown of fees payable and by whom. This is an outstanding requirement. The registered provider must ensure that the assessment process includes the areas as discussed relating to standard 3 in this report. The registered provider must ensure that all resident agree and sign their care plan where practical. The registered provider must ensure that all residents are able to access the services of other health care professionals including dentists, opticians and hearing aid services. The registered provider must ensure that all staff signs the medication record following administration of medication. This is an outstanding requirement from the last two inspections. Timescale for action 08/01/07 2. OP3 14 (1) a 18/12/06 3. OP7 15 (1) 18/12/06 4. OP8 13 (1) b 08/01/07 5. OP9 13 (2) 20/11/06 Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 27 6. OP19 23 (2) b 7. OP19 23 (4) b c (iv) 8. OP19 23 (4) 9. OP29 19 (1) 4 (b) 10. OP30 18 (1) (c) (i) 11. OP38 18 (1) (a) An action plan (including timescales) must be produced and a copy forwarded to the Commission to rectify the issues identified to the Manager and published in this report as requiring repair or refurbishment. A programme of routine maintenance must be produced with records kept. The registered provider must ensure the fire escape is kept in a good state of repair and all fire escape exits are easily opened so that a swift evacuation of the home can be carried out in the event of an emergency. The registered person must ensure the recommendations made by the visiting fire officer are carried out as a matter of urgency. The registered person must ensure that all new staff must have two written references in place prior to employment. This is an outstanding requirement. The registered person must ensure that all staff receive induction training in the first six weeks of employment and foundation training in the first six months with records kept to evidence this. This is an outstanding requirement. The registered person must ensure that all staff attends mandatory training. This is an outstanding requirement. 08/01/07 13/11/06 13/11/06 13/11/06 08/01/07 08/01/07 Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 28 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 OP10 Good Practice Recommendations The inspector strongly recommends that when residents are to be prescribed dressings or treatments by visiting health professionals the procedure should be carried out in the privacy of their bedrooms or an alternative suitable environment. The inspector recommends that the home look at how they can prevent the resident who smokes from burning the carpet in their bedroom. The inspector strongly recommends that the home look to providing a shower facility for the residents who wish it. The inspector recommends infection control training so that all staff are aware and up to date with recommended practices. The inspector strongly recommends that the manager monitor the staffing levels in particular with regard to the management of tea times and the laundry facility, as there is no one employed to carry out this function. 2. 3. 4. 5. OP19 OP21 OP26 OP27 Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 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 © 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 Glade, The DS0000005322.V309781.R01.S.doc Version 5.2 Page 30 - 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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