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Inspection on 02/02/09 for The Glen Residential Home

Also see our care home review for The Glen Residential Home for more information

This inspection was carried out on 2nd February 2009.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

We saw all staff at The Glen being helpful and friendly to people who live there and treated them with respect and friendliness. `I am glad I came here. I could not have come to a better one`, one resident said. Surveys stated: `Very happy to be in this home. Could recommend highly to others`, and `I am very satisfied with everything, and very happy to live here`. People are supported to maintain relationships with family and friends. A resident said, `My visitors are made to feel welcomed by staff`. A visitor confirmed she was always welcomed by staff. The menu is varied, and the food is well presented and home cooked. People living at The Glen praised the home cooked food. The home is clean and tidy, and good standards of hygiene are maintained with no odours present. ` The home is always kept clean`, one resident said. Members of staff have received training in many different areas of care practice to help them improve their skills. Management are very supportive of staff so that they can produce a high standard of care to residents.

What has improved since the last inspection?

Care planning now includes checklists to monitor residents health so swift action can be taken to promote residents health if needed. Rooms have been redecorated and carpets and linen renewed. Staff have a better understanding of how to protect residents from abuse.

What the care home could do better:

Care planning needs to include appointments regarding medical checks so that residents are assured of having these at regular intervals so as to maintain their health. Medication must always be accurately recorded as being received so that all medication can be properly accounted for. There needs to be a clearer understanding of how to `safeguard` people who live at The Glen so all staff are fully aware of outside Agencies if they needed to `whistle blow` on the home if the in house arrangement failed - this will further protect people at the home from abuse. Staff training should include training on all residents conditions to better equip staff to meet all residents needs. Health and safety systems need to be reviewed to ensure full protection for residents.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Glen Residential Home 20 Groby Road Glenfield Leicester LE3 8GJ     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: Keith Charlton     Date: 0 2 0 2 2 0 0 9 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. that people have said are important to them: They reflect the things 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 26 Information about the care home Name of care home: Address: The Glen Residential Home 20 Groby Road Glenfield Leicester LE3 8GJ 01162871165 01162871165 theglen.jennifern@virgin.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Jennie Neale Name of registered manager (if applicable) Mrs Jennie Neale Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: No one falling within category PD(E) may be admitted into the home where there are 2 persons of category PD(E) already accommodaed within the home. The registered provider may only accommodate a maximum of 6 service users in the Glen Residential Home. Date of last inspection Brief description of the care home The Glen is a large, detached house, situated on a slip road off a busy thoroughfare in Glenfield, on the outskirts of Leicester. It does not stand out from its neighbours. Accommodating four older people, it is also home to the registered person and a friendly German Shepherd dog, Jessie. It is commended for the very homely environment which it creates for its residents. All areas of the home are decorated and furnished to a high standard. There are six single bedrooms, some of which are en suite, a comfortable lounge, dining room and pleasant conservatory and a very large, Care Homes for Older People Page 4 of 26 care home 6 Over 65 4 0 0 2 Brief description of the care home easily accessed, secluded rear garden with patio area. The front driveway of the home provides off road car parking space for several cars. Fees range between 364 and 375 pounds dependent on level of care needs. This information was provided by the Manager on the day of the inspection. Care Homes for Older People Page 5 of 26 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 key inspection included a visit to the service. We (the CSCI) visited The Glen on the 2nd February 2009. The Registered Manager and staff in the home helped us during the visit. The last key inspection of the service was on the 8th November 2006. The main method of inspection we used was case tracking. This means looking at the care given to people in different ways. We did this by, - talking to the people who live in the home, - talking to staff and management, Care Homes for Older People Page 6 of 26 - watching how people are given support, - looking at records. We also looked at the Annual Quality Assurance Assessment (AQAA). This is a document the provider (the person who owns the service) sends to us at the CSCI, and it tells us what the provider thinks about the service they deliver to people who live at The Glen. As well as this, we looked at information that had come to our attention since the last key inspection in November 2006. We spoke with five people who live at The Glen during our visit. Two surveys were received from residents. People told us that staff were always friendly and caring. One person said staff are lovely. They would do anything for you. None of the people spoken with had any complaints about attitude of staff. We spoke with two members of staff during our visit to the home who told us about working in the home and gave us their views. They were very positive about working at The Glen and wanted to provide excellent care to people living there. One staff member said: I like working here. We all try to make the residents comfortable and everyone is friendly. We checked all the standards that the Commission for Social Care Inspection has decided are key standards during this inspection. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report to make sure we respected their confidences. What the care home does well: What has improved since the last inspection? What they could do better: Care planning needs to include appointments regarding medical checks so that residents are assured of having these at regular intervals so as to maintain their health. Medication must always be accurately recorded as being received so that all medication can be properly accounted for. There needs to be a clearer understanding of how to safeguard people who live at The Glen so all staff are fully aware of outside Agencies if they needed to whistle blow on the home if the in house arrangement failed - this will further protect people at the home from abuse. Staff training should include training on all residents conditions to better equip staff to meet all residents needs. Health and safety systems need to be reviewed to ensure full protection for residents. Care Homes for Older People Page 8 of 26 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 9 of 26 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 10 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at The Glen have had their needs properly assessed before moving into the home. Evidence: Residents spoken to said they had enough information at the time of their admission to make up their minds about the home. Yes, my daughter and me got information about the home which was all about what the home offered to residents, one resident said. We case tracked a person living in the home who had recently moved in to The Glen. We checked that she had received information to help with the choice of home, and she said she had received enough information. We also checked that this person had her needs properly assessed prior to moving in, to ensure that the staff at the home could meet their needs. She said the Manager had seen her in hospital and asked her Care Homes for Older People Page 11 of 26 Evidence: about the care she would need. The AQAA stated that prospective residents needs are assessed prior to them staying, relevant information is provided and assessments are carried out by keyworkers at home/hospital etc and that relatives are then sent a satisfaction survey, which will help to see that all needs are being met with this process. Both residents surveys received said that they had received enough information about the home before they moved in and that they had received a contract. Care Homes for Older People Page 12 of 26 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. People at The Glen receive good health and social care practice though some details in care plans and medication practice needs to be added. Evidence: Residents said that staff were excellent in providing personal care to them: staff are really friendly. You cannot fault anyone and staff are all lovely. They would do anything for you, were some of the many very positive comments that residents made. All residents said that their privacy and dignity was respected, e.g. staff knocking on doors before entering their bedrooms. Residents spoken to could not recall having a care plan though said they were not bothered as they got the best care anyway. Both residents surveys said that they get the care and support they need, they receive the medical support they need and that staff listen and act on what they say. We checked the care plans of two people living at the home who were case tracked Care Homes for Older People Page 13 of 26 Evidence: and had care plans to support their care. Plans showed detail regarding the support required by staff to ensure the physical health of people living at the home, though there was little information to inform staff of the preferred daily living routines of residents or previous life history to ensure their social and emotional well-being is fully supported and to properly inform staff as the individuality of residents. The AQAA stated that care plans cover essential needs and that plans now cover physical needs charts that have been introduced to fully cover these areas of care needs. Accident records were also checked - there had only been one fall in the past seventeen months and medical services had been contacted when a resident had a potentially serious injury. We checked the medication records, and found that there was accurate recording of the administration of the medicines in the home except where there had been one advance entry of a medication being given out, when it had not. Medication had been signed as having been received for January but not February, so this compromised the audit trail of medication. Where medication had not been supplied it could not be ascertained why not as records had a dash and not a code to explain the reason. The Manager said staff giving medication to residents had all recieved in house training though this is shortly due to be supplemented by distance learning training. We spent time watching staff interaction with people living at The Glen. We saw staff being gentle and caring to people and having a joke with them, and throughout the day we observed the staff at The Glen as doing their best to meet the needs of people living at the home. We also saw that a resident was properly assisted by staff with her moving and handling when using her frame. Care Homes for Older People Page 14 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are opportunities for people to take part in regular activities and have a relaxed lifestyle. Evidence: Residents said that they were satisfied with the current activities. One resident said We do something every day and I am satisfied with that. Residents and staff said there were no rules - e.g. people could get up and go to bed when they liked, choose their own clothes, have as many showers as they liked etc. The AQAA stated that there are daily activities and that staff sit and chat with residents. Both residents surveys received said that they get the activities they want. There are one-to-one activities such as walking around the garden, communal activities such as chair exercises and games. We observed a game being played with a lot of laughter from residents and staff. Staff said there are outings in warmer weather. Visitors are welcomed at The Glen and we were informed by residents that they could come at any time. One visitor confirmed this was the case and said the care supplied by staff was excellent. Care Homes for Older People Page 15 of 26 Evidence: We found out that staff have attended a course to help them understand more fully how to care for people with dementia. The only issue was that staff keep and give out alcohol. The Manager agreed that in the future that residents can keep their own alcohol if they were risk assessed as being safe to do so. This will further promote choice and dignity. We observed lunch being served. There was a choice of food if residents did not want to have the dinner offered. All residents said that the food was tasty and home cooked. A resident said that the Manager got her salmon when she requested this. Food was well presented and looked appetising, with good portions being served to each person. There were two courses with two vegetables served. One resident was helped to eat her dinner in a gentle and respectful way. Residents were provided with fruit cut up after dinner, thereby encouraging further healthy food choices. Care Homes for Older People Page 16 of 26 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 are listened to and protected from abuse. Evidence: Residents said that they had no complaints but if they did they thought the staff or management would quickly get it sorted out. A resident said, I have never needed to think about complaining as its such a lovely home. Both residents surveys received said that they know of who to speak to if they are not happy and they know the complaints procedure. The AQAA stated that there staff have received abuse training and that there have been no complaints in the past 12 months. The Manager said that there had been no complaints since the home opened so this is why there was no complaints book. We talked to staff to find out how much they knew about protecting people in the home from abuse. Records showed they had received training about safeguarding adults from abuse, and they knew the in house procedure but struggled on all the Agencies to whistle blow to if the in house procedure failed. We looked at the staff recruitment records to see whether all the proper checks had Care Homes for Older People Page 17 of 26 Evidence: been made on staff before they started employment at The Glen. We found records which showed staff had started work with written references and legal checks in place to help them reach the judgement that people were safe to start employment. Care Homes for Older People Page 18 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at The Glen live in a safe and homely environment. Evidence: All residents spoken with said that they liked their bedrooms: My bedroom is very homely and I could bring all my own things here, one resident said. Both residents surveys received said that the home is always fresh and clean. One said: The Glen is very clean and the bed linen and towels are always clean and fresh and, Cleaned every day to a high standard. We saw people at The Glen living in a clean and well maintained environment. The furnishings in the communal area are homely and of a good standard, and people are encouraged to bring their personal possessions into their bedrooms. The AQAA stated that there is a safe and clean environment, equipment is serviced, fire doors have been fitted, rooms have been decorated and carpets and linen renewed, and there are maintenance records. Care Homes for Older People Page 19 of 26 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. Residents receive good care from well trained staff who provide swift assistance when needed. Evidence: Residents said that staff had enough time to spend with them and there was no significant waiting for personal care.There are always enough staff around, one resident said. Both residents surveys received said that staff were always available when they needed them. We spoke with the Manager about the staffing - there are two to three staff on duty until after lunch, then two staff until after tea and then there are two people available for care in the evening/at night.This was shown to be the case on the staff rota. Kitchen and domestic duties are part of the duties of the staff. The AQAA stated that staff had training on essential care practice and that further training was planned for a number of issues - and that over five out of six staff have attained at least NVQ 2, well over the National Standard. We found that staff have been trained on a number of relevant issues such as Moving and Handling, Fire Safety, First Aid, Food Hygiene, Medication and residents conditions such as Dementia though not others such as Sight and Hearing Impairment, Stroke, Parkinsons etc. The Care Homes for Older People Page 20 of 26 Evidence: Manager said this training would be arranged and a Training Matrix drawn up to indicate at a glance which staff needed training in specific issues. Staff records showed that proper checks had been carried out to protect residents from unsuitable staff. Care Homes for Older People Page 21 of 26 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. Management maintain a high quality of life for people at The Glen. Evidence: Both staff and residents said that Jennie, the Manager, was very friendly, supportive and efficient. One resident said, Jennie is lovely and she runs this place very well. We couldnt be in a better home. This positive view of the Manager was shared by staff who said that management were very supportive and listened if they raised any issue. There was evidence of Staff Meetings discussing relevant issues regarding the care provision to residents. Its very homely here and we get on very well, one staff member said. The Registered Manager has the relevant qualifications to be in charge at The Glen as she holds a Registered Managers Award. She updates staff practice with ongoing training. There is an annual appraisal for staff to see how they care for residents though no evidence on staff records of ongoing staff supervisions - the National Standard is six Care Homes for Older People Page 22 of 26 Evidence: times per year. We saw evidence that Management use different ways of finding out from people who live at the home and their relatives, what their views are about the care given at The Glen and how they can improve. There are annual quality assurance questionaires supplied to all relevant parties - residents, relatives, medical staff etc. These were all very positive about the care supplied to residents. We saw safe working practices, and were informed by staff that they felt appropriately supervised to do their jobs. There are regular checks for fire safety. The Owners said that all the requirements of the Fire Officer as of the Fire Report of July 2008 had been met, though there was no supporting evidence from the Fire Service to confirm this. Residents are protected from hot water temperatures by installed water valves to protect residents from scalding risks though when we the hot water temperature from a bathroom it was 47c, above the safe standard of 43c. The Owners said this bathroom was not used by residents to have a bath as all residents preferred a shower, though they did have access to it, so it would be closed off until it was needed and a valve would be fitted to ensure it would not cause a scalding injury to a resident. The Owners have just purchased a new Health and Safety manual so they will be reviewing all practices and extending risk assessments to issues such as window restrictors and hot radiators. Records of money transactions are not kept as the Manager said that all monies are handled by residents representatives. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Care plans need more detail regarding medical appointments and the life history and preferred daily preferences of residents. The Provider should ensure that staff follow the correct procedures for the administration and recording of medication. The Provider should ensure staff know all the Agencies to refer to if they suspect abuse has taken place. Staff training should include training on all residents conditions to better equip staff to meet all residents needs. Health and safety systems need to be tightened to ensure full protection for residents in respect of risk assessments for safe working practices and obtaining a confirmation from the Fire Service that they approve the follow up work undertaken from the requirements of the July 2008 Fire Report. 2 9 3 4 5 18 30 38 Care Homes for Older People Page 25 of 26 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 © (2009) 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 26 of 26 - 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!