Care Home: Galanos House

What the care home does well The home continues to be a bright, cheerful, and well-maintained environment, and much has been done to ensure that the home, despite its size, has retained some homely touches. Residents were obviously at ease within the home, and enjoyed the many different communal areas it offers. The home continues to offer a service to residents that is friendly and caring and aims to meet the social and physical care of those using the home. Visitors to residents are frequent and made welcome. Comments from residents included `One of the finest places you could wish for` and `a home from home`. Residents benefit from a variety of activities, both in the home and outside, geared to individual needs and wishes. `Nice holidays and outings`, commented one resident, while a relative commented that the home `understood` what different residents wanted. One relative was very pleased that the home far more dynamic and personalised than the stereotypical image of a home with everyone slumped in a large lounge, with the TV on. Training opportunities are made available to equip staff with the skills they need to undertake their roles. Residents and their families find staff to be very helpful and kind. `The nurses are angels` was one comment from a resident, and a relative `always found them helpful`. The home is run by a competent management team, who have experience in the care sector. Residents commented on how well the home was run, with visits and appointments being arranged promptly and efficiently. What has improved since the last inspection? Shortfalls identified in the previous inspection regarding medication and care planning have been remedied. What the care home could do better: The good, personalised system of medication administration is compromised if staff do not always ensure that all medication is recorded accurately, and that any shortfalls in recording are identified and rectified immediately. Effective staff recruitment is compromised if due attention is not paid to the suitability of all references. Care should be taken that the use of the building by anyone other than residents enhances, rather than compromises, the well-being of residents. CARE HOMES FOR OLDER PEOPLE Galanos House Galanos House Banbury Road Southam Warwickshire CV47 2BL Lead Inspector Martin Brown Key Unannounced Inspection 8th January 2008 08:30 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 Galanos House DS0000035730.V357158.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. Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Galanos House Address Galanos House Banbury Road Southam Warwickshire CV47 2BL 01926 812185 01926 815596 jawilson@britishlegion.org.uk www.britishlegion.org.uk The Royal British Legion 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) Ms Jo-Anne Wilson Care Home 60 Category(ies) of Dementia (60), Old age, not falling within any registration, with number other category (60) of places Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care (with nursing) and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category (code OP 60) and service users with dementia (code DE 60). 6th March 2007 Date of last inspection Brief Description of the Service: The original Royal British Legion Home, Galanos House, was built in the mid 1960s as a country home for elderly and incapacitated ex-servicemen and women and their dependents (residents must fulfil certain eligibility criteria). A wealthy Greek merchant, Christos Galanos, gave the funds for the building in a bequest. The new home was purpose-built and ready for residents in September 2002. It is registered to provide nursing and personal care to elderly residents over the age of 65 and 8 younger adults between the ages of 54 and 65. It has 60 rooms, all en-suite and set in approximately 3 acres of grounds, not far from the market town of Southam. Car parking space is available at the front of the home. The homes décor, furniture and furnishings are of a high standard. The home has a large airy dining room with tables seating 2, 3 or 4 residents. There is a conservatory, lounge, bar and seating area situated on the ground floor. The first floor has a library, lounge, a well-equipped activities room and other smaller seating areas. Residents are encouraged to bring items in with them and can furnish their private room to their own taste if they wish. The gardens are landscaped and well maintained, being accessible to all of the current residents. There are a number of seating areas, which are well used in good weather. There are vehicles at the home to transport the residents on trips and for appointments. Residents also benefit from opportunities to go on an annual holiday. Information about the home is given to prospective residents and their families via the ‘Statement of Purpose’ and other information brochures. Information provided by the service shows that fees range from £470 Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 5 residential and £700 nursing per week, depending on assessment. Additional charges are made for chiropody and personal items. Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This report has been made using evidence that has been accumulated by the Commission for Social Care Inspection. The inspection visit was unannounced and took place on 8th January 2008, between 8.30am and 5.45pm. During that time, many of the residents were spoken with, and were able to give good accounts of their experiences at the home. Some residents have cognitive impairments and found it more difficult to engage in conversation. Although the home now includes dementia care, staff and management advised that dementia is currently not the primary reason for residents needing care. Staff and management were spoken with, and interactions between staff and residents were observed. Two relatives and a visiting professional were spoken with during the inspection, and a relative was spoken with by telephone following the inspection. The overwhelming majority of comments concerning the service were positive, with remarks such as ‘fantastic’, ‘so glad I came here’ being typical. The Annual Quality Assurance Assessment, completed and returned by the manager earlier in the year, also informed the inspection. Policies and procedures and care records were examined, and six residents were ‘case tracked’, that is, their experience of the service provided by the home, was looked at in detail. Staff, management and residents, were welcoming and helpful throughout the inspection. What the service does well: The home continues to be a bright, cheerful, and well-maintained environment, and much has been done to ensure that the home, despite its size, has retained some homely touches. Residents were obviously at ease within the home, and enjoyed the many different communal areas it offers. The home continues to offer a service to residents that is friendly and caring and aims to meet the social and physical care of those using the home. Visitors Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 7 to residents are frequent and made welcome. Comments from residents included ‘One of the finest places you could wish for’ and ‘a home from home’. Residents benefit from a variety of activities, both in the home and outside, geared to individual needs and wishes. ‘Nice holidays and outings’, commented one resident, while a relative commented that the home ‘understood’ what different residents wanted. One relative was very pleased that the home far more dynamic and personalised than the stereotypical image of a home with everyone slumped in a large lounge, with the TV on. Training opportunities are made available to equip staff with the skills they need to undertake their roles. Residents and their families find staff to be very helpful and kind. ‘The nurses are angels’ was one comment from a resident, and a relative ‘always found them helpful’. The home is run by a competent management team, who have experience in the care sector. Residents commented on how well the home was run, with visits and appointments being arranged promptly and efficiently. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 8 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. Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 9 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 Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 10 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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be confident that their needs will be assessed and that the home will judge appropriately whether or not it can meet these needs. EVIDENCE: A brochure and a Resident Guide with information about the home, the eligibility criteria and the admission process are available to anyone who is considering moving into the home. The information provided by the manager on the Annual Quality Assurance Assessment demonstrated a clear admission and assessment procedure, residents and relatives spoken with confirmed that moves to the service was a positive and informed choice. A typical comments was ‘I’m so glad I was able to come here’. The manager will generally visit a prospective resident to gather relevant assessment material to ensure that the service can meet their needs, while visits by the prospective resident, and, where appropriate, relatives, are made Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 11 before a decision is made. Two relatives commented that they were encouraged to visit to ensure that they were satisfied that the service was the right one for their parent, and that he was satisfied with it. Assessments looked at also included life histories of individual residents, helping the service to ensure that they were able to meet the current and future needs of individual residents. The manager gave an example of where the service could not meet someone’s dementia related needs, but advised that these had only became apparent after the service, with medical support, had successfully resolved specific physical needs for this person. The home does not provide intermediate care and therefore standard six was not looked at. Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 12 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): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their health needs, as detailed in care plans, are met satisfactorily, with the prompt support of relevant health professionals whenever needed. While medication procedures were overall very positive, greater care must be taken in recording of controlled medication to ensure that residents’ wellbeing is not compromised. EVIDENCE: A sample of six care plans were looked at, and they showed clear and consistent guidelines to the care for each person, with an emphasis on the relevant areas for that individual. Individual assessment forms all had small boxes to cover individual aspects of care. Where these indicated specific difficulties, these were followed up in separate risk assessments, in areas such as swallowing difficulties, mobility, Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 13 pressure sore risks. Review dates showed that risk assessments and care needs were regularly reviewed. Records, and discussion with staff and management showed the involvement of dieticians, speech and language therapist and other specialists as required. One care plan gave details of what to do in the eventuality of the person having a seizure, and included instruction on the use of rectal diazepam. Staff questioned on this said that this person had not had a seizure and was not on medication for seizures. The manager advised that this information had been received along with the resident, and agreed that if this documentation was no longer relevant, it should be removed, after medical consultation. Records, and discussion with staff, residents, and relatives, showed prompt action was taken whenever there were health concerns, with appropriate specialist help being sought. One relative commented that she had had to draw staff’s attention in the past to the fact that the person she visited had not been offered sufficient fluids. A fluid chart was seen to be in place to record that this was now happening. Risk assessments, confirmed by discussion with staff, showed a balance between health concerns and individual rights. In one instance, a resident with swallowing difficulties still liked to drink water occasionally. Although advising against this, the service accepted his wish to continue doing this, with guidance for the eventuality of any difficulties resulting from this. Staff spoken with showed a good understanding of individual needs as laid out in care plans, being aware of appropriate actions to minimise risks in areas such as skin vulnerability, mobility, and falls. One visiting professional said that the home always keeps medical practitioners informed and up-to-date on any changes, and takes prompt action to get appropriate medical help when needed. Observations showed staff interacting with residents in a warm, friendly and professional manner, upholding dignity and privacy. All residents spoken with, as well as relatives, were complimentary about the staff. Comments noted included, ‘the medical care is good’, ‘never heard staff raise their voice’, ‘staff come quickly if you ring the bell’. One resident gave an example of how, when the home suspected a hearing problem soon after his arrival, a hearing test was promptly organised and a hearing aid soon followed. All residents have lockable cupboards, and have lockable doors and keys if they wish. Many residents wished to keep their doors open during the day. No one spoke of concerns about their privacy. On the contrary, several spoke of Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 14 how the building was large enough to allow for privacy whenever wished for, and that ‘the only time you see lots of people is at mealtime’. Medications practices and procedures were examined. All residents have individual locked cabinets for their own medication, allowing for self medication, and a greater sense of empowerment than does centrally–held medication. In most instances, staff undertake this role, with residents’ agreement; where residents self-medicate, risk assessments are in place. Most medications are dispensed via ‘blister packs’, allowing a clear picture of whether or not medications have been taken at the appropriate time. This is further confirmed by Medication Administration Record Sheets, a sample of which were checked and seen to be accurate. Some medications are not dispensed via ‘blister packs’; generally short course of antibiotics or that of recent admissions. These were not stock controlled on a daily basis, meaning that any error in administering may not be noted until a course was completed, or until an audit was done. Staff and management agreed that daily stock control for these few medications should be recorded, so as to minimise the risk of any error happening and not being immediately spotted. Controlled medication was looked at. This was seen to be stored and dispensed accurately, and recorded accurately, except for one instance, where a mistake in subtracting meant that recording of a liquid medication was inaccurate. Examination of the remaining contents of the bottle showed that administration was accurate, and that the error was purely one of subtraction. Staff concerned agreed however that it was unsatisfactory that the error had been made and not noticed, particularly as it was a controlled medication. The error was noted and a correcting amendment was promptly added to the record and signed by the nurses concerned. Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 15 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): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a wide variety of activities, catering for the wide variety of interests and capabilities. The planning of further facilities on the premises should further enhance this. The rights of residents may be compromised by people from outside the service using facilities, if this is not managed appropriately. EVIDENCE: Residents continue to benefit from a wide range of activities. On the morning of the inspection, an activities co-ordinator had skittles and other activities to encourage dexterity and socialising in the dining area, and in the afternoon, an organist led a sing-along session. The activities organiser showed awareness of the needs of individual residents, allocating time for individual activities where these were judged beneficial, based on information gleaned from assessments, life histories, and discussion with individual residents and their families. Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 16 Residents commented that there were ‘plenty of activities’. One noted how all trips ‘were well-organised’. Residents spoke favourably about regular holidays to Blackpool, and how one was being planned for Kent in the summer, and were very complimentary about the wide variety of trips and activities outside the home. One relative commented that the home ensures even those who are not ‘natural joiners in’ are supported in activities, adding that ‘they always know what people like’. Some residents spoke of how they, or others, were attending college courses in the local town. A gardening shed/greenhouse was now available, to support and promote an interest in gardening for ‘green fingered’ residents. Several residents mentioned this and were keen to use it in the warmer weather. Two residents commented on there being nowhere to store ‘projects being worked on, such as models or other large items. One person said it was a minor frustration to be working on a model or similar in a communal area, and then have to put it all away at the end of a session. He keenly awaited the construction of a ‘workshop’ where such items could be worked on and safely left out. The manager advised that such a workshop is planned, using money raised for and by the service and allocated for such activities. One person was using the computer facilities in the home’s library, and was keen to show the manager his latest finding on the internet. Visiting relatives were spoken with. They were complimentary about the service, and how welcoming and supportive it was. Residents are free to have visitors as they wish, and the manager advised that many have friends and visitors other than family. One relative commented that she was a frequent visitor, was always made welcome, and often stayed for Sunday lunch. Where residents had no or restricted family contacts, the service helped to organise befrienders, using local voluntary groups. Residents spoken with were confident that they were able to exercise choice and control over their lives, with contact with relatives, friends, and outside bodies being supported by the service. One resident expressed concern that the home was being used by people with no direct connection with the home, and that this had a negative impact on some residents. The manager was aware of this concern, and it is being responded to. A meal was taken at lunchtime with residents. The main dining area is a large one, and was used for other activities outside of mealtimes. Lunch was a Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 17 relaxed, unhurried occasion, with help being offered as needed. Residents needing more support were seen to be supported in a smaller dining room. The meal was tasty and well-presented, and residents spoken with at lunch said this was typical of meals provided. ‘A good selection of food – excellent’ was one comment. Choices were offered, and special diets catered for, including those with diabetes, and vegetarians. Everyone spoken with had a high regard for the quality and range of food. Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 18 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that any concerns raised will be listened to and acted upon. The rights and privacy of residents may compromised if policies and protocols regarding the use of the home by visitors not directly coming to see individual residents is not made clear to all. EVIDENCE: One complaint and one allegation have been received by the Commission for Social Care Inspection since the last inspection. The complaint principally concerned the use of facilities at the home by nonresidents, and alleged non-consultation of residents concerning proposed developments at the home. The manager advised that this is being addressed by the area manager for the service, and gave details of this. The resident was spoken with during the inspection, and was forthcoming with a number of concerns he had raised on his own behalf and, he stressed, on behalf of those he felt shared his concerns but were not able to raise them as articulately. He was aware that the service was responding to his complaint. Other residents spoken with did not express concerns about other people coming into the home: most indicated that they were happy to see visitors in the home. There Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 19 was no evidence in the visitor’s book of such groups visiting recently. The manager advised that these groups may not sign in, although most visitors appeared to be signing the visitor’s book. The manager agreed that a balance had to be struck to the home being welcoming to visitors with similar interests as the residents, and with the residents’ best interests at heart, and the need to ensure that all residents were confident that the home was their home, and they were not unduly inconvenienced by visitors. Other residents spoken with during the day said that they had no complaints concerning the home, but were aware of who they could speak to if they had concerns. Several commented on the approachability of the manager. An allegation by a service user resulted in the prompt suspension of a staff member, pending resolution of the incident, and the following of procedures according to the local Safeguarding Adults protocol. The incident has not yet been fully resolved. The manager agreed that any incidents resulting in the suspension of staff should be resolved as speedily as possible, without compromising a fair and just outcome. Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 20 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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a spacious, bright, airy and well-maintained environment that is clean and hygienic. EVIDENCE: The home is a large, purpose-built, spacious, building that, on the day of the unannounced inspection was clean, tidy and entirely free from offensive odours. Relatives commented on this commendable fact, accrediting it to a combination of good hygiene and design, and staff and management diligence. Corridors are wide, allowing for easy passage, and there are a variety of small communal lounges and alcoves, allowing residents to have quieter areas to sit in without necessarily having to go to their own rooms. Several residents commented on this fact, to the effect that the home was spacious enough to not get crowded. Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 21 The dining area is large, and is also used for activities, and showing films. Nearby, there is a refurbished bar area, that, I was advised, is open most evenings, and weekends. There are attractive outdoor areas, which many residents said they enjoyed in the warmer weather. One section of hedging separating the grounds from neighbouring farmland had a length of barbed wire strung along it, causing a potential hazard. The manager advised that this was not put in place by the home, but would investigate, and ensure it was safe, or removed. There are two lifts to access the second floor. On the day of the inspection, one of these was not working properly, and the lift engineer was out promptly to rectify this. Bathrooms are made attractive and ‘homely’ by tiling and small decorative features, with suitable baths to meet residents’ needs. It was noted that there was a toilet marked ‘visitors’. The manager agreed that all toilets should be open to all, and all have the same high standards of cleanliness. She advised that the toilets tended to be used by all. Toilet doors are able to be opened both ways, in the event of emergency. One downstairs toilet was hard to close fully. The manager advised that maintenance personnel would be informed of this and remedy it promptly. Storage of wheelchairs, hoists, and laundry baskets is still an issue, as acknowledged by staff and management. The manager advised that any further development should include more storage space. Storage for such items notwithstanding, the home generally managed to appear spacious and uncluttered. The home has a large laundry, with 2 dryers and 2 washing machines, which are suitable to wash clothes at high temperature if required. There are appropriate hand washing facilities for staff, and good hygiene procedures. A tour of the kitchen showed an adherence to good food hygiene standards. The kitchen is clean large and well maintained with plenty of storage and freezer space available, which were clean, tidy and well maintained. Stocks in the kitchen were plentiful, and stored appropriately. A sample of individual rooms were seen. These were well-laid out, and personalised according to individual wishes, with adaptations and aids as required. There had been a reported incident where a hoist had broken, and this is being appropriately investigated. Records show that such equipment is regularly checked, in accordance with requirements. Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 22 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): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are highly regarded by residents and work together well to meet their needs. They all receive training related to the needs of residents. Recruitment procedures in respect of references must be more robust to ensure that vulnerable residents are protected at all times. EVIDENCE: There were sufficient staff on duty to meet residents’ needs. One comment from a resident was that ‘staff are always there when you ring the bell’. A relative, who frequently visits at varying time of the day, said ‘there were always enough staff’. Some staff themselves made the comment that, as the needs of residents had increased in recent years, they felt more ‘rushed’ in the time they spent with individual residents. There is sufficient ancillary support from cleaners, and from caterers, to support the care and nursing staff, and the home also employs administration, activity, gardening and maintenance staff. Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 23 Additionally the home employs a ‘resident coordinator’ who is responsible for making sure that residents are able to attend appointments, provides escort to hospital and arranges some outings such as shopping trips. One resident commented that ‘everything is really well organised – from trips out, to hospital visits’. Training opportunities made available for staff to ensure that they have the required skills to care for the residents in the home are good. The manager has a training plan in place for the year, with some of the key mandatory training courses repeated during the year, to ensure that staff have opportunities to attend. On the day of inspection, many staff were on site, attending a dementia course. The Annual Quality Assurance Assessment returned by the manager detailed a satisfactory number of staff having achieved National Vocational Qualification level 2 or above, with others working towards this qualification. Staff demonstrated in discussion, and in their interactions with residents, a good understanding of residents’ needs and how to meet them. A sample of staff recruitment records were examined. All Criminal Records Bureau were satisfactory. References on application forms were looked at. One application for a part-time worker with no unsupervised access to residents had only one reference, a personal one, returned. As the person had very limited work experience, no employment reference had been returned. The manager accepted that this should have been followed up, and alternatives, such as educational or other vocational references sought. This person is related to another person working in the home. The manager has advised, following the inspection, that an acceptable work-related reference has now been received. A nurse had been employed with two references, neither of which referred to her previous employment, and which both appeared to be personal references by previous work colleagues. Following the inspection, the manager advised that this has been followed up by a reference request from the previous employer. One further reference for another worker had statements that were ambiguous in respect of that person’s capabilities. The manager explained how she had followed these up by telephone and satisfied herself that there was not a cause for concern. She accepts that she should have recorded the details of this conversation in the relevant file, and later confirmed that this has now been done. Following these noted shortcomings, a larger sample of recruitment files were looked at. All others were seen to be satisfactory, indicating that these were isolated examples of references not being scrutinised and followed up adequately. Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 24 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): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from clear and approachable management in a home that is run in their best interests the management, and where the health, safety and welfare of all is promoted and protected. EVIDENCE: The home continues to be managed by a person of good integrity who is an experienced health care professional. She has had a number of years experience working with the client group and as well as being a qualified nurse, has achieved the Registered Managers Award. Staff spoke of good support from the management. Relatives and residents spoken with commented that the manager was very approachable. Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 25 She has an ‘open door’ approach, and spends time in the home speaking to residents and their families and listening to their points of view. Quality assurance audits take place regularly, and residents and relatives are given an annual questionnaire to complete. Spot checks are regularly undertaken. Procedures for the receipt and safe keeping of residents’ monies are good. Records of residents’ meetings showed positive outcomes, with residents putting forward ideas to be taken up, such as having a purpose built workshop. A catering group has been set up to address and resolve issues around meals, such as times and serving rotas. Safety checks showed due attention being paid to legionella testing, with outside consultancies being used to highlight any vulnerable areas, with followup testing and action as required. Gas checks were up to date, and a current fire risk assessment, signed as ‘satisfactory’ by the local Fire Officer, was in place. Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 26 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 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? no 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 OP9 Regulation 13 Requirement Details of the amounts of Controlled Medications must be recorded accurately at all times, to ensure the well-being of residents is not compromised. Procedures for obtaining satisfactory references must be followed in all instances, to ensure that the well-being of residents is not compromised. Timescale for action 16/02/08 2. OP29 19(1)(c) 16/02/08 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 OP7 Good Practice Recommendations All information on care plans that is no longer relevant should be archived or otherwise made clear that it is no longer part of current care needs, so that care needs of individuals remain clear to staff. All ‘non blistered’ medication should be stock controlled on a daily basis, to ensure that any error is immediately DS0000035730.V357158.R01.S.doc Version 5.2 Page 28 2. OP9 Galanos House apparent. 3. OP18 All allegations, especially those involving the suspension of a member of staff, should be resolved as speedily as is possible without compromising justice and fairness or the safety of vulnerable individuals. The home should take care to ensure that the well-being of residents is not compromised by its use by others from outside the home. The home should ensure that the length of barbed wire between the grounds and adjacent farmland is not a hazard to anyone at the home. 4. 5. OP18 OP19 Galanos House DS0000035730.V357158.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Birmingham Local Office Commission for Social Care Inspection 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Galanos House DS0000035730.V357158.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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