Care Home: Gallions View Nursing Home

What the care home does well The home provides a very congenial setting set as it is amongst spacious grounds with all resident accommodation at ground floor level. Residents who choose to stay in their room enjoy the view from their room and many have direct access into the spacious and well maintained grounds from their bedroom. Administration including record keeping is well managed. From the various surveys we circulated we are told very succinctly what the home does well is provide, “General care and attention”. The documentation that provides evidence of residents’ needs and how that care is being delivered are comprehensive and well managed. We some very good examples of nursing care including the care of wounds. Overall the outcomes, how residents experience the quality of care, seem very good for most residents. Our expert visitor was impressed by this service from the outset, “I was standing at the threshold of a large territory where four single storied houses stood displaying gorgeous lawns in between. At the reception I was welcomed with outstanding courtesy even before I could introduce myself.” He also found residents and their visitors equally impressed and was told, “This is by far the best home he (the resident) has been to.” Our expert visitor commented about what he thought the home does well: “The home is located in a very peaceful area. Its four single storey houses stand apart with spacious lawns and artistically arranged flower beds in between. It incorporates all the factors required for an ideal care home. The air is fresh and invigorating. It permeates right into the rooms of the residents. I could not detect any foul smell any where on the premises. The entire staff seems to have adopted a culture of care, courtesy and calm. This combination results in high quality of services rendered to the residents.Gallions View Nursing HomeDS0000006761.V376777.R01.S.docVersion 5.2Everyone admired the friendliness of all the staff, quality of food, nurses punctuality in giving out medication etc. Generally speaking most of the care home affairs seem to be well managed.” What has improved since the last inspection? Seven requirements were issued in 2008 and these have been addressed including, administration of medication, staff recruitment practices, care plan documentation, staff levels in particular nurses. We also required the home to deal with old, worn or dirty furniture. The home delayed several months in addressing the matter until we served Notices in June 2009 when the matter was swiftly resolved by BUPA. We also note that the service has another new manager and so she will need to register with the Commission and for this reason that requirement will be restated. What the care home could do better: Few requirements are issued by the Commission reflecting the improvements made since our visits in 2008. BUPA was committed to refurbishing the units and has delayed this for several months but again the organisation has given an undertaken that refurbishment is deferred not cancelled. Information provided in the statement of purpose and resident guide will need to be updated to include the new manager’s details and the Commission’s new contact details in Newcastle (contact details are given on the last page of this report). Our expert visitor thought a form of transport, perhaps a ‘people carrier, on site would be a welcome improvement and this endorses a comment we received from a visitor suggesting residents need more stimulation. Another commentator suggested more ‘physiotherapy’ but this may refer to their idea for more ‘occupational therapy’ and social activity aimed at improving in both mental and physical well being. We recommend greater clarity and detail in care plans. So for example where a care plan indicates the need to ‘motivate’ a resident more information about how that may be achieved is advised. Because there have been a number of complaints this year and a number of investigations by the local authority care managers into matters of ‘safeguarding’ – where poor care practice is suspected – we are requiring the home to provide us with details of these matters so that the Commission can monitor any possible breach of Regulations by the service. Our visiting expert said in this section of this report: “Most of the furniture is old and in need of replacement. During my interviews I found that some staff struggled to provide proper answers to certain questions. In fact they told me that they would welcome refresher courses as well as training courses leading to NVQ [national Vocational Qualification] qualifications. Although, a lot of activity is arranged within the home, an outing every now and then is a very important function. It helps to break away the monotony of the site. I thoroughly enjoyed my day and it was a great pleasure to meet all these wonderful people and the residents”.Gallions View Nursing HomeDS0000006761.V376777.R01.S.docVersion 5.2 Key inspection report CARE HOMES FOR OLDER PEOPLE Gallions View Nursing Home 20 Pier Way Thamesmead London SE28 0EU Lead Inspector Michael Williams Key Unannounced Inspection 29th July 2009 10:00 DS0000006761.V376777.R01.S.do c Version 5.2 Page 1 DS0000006761.V376777.R01.S.do c Version 5.2 Page 2 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 3 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Name of service Gallions View Nursing Home Address 20 Pier Way Thamesmead London SE28 0EU 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) 020 8316 1079 020 8854 5331 condonc@bupa.com www.bupa.com BUPA Care Homes (CFHCare) Ltd Manager post vacant Care Home 120 Category(ies) of Dementia (30), Old age, not falling within any registration, with number other category (90) of places Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 5 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places: 90) 2. Dementia - Code DE (maximum number of places: 30) The maximum number of service users who can be accommodated is: 120 19th August 2008 Date of last inspection Brief Description of the Service: Gallions View is a Care Home that provides nursing care for 120 residents. It is owned and managed by BUPA Care Homes (CFHCare) Ltd. It is situated in spacious grounds in West Thamesmead and is within a reasonable distance of the town centres of Plumstead and Woolwich with their transport links and a range of shops and markets. Gallions View consists of four purpose built bungalows, each accommodating thirty residents, and a central two-storey building housing the administrative staff, the laundry, kitchen and hairdressing salon. There is a fifth unit, the Bevan Unit, which is an NHS Intermediate Care Unit. Each unit has its own Statement of Purpose, and one unit offers specialist nursing care for people suffering from dementia. All the rooms are for single occupancy. None has ensuite facilities other than a hand wash basin. There are an adequate numbers of shared bathroom and toilet facilities. The site is landscaped, with gardens adjacent to each unit, secure fencing around the perimeter. There is car parking to the front of the building. The fees charged by the home, as at 29/7/09, range from £553 to £884 per week. This does not include additional charges for person items such as chiropody, hairdressing, newspapers and toiletries. Additional charges for extra care will be by negotiation with the funding authority. Gallions View Nursing Home DS0000006761.V376777.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. In the preparation of this report we conducted an unannounced site visit on 29th July 2009 when the lead inspector Mr Williams was accompanied by an ‘Expert by Experience’ (referred to in this report as the Commission’s expert visitor). We also conducted a briefer, unannounced random visit on 12th June 2009. As well as these site visits we also took account of information made available to us. This includes the home’s AQAA (Annual Quality Assurance Assessment). The home also supplied us with reports of untoward incidents and accidents, called notifications. The local social service department also provided information about safeguarding investigations they undertook to ensure the well being of residents in the home. What the service does well: The home provides a very congenial setting set as it is amongst spacious grounds with all resident accommodation at ground floor level. Residents who choose to stay in their room enjoy the view from their room and many have direct access into the spacious and well maintained grounds from their bedroom. Administration including record keeping is well managed. From the various surveys we circulated we are told very succinctly what the home does well is provide, “General care and attention”. The documentation that provides evidence of residents’ needs and how that care is being delivered are comprehensive and well managed. We some very good examples of nursing care including the care of wounds. Overall the outcomes, how residents experience the quality of care, seem very good for most residents. Our expert visitor was impressed by this service from the outset, “I was standing at the threshold of a large territory where four single storied houses stood displaying gorgeous lawns in between. At the reception I was welcomed with outstanding courtesy even before I could introduce myself.” He also found residents and their visitors equally impressed and was told, “This is by far the best home he (the resident) has been to.” Our expert visitor commented about what he thought the home does well: “The home is located in a very peaceful area. Its four single storey houses stand apart with spacious lawns and artistically arranged flower beds in between. It incorporates all the factors required for an ideal care home. The air is fresh and invigorating. It permeates right into the rooms of the residents. I could not detect any foul smell any where on the premises. The entire staff seems to have adopted a culture of care, courtesy and calm. This combination results in high quality of services rendered to the residents. Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 7 Everyone admired the friendliness of all the staff, quality of food, nurses punctuality in giving out medication etc. Generally speaking most of the care home affairs seem to be well managed.” What has improved since the last inspection? What they could do better: Few requirements are issued by the Commission reflecting the improvements made since our visits in 2008. BUPA was committed to refurbishing the units and has delayed this for several months but again the organisation has given an undertaken that refurbishment is deferred not cancelled. Information provided in the statement of purpose and resident guide will need to be updated to include the new manager’s details and the Commission’s new contact details in Newcastle (contact details are given on the last page of this report). Our expert visitor thought a form of transport, perhaps a ‘people carrier, on site would be a welcome improvement and this endorses a comment we received from a visitor suggesting residents need more stimulation. Another commentator suggested more ‘physiotherapy’ but this may refer to their idea for more ‘occupational therapy’ and social activity aimed at improving in both mental and physical well being. We recommend greater clarity and detail in care plans. So for example where a care plan indicates the need to ‘motivate’ a resident more information about how that may be achieved is advised. Because there have been a number of complaints this year and a number of investigations by the local authority care managers into matters of ‘safeguarding’ – where poor care practice is suspected – we are requiring the home to provide us with details of these matters so that the Commission can monitor any possible breach of Regulations by the service. Our visiting expert said in this section of this report: “Most of the furniture is old and in need of replacement. During my interviews I found that some staff struggled to provide proper answers to certain questions. In fact they told me that they would welcome refresher courses as well as training courses leading to NVQ [national Vocational Qualification] qualifications. Although, a lot of activity is arranged within the home, an outing every now and then is a very important function. It helps to break away the monotony of the site. I thoroughly enjoyed my day and it was a great pleasure to meet all these wonderful people and the residents”. Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 8 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Gallions View Nursing Home DS0000006761.V376777.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 Gallions View Nursing Home DS0000006761.V376777.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): NMS 1 and 3: People using the 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 and their representatives can be assured that information provided by the home will be appropriate and assessments will be conducted so as to ensure residents will know their needs can be met. EVIDENCE: To evaluate these standards we spoke to residents, their visitors, to staff and to heads of units and we checked case files and other relevant documentation. The Commission’s expert also sat with several residents to glean a more detailed insight into residents’ experiences in the home. Assessments are in place and this ensures prospective residents are matched to the unit most suited to their needs – because some unit provide general nursing care whilst others provide for residents with dementia. In 2008 we required the home to give written confirmation to residents, and/or their representatives and placing authorities of these details and this is now in place as well. The manager has changed since we visited earlier in 2009 and the details of the Commission contact centre have also changed so the home needs to update these details and a requirement is made to that effect. Gallions View Nursing Home DS0000006761.V376777.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): NMS 7 to 10: People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health care is to a high standard so residents can be assured that their health care needs can be met. EVIDENCE: To assess health and nursing care we checked the care plans, met with residents and spoke to the staff nurses on duty during our visit. Care Plans follow a standard BUPA format and are very detailed and comprehensive so they include numerous assessments of personal and social needs include nutritional needs, skin care, wound care, susceptibility to falling, and including any matters identified in the care manager assessment done at the time of admission. Particularly noteworthy on this occasion was the improvements in wound care using a modern technique of medicinal honey. The photographs demonstrated clean and healthy wounds clearly healing very well. Other aspect of health care are being well managed, moving and handling for example. The units we visits had a plentiful supply of different types of hoists to ensure residents can be Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 12 moved from area to area in a safe manner. The service also has ‘assisted’ baths so that residents with mobility problems can use these facilities in safety. Medicines are now being well managed and we identified no errors in the storage, administration, recording and disposal of medication. Although this care home has no ensuite facilities in the bedrooms, other than a wash hand basin, residents can be afforded privacy and dignity in the bathroom and toilets. We saw no breaches of privacy and staff were treating residents with dignity and for example knocked doors before entering and explained why they had entered when they went into residents’ bedrooms. Residents’ care plans are being checked monthly to ensure they remain up to date and are being revised, in consultation with the resident or their representative, where changes are noted. Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 13 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): NMS 12 to 15: People using the 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 living in Gallions View can be assured that the home makes good arrangements for the social care of residents. So residents will know that their social and emotional needs are addressed as well as health care needs. EVIDENCE: We found that standards in this area were to a high level when we checked them in detail in 2008 and we are advised there have been no substantial changes to the way in which social care is provided so this section is largely recorded as before. Three activity organisers were employed with plans in place. The senior activity organiser told us in 2008 that a variety of activities such as bingo, film shows, sing-along and quizzes were provided flexibly for residents. Outings were costly to organise and only a limited number of places were available and notices around the home make this clear with contributions requested where supplements are needed. Activity staff also arranged for entertainers to visit the home twice a month and residents who wanted to attend were taken from all units to these sessions. A bingo session was again observed on the day of the inspection. Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 14 An activity person was employed for Squires House for 18 hours a week, (this is the unit catering for people with dementia). The nursing staff prepared social and activity care plans and those seen could be improved to ensure they provided adequate detail in relation to the person’s preferences and social interests so we restate this recommendation. Our expert has given several suggestions that we pass on from residents and their visitors; “The home should include discussion groups in our activities”. He also thought it would be helpful to be able to provide new visitors with a map of the locality and the site and also include details of transport in the area. Residents we spoke to were satisfied with the visiting arrangements. During the course of the inspection we noted numerous relatives around the site. Although the Commission no longer sends surveys to relatives (to obtain their views of the service) we invite residents to circulate surveys to all visitors, family and professional and in this way we did receive some feedback from them. Relatives seen were satisfied with the service, the food provided and communication with staff. However over the course of 2009 we have heard about their concerns in relation to the need for more leisure activities, the décor and furnishings. This was particularly an issue on Squires House but at least the very damaged and unsightly chairs have been replaced - with more specialised ones in prospect we are told by the manager. Meals were brought to the house from the main kitchen in heated trolleys. A four weekly menu was provided and showed that a varied diet was provided. Residents were encouraged to choose a meal from the daily menu and if the meals on offer were not to their liking they could choose an alternative such as omelette, jacket potato or a salad. Residents were seen having lunch in the houses we visited and those we spoke to said they were satisfied with the meals provided. Staff were observed assisting residents with their meals. On the day of the second visit lunch was observed on Squires house. A high percentage of residents on this house needed assistance with their meal. Pureed foods were served separately and some families visited at lunchtime to help their relative with their meal. Our expert found, by sampling the meals himself that, “My lunch tasted nice; it was decently served and was not heavy on the stomach. Just right for the dwellers of a home usually with limited mobility”. A resident commenting on the food and the general atmosphere of the home told our expert, “She has been in the home for three years. She liked the people and the food. She was very satisfied with the way a nurse administered personal care to her in the mornings and evenings, and she liked the windows, they bring the light in”. We checked the catering arrangements including the large kitchen and note that the last environmental health check found the arrangements in the kitchen ‘satisfactory’ and the kitchen certainly looked well managed when we visited. Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): NMS 16 and 18: People using the service good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedures for dealing with complaints and safeguarding are to a good standard so that resident may feel they concerns will be listened to and they will be protected from harm. EVIDENCE: A copy of the complaints procedure was displayed in each house. The procedure provided information for residents and relatives about whom they should speak to if they have any concerns and how the complaint procedure was implemented. Relatives and residents spoken with knew who to talk to if they had any concerns. A clear and easily understood system is in place to record complaints made about the service. From information included in the Annual Assessment (the AQAA) the home sent us we learn that the complaints had been made about the service are being followed up and investigations referred to the local authority where that is appropriate. Complaints are being recorded seen included the original complaint, the investigation and the response to the complainant. A monthly audit is being completed on complaints and sent to head office. There is a policy/procedure in relation to ‘safeguarding’ (protecting vulnerable adults from abuse). Staff we spoke to had a good understanding of safeguarding adults and knew what action they should take if abuse was suspected or alleged. All allegations of abuse are, correctly being notified the local social services and the Commission so we can monitor action taken by the home and socials services to protect residents. We are requiring an updated list. Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): NMS 19 and 26: People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall we assess this service as providing good, safe and comfortable surrounding so residents know they will be living in a largely comfortable and protected environment. EVIDENCE: It is regrettable that the planned refurbishment of Gallions View has been delayed. The manager again assured the Commission that although delayed refurbishment has not been cancelled and in due course the proposed improvements to the environment will be made. We note that it was only after formal complaints had been made and Enforcement Notices served upon BUPA in June 2009 that the worst bits of furniture were finally removed, for example from Squires House. This was despite the requirement we issued to do so by October 2008. This tardiness does not engender confidence in residents and their families. Although we assess the premises as good are there areas in need of improvement and BUPA Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 17 is aware of this. Furniture and fittings in some bedrooms are damaged such as laminate on units and handles missing on drawers and doors. We met with the on site maintenance person and were impressed by his hard work and dedication in maintaining so many aspects of Gallions View including fire safety, electrical checks, water safety checks, health and safety checks, as well as maintaining the fabric of the building and responding to urgent requests for repairs. He is assisted by a part time gardener but the home should consider whether more hours are required for this demanding role. We note that the bedrooms do not have ensuite facilities such as toilet or shower and must be made clear to prospective residents since this lack of facilities does not meet modern standards (The National Minimum Standards allow for the fact that older care homes did not have such facilities and the NMS require them to have no less facilities than in 2002 so as to take account of the implications of fitting ensuite facilities into older premises). We also note that bedrooms although they have fire doors do not have self-closing devices (to reduce the likelihood of fire and smoke spreading); again we are advised that the local Fire Authority has accepted this arrangement. The single story units are set in spacious grounds and residents tell us how much they like the setting for this home. We found the units to be clean and tidy and odour free. We make a general requirement to upgrade those areas in need of refurbishment without undue delay. Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): NMS 27 to 30: People using the service good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing arrangement in this home are satisfactory so as to ensure residents are protected my good recruitment, training and support of staff. EVIDENCE: To assess this section we met with staff and the manager, asked the views of residents and their visitors and we checked the records in respect of staff recruitment, their induction, training and supervision. The home now has two nurses working on the units to allow for the fact that each accommodates up to thirty residents who require nursing care. The Squires unit for example has very dependent residents with dementia and nursing care needs. In addition to the qualified nurses there are five care assistants in each unit. We are advised that this level of staffing meets residents current needs. The recruitment documentation was in good order and with detail checklist we, and the managers, are able to see at glance what checks have been undertake. So we checked that Police [CRB] are undertaken for each member of staff member they are employed to work with this vulnerable client group. New staff were provided with a structured induction programme including three days ‘shadowing’ staff. Core training such as moving and handling was provided for new staff prior to starting work and other training such as health and safety, fire, infection control, manual handling, safeguarding adults, Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 19 accident reporting and Personal Best were included in the induction programme. There was a training plan for 2008 to show details of the training provided each month. A number of staff were accredited moving and handling trainers, which enabled new staff to receive training in the houses. Some staff training was provided in house and other training was provided throughout the BUPA homes in the South East. Individual training records were kept for staff and we took a print-out of the training matrix so we can check in detail that the usual range of training such as fire safety, health and safety, dementia care, infection control, food hygiene and so forth are being offered to the relevant staff groups. The records we saw now seemed to be up to date so as to ensure training relevant to each member of staff’ role is provided regularly and the training is updated year by year. Staff we spoke to were satisfied with the training provided. This training input has clearly had dividends since our expert found that the residents say of staff, “I feel that staff enjoy having us residents in the home.” Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): NMS 31, 33, 37 and 38: People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has changed but residents can be advised that the management of the home is satisfactory so that they can be assured that Gallions View is being run in their best interests. EVIDENCE: Since the inspection in 2008 the service has had two manager changes and by 2009 another change of manager. Another new manager has been appointed and will need to submit an application for registration without delay. Apart from the change of manager we are advised that there have been no substantive changes to the running of Gallions View and so the findings this time are similar to 2008. The people we spoke to living and working on site told us that people managing the home (the site manager, deputy and area managers for Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 21 example) visit the units regularly to offer support and monitor care practices. The home had a quality assurance system in place. The system included monthly audits of specific topics such as medication, record keeping and health and safety. The houses senior nursing staff complete audits and the quality manager checks the findings to ensure that they were accurate and that appropriate action was taken to improve the service. We saw some of the completed audits and these included action plans to address deficits thus identified. Annual satisfaction surveys were sent to residents and relatives and feedback was obtained from through relative and resident meetings and we checked some of these as well. Relative/resident meetings are held regularly. Staff meetings were held on the houses and management held regular meetings such as clinical, head of departments, GP and night staff meetings. Management provided support and assistance for residents to manage personal allowance money. Safe systems were in place to do this. Residents’ money was held in a shared bank account with interest paid proportionately to individual residents. Records were kept for money received and receipts kept for money spent on the resident’s behalf. Individual records were kept on the computer for residents and were made available to relatives, residents and other interested parties as needed. A safe was provided to hold money and valuables for residents. A record of the items stored in the safe is maintained and held securely. Accident records were viewed and were well completed. Records included the personal details of the person, the time and place of the accident, noted if any injuries were sustained and if any medical treatment was needed. Accidents and other issues, which may affect resident’s health or well-being, were reported under Regulation 37 to the Commission. From information provided in the AQAA (their Annual Quality Assurance Assessment form) attention was given to providing a safe environment for residents and others. The information includes the last service date for moving & handling equipment, gas and electricity supply service and fire safety equipment. A maintenance technician was employed to attend to everyday repairs and address health & safety issues. Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 22 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 2 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 3 Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 23 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 OP1 Regulation 6 Requirement Timescale for action 30/10/09 2 OP12 3 OP19 4 OP31 Statements of Purpose and residents’ Guide to be updated with information about the new manager and the Commission’s contact centre in Newcastle. 16(2)m Social Activity: the home must 30/10/09 review he range of social activity and opportunities residents have offered to them including local excursion into the community. 16 and 23 Premises: the home must 30/10/09 provide the Commission with an action plan of refurbishment of the premises. Care The person managing the service 31/10/09 Standards must register with the Act 2000, Commission to ensure Part II (11 compliance with this section of (1)) the Care Standards Act. The Commission must be informed in writing of the action taken to comply with this requirement. Outstanding from 31/10/08 but we acknowledge that another new manager has been appointed Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 24 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 OP12 Good Practice Recommendations Management should ensure social care plans reflect resident choice and interest. Consideration should be given to the recording of activities to ensure activity staff spend appropriate amount of their time with residents. Transport: it is recommended that the home consider providing a vehicle so that residents can take excursions into the local community. 2. OP13 Gallions View Nursing Home DS0000006761.V376777.R01.S.doc Version 5.2 Page 25 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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