Care Home: Garlands Residential Care Home

What the care home does well There were many positive comments received from people living in the home such as, "Its wonderful here, staff are wonderful, its home". Another said "The staff are very good and the home is beautifully clean". The home provides a caring, warm and friendly environment for people. The staff are caring and considerate to individual needs and work hard to ensure people experience a homely environment. The registered person purchased the home in May 2007 and has worked hard to make improvements to the building. People are provided with food they enjoy. The homes owners are making improvements to menus to ensure people are provided with a choice of meals that are enjoyable and nutritional. What has improved since the last inspection? The registered person has worked hard to ensure there are continuous improvements to the building such as some redecoration and repairs. What the care home could do better: Greater care is required in the way medication is dealt with to ensure it is safe and protects people. The recruitment procedure requires some improvement so that it is robust and protects people. CARE HOMES FOR OLDER PEOPLE Garlands Residential Care Home Church Street Heckmondwike West Yorkshire WF16 0AX Lead Inspector Bronwynn Bennett Unannounced Inspection 1st November 2007 08:15 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 Garlands Residential Care Home DS0000069799.V353914.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. Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Garlands Residential Care Home Address Church Street Heckmondwike West Yorkshire WF16 0AX 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) 01924 477345 davidgill@bolland03.fsnet.co.uk David Bolland Miss Linzi Bolland Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 20 2. Date of last inspection Brief Description of the Service: Garlands Residential Home is a privately owned and managed care home providing personal care and accommodation for up to twenty elderly men and women. Garlands residential Home is a detached property set in attractive gardens and grounds. There is a small car parking area and ramped access to the front of the property. The home is on two levels, the upper level being accessed via a chair lift or stairs. The care home is staffed twenty-four hours a day. The Provider informed the Commission for Social Care Inspection on the 1/11/07 that the fees range from £344.66 to £368.12 per week. Information about the home and the services provided are available from the home in the statement of purpose and service user’s guide. Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included an unannounced visit. The visit began at 8.15am and finished at 3.45 pm. During this visit the inspector spoke to people living at Garlands Residential Care Home, some staff, the manager and the registered provider. The inspector read records of people’s care and records about staff working at the home, looked at how medicines are given and looked at the accommodation available in the home. There were nineteen people living at the home on the day of this visit. Before this visit the Commission for Social Care Inspection sent out questionnaires. Seven questionnaires were received from people living at the home and their relatives. Prior to this visit the manager gave the CSCI information that had been requested, for example about any illnesses, accidents and incidents and how the home is managed. The inspector would like to thank everyone for their assistance during this inspection process. What the service does well: There were many positive comments received from people living in the home such as, “Its wonderful here, staff are wonderful, its home”. Another said “The staff are very good and the home is beautifully clean”. The home provides a caring, warm and friendly environment for people. The staff are caring and considerate to individual needs and work hard to ensure people experience a homely environment. The registered person purchased the home in May 2007 and has worked hard to make improvements to the building. People are provided with food they enjoy. The homes owners are making improvements to menus to ensure people are provided with a choice of meals that are enjoyable and nutritional. Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 6 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. 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. Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. People who use 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. No individual moves into the care home without having their care needs assessed. EVIDENCE: The way people are admitted into the care home was discussed with the manager. Pre-admission assessments and social work assessments were looked at. Good practice advice was given to the manager about the level of information required in a pre-admission assessment. This is so staff at the home know what people’s needs are and how they can be met. Four out of the six people who responded to the survey said they had received sufficient information about the care home before deciding if it was the right place for them to live. Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 9 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 and 10. People who use 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. Health, personal and social care needs are set out in individual care plans and generally people’s health care needs are met. The home’s medication procedures need to be updated in order to fully protect people from medication errors. People are treated with dignity, respect and privacy. EVIDENCE: Positive comments were received from everyone who took part in the survey when asked if they receive the care and support they need, and if staff are available when needed, people said that staff listen and act on what they say. Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 10 The care records for three people were looked at. The information was person centred and reflected individual choice and care needs. There was also information about individual life experience, social and cultural needs, such as family, religion and the individuals preferred lifestyle. Generally there was sufficient information available to staff to ensure individual care needs can be met. All the records looked at showed the individual had been involved in their care plan and were reviewed and up to date. Nutritional risk assessments and assessments to measure an individual’s risk of developing a pressure sore were seen in the care records and there was information to show that people had been referred to the appropriate professional where there were concerns to health, for example, GP or dietician. There were care plans and risk assessments to ensure people are moved safely. However one care record required improvement, as the inspector observed one individual being moved inappropriately by the staff. This was discussed with the manager who agreed to take immediate action and seek further support and guidance from a manual handling advisor. The content of the daily records requires some improvement so that they reflect the individual care plan, and reflect the care and support being given by staff. The medication and medication records checked for two people were correct. However there was an error in the PRN (when required) medication belonging to another individual. This was discussed with the manager who agreed to take immediate action in the matter. Where the instructions for dispensing medication shows one or two tablets may be given the MAR (medication administration record) must clearly show how much medication has been administered to that person. One person has chosen to continue to administer some of their medication and require some support from staff to do so. It is a recommendation of this report that the manager arrange suitable training for staff, through a district nurse for example, to ensure this practice is safe and protects the person concerned and staff. The manager agreed to deal with this matter as soon as possible. Throughout this visit the people living at the home were seen being treated in a dignified and respectful manner by the staff and respecting privacy and dignity was recorded in the care records looked at. Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 11 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 and 15. People who use 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. Individual cultural, religious, social needs are being met and people are supported to maintain contact with their family and friends. People are able to exercise choice and control over their lives. The home provides the people living at the home with a varied and nutritious diet. EVIDENCE: The home arranges activities every afternoon. Some entertainment is brought into the home such as motivation to music and a singer. The hairdresser visits the home every week and people go out to the local pub, shops and the local church. There are also trips being planned for Christmas shopping and lights and to the bingo one evening each week. A relative who responded to the survey felt there should be more activities arranged in the home and the registered provider said the home was trying to improve the range of activity currently provided to people. Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 12 During this visit people were seen visiting the home. The manager said that there are no restrictions on visiting. One person had chosen to go out with their relative, and people are supported to go out into the community. The home provides specialist diets such as diabetic meals. The manager said the three-weekly menu currently available is in the process of being changed. There is a choice of food available at every meal and the home has recently been awarded a four star rating from Kirklees Council. Everyone spoken to during this visit said that there is a choice of food available, plenty to eat and the standard of meals served was good. The meals served during this visit looked appealing and were well presented. The inspector sampled a desert that was very nice. Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 13 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 and 18. People who use 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 living at home and their relatives are confident their complaints will be listened to and acted upon. Individuals are protected from abuse. EVIDENCE: There has been one concern raised about the home and brought to the attention of the CSCI who are satisfied that this concern has been suitably investigated by the registered provider. Everyone who responded to the survey said they knew who to speak to if they were not happy and six out of seven people knew how to make a complaint. There were positive comments gained from the relative surveys and one relative said there are notices posted around the home about that gives information on how to make a complaint. One of the staff spoken to during this visit had a good understanding of adult protection (safeguarding) matters, and all staff have received safeguarding training to ensure they know how to respond should there be any allegations of abuse in the home. Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 14 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 and 26. People who use 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. Generally people live in a safe and well-maintained environment. The home is clean and people have comfortable rooms with their own possessions around them. EVIDENCE: Everyone who responded to the survey said the home is fresh and clean. During this visit one person commented that the home is “beautifully clean”. The inspector had a look around the home and it was fresh and clean. Since purchasing the home the registered provider has worked hard to make improvements. There has been some redecoration and general repairs. The dining room is being improved with replacement flooring and new furniture. Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 15 Some individual rooms were seen and had been personalised by the person with items such as pictures, personal effects and bedding. The registered provider said there will be a rolling programme of maintenance put in place to ensure the home is safe and in a good state of repair. The homes laundry facilities looked clean but require some organisation and removal of clutter. This was discussed with the manager who agreed to deal with this matter. The inspector accepts that the home has recently been purchased by a new provider, and that time needs to be allowed to identify and carry out any improvements to the home. Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally staff are employed in sufficient numbers and receive training to ensure they are competent to do their jobs. Generally people are protected by the home’s recruitment practices. EVIDENCE: Everyone who responded to the survey said the staff were available when needed and listen and act on what they say. A relative commented in the survey that “the staff are very helpful”. Another said “staff are caring and respectful, they look after my mum with loving care. Anything she wants they try to get her”. People spoken to during this visit said the staff are caring and supportive. The staff provide a homely atmosphere for people to enjoy. During this visit staff were observed being caring towards people and treating people with dignity and respect. The records for three staff were looked at. The records contained some of the required information to ensure the way the home employs its staff protects people However, none of the records contained a full employment history and the manager was still awaiting a reference for one of the staff. This was Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 17 discussed at the time with the manager who agreed to take immediate action in the matter. All new staff undertake basic induction training and the home is currently working towards staff completing “Skills for Care” induction standards. (Skills for Care is the national training organisation). Eleven staff have achieved the NVQ level 2 or in care. The manager said that some staff are waiting to be registered for this training. The home has worked hard to ensure all its staff receive basic training to ensure they are competent to carry out their role. All staff have completed adult protection (safeguarding) training, fire and manual handling training. In addition many staff have undertaken or training is planned in food hygiene, first aid, health and safety and infection control. Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 18 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 and 38. People who use 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. The home is run and managed by a person who is fit to be in charge and run in the best interests of people who use the service. The financial interests of people are safeguarded. Generally the health and welfare of everyone is promoted and protected. EVIDENCE: The home’s manager is Ms Linzi Bolland, she has many years experience of working with older people and it expected she will commence NVQ level 4 in the near future. Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 19 A quality assurance audit has been carried out, the results of which have been published and made available in the home. The registered provider is available in the home on a daily basis and staff meetings take place. One relative commented in the survey: “the new owners are interested and caring and making improvements to the home itself; and liaising with residents and relatives to improve their quality”. Three individual finances and financial records were checked and were correct. The fire records were checked. There is weekly testing of the homes fire alarm system and the manager said the emergency lighting is also checked. However there were some gaps noted in the recording of emergency lighting. The manager agreed to address the matter immediately and ensure that all the appropriate records are kept relating to fire safety. Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 20 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 3 14 3 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 Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NA 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. 3. 4. 5. 6. Refer to Standard OP7 OP8 OP9 OP9 OP29 Good Practice Recommendations The daily records kept should fully reflect the individual care plan and how that person has spent their day. Where there are concerns about how to move a person safely advice should be sought from the appropriate professional. The recording of all PRN medication should be made clear on the MAR (medication administration Record). To ensure the safety of everyone, staff require the appropriate training in order that they are competent to support people who self administer their medication. To ensure people are protected from unsuitable members of staff, all staff records should contain a full and employment history and two written references. Written records are required for all emergency lighting checks to demonstrate that such checks have been carried out and any faults have been remedied. OP38 Garlands Residential Care Home DS0000069799.V353914.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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. 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