Care Home: Glanmor

What the care home does well Staff support residents to manage their own medication whenever they can. The medication records examined were in good order. The home has a policy in place for all medication, and all staff have medication training. The healthcare professional told us that medication was handled appropriately in the home and that care plans were in place to support people who wished to do so. The risk assessments which are in place for residents were current and clearly linked to care plans. Risk assessments were in place for a number of issues including anxiety and showing physical aggression to staff as well as potential medication problems. In discussion with the staff, it was clear that they were aware of the ways in which residents could be at risk, and were taking measures to avoid these. When we asked the healthcare professional what the home did well, she said: "It`s well organised, and provides a comfortable home for individuals". One staff member said: "For the most part, the service keeps the residents as well as they can be, in a happy environment". One resident told us: "The relationship between staff and residents is very good. I receive positive input and support in everything I do". Another said:" I receive excellent support from my keyworker. They like me to be as independent as possible, which involves doing my own laundry". Another resident said: "I feel happy with the support I get. I am happy with life, but know that I can confront the management with any complaints that I have". What has improved since the last inspection? Care plans were clear and have been clearly linked to any risk assessments needed. All the ones we looked at contained accurate, up-to-date information. This means that all staff and residents can be sure that they are working together in a consistent way to give the support they need to people. All bathrooms and WCs now use single soap and hand towels so that any risk of cross-infection is minimised. What the care home could do better: Some decorating has been done since our last visit. There has been a new kitchen, boiler and utility room fitted. One bedroom was decorated for the new resident moving in, and another two have been painted and the residents are being consulted about new carpets for their floors. However, some carpets in the hallway and stairs very dirty and worn, leaving the main entrances looking shabby. The downstairs toilet floor has cracked and has torn lino and paint peeling of the walls. It also has a broken toilet roll holder. This could leave residents open to any cross infection. The dining room walls were peeling paint and dirty. The manager explained that there is a cyclical programme of renovation, and that some of this work is done by ABLE and some is done by the housing association. The manager has been told to replace the carpet and the lino and to have the rooms with the peeling and dirty walls painted, so that residents can live in a homely, comfortable environment which is free from any risk to infection.When we asked the healthcare professional how she thought the service could improve, she said: "By increasing confidence in staff to deal with matters in the home regarding individual health needs". Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Glanmor Bath Road Chippenham Wiltshire SN15 2AD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alyson Fairweather     Date: 0 2 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Glanmor Bath Road Chippenham Wiltshire SN15 2AD 01249651336 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : able.glanmor@virgin.net ABLE (Action for a Better Life) care home 7 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 7 Glanmor is a large, detached house converted from two semi-detached homes. It is situated within walking distance of Chippenham town centre and provides a service for seven residents who have or are recovering from mental illness. The home has a close support network with the local community psychiatric team. Glanmor is managed by ABLE (Action for a Better Life) and Sarsen Housing Association owns the property. There is a large secluded garden surrounding the home, with a paved patio area, and a car park at the rear. The current fees charged by Glanmor are 650 pounds to 700 pounds per week, although these are subject to review. Care Homes for Adults (18-65 years) Page 4 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place on 2nd July 2009. Five residents, the manager and several care staff were present and spoken to. Two residents wrote to us, as well as one member of staff and one health professional who has a client living in Glanmor.We walked round the premises and examined several records, including care plans, risk assessments, health and safety records, and staff training. We also received an Annual Quality Assurance Assessment (AQAA) from the manager. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Care Homes for Adults (18-65 years) Page 5 of 29 Care Homes for Adults (18-65 years) Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Some decorating has been done since our last visit. There has been a new kitchen, boiler and utility room fitted. One bedroom was decorated for the new resident moving in, and another two have been painted and the residents are being consulted about new carpets for their floors. However, some carpets in the hallway and stairs very dirty and worn, leaving the main entrances looking shabby. The downstairs toilet floor has cracked and has torn lino and paint peeling of the walls. It also has a broken toilet roll holder. This could leave residents open to any cross infection. The dining room walls were peeling paint and dirty. The manager explained that there is a cyclical programme of renovation, and that some of this work is done by ABLE and some is done by the housing association. The manager has been told to replace the carpet and the lino and to have the rooms with the peeling and dirty walls painted, so that residents can live in a homely, comfortable environment which is free from any risk to infection. Care Homes for Adults (18-65 years) Page 7 of 29 When we asked the healthcare professional how she thought the service could improve, she said: By increasing confidence in staff to deal with matters in the home regarding individual health needs. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective clients and families are given information leaflets so that they can choose whether or not they wish to use the service. All residents have their individual needs assessed before they arrive, so that staff know how best to support them Evidence: The home has a comprehensive Statement of Purpose and Service User Guide which give an overview of the service which will be provided. This has recently been updated, and a copy is given to every potential resident. It gives details of the organisations complaints procedure. Of the two residents who wrote to us both said they had been asked if you wanted to move to the home and that they had received enough information before they moved in. One person said: From the very first day of moving in I have enjoyed living at Glanmor. On the very first day I moved in there was a barbecue, and I remember thinking I would be happy here - and still am. Another said: I have been kept informed about Glanmor both before and since moving in. Most residents have been at Glanmor for some time. If an independent referral is Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: made, information would be received from medical teams and from various other professionals. Each new resident would be offered a series of trial visits, in order to give them time to get to know the home, the other residents, and the staff. Staff would try to find out what they would like to do with their daily routine before they move in. The referring mental health teams would provide a copy of the most recent Personal Recovery Plan, which gives details of how the potential resident can best be supported with their mental health needs. The most recent resident was admitted last year, so we looked at that persons records to see what information had been received by the home. The referral agency, the Community Mental Health Team (CMHT) had completed an extensive application form, although no previous risk assessments were attached, and no previous care plan info was given. The manager, Ms Hamblin and a colleague went to visit the previous care home where the person was living. They asked the staff there for information and spoke to the resident themselves. They had a list of questions they uses, but no formal assessment template. We have recommended that they develop one for their own use so that the information gathered about a new referral can be standardised. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans reflect the needs and personal goals of residents, who are assisted to make decisions about their own lives. They are supported to take risks where appropriate, and encouraged to be as independent as possible. Evidence: A great deal of work has been done by staff in relation to compiling care plans for residents. Each plan now has an index page which quickly shows where to find specific care plans. Care plans include information on communication, accommodation, literary skills, health and social activities, as well as individuals personal Recovery Plans. Care plans have been reviewed regularly, but are also done so when the situation has changed, and are signed by the resident. A system of daily records is in place, and a weekly rota of activities is kept for residents. When we asked staff if they are given up-to-date information about the needs of the people they support or care for in the care plan, everyone said that they did. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: Residents are supported to make decisions about their own lives with guidance from the staff. They are encouraged to manage their own finances wherever possible, although some have family involvement and other support. Four people handle their own financial affairs (two with support). One person has a corporate appointeeship, one has a court of protection order and one persons family manages their money for them. Where restrictions are in place, for example to limit self harm or harm to others, this is clearly recorded and guidelines are drawn up for staff to follow. When we asked if the care service respects individuals privacy and dignity, the care professional who wrote to us said: usually. She went on to say that staff provide support if individuals have an activity they want to start. She told us that options are given regarding menu choices for the week, allowing people to contribute to what they actually eat. There were risk assessments in place for several residents, some of which had recently been reviewed. Risk assessments were kept alongside the medication records, and were on the residents file. The ones on file were clearly linked to the residents care plans, and these included ones for support during showering, smoking, anxiety and showing physical aggression to staff as well as potential medication problems. One person had a risk assessment which enabled them to counter-sign for their own controlled drugs. This would only be in the event of two staff not being on duty. In discussion with the staff, it was clear that they was aware of the ways in which residents could be at risk, and were taking measures to avoid these. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social and leisure activities are varied and tailored to individual need, with residents choosing what they wish to do. Residents have as much or as little contact with family and friends as they wish, and are encouraged and supported by staff. Residents rights are respected and responsibilities recognised in their daily lives. They are offered a healthy diet and enjoy their meals and mealtimes. Evidence: Residents can choose when to be alone or in company, and when not to join an activity. They have unrestricted access to the home and grounds, and can come and go as they please. In house activities include the use of a computer, arts and crafts, games, gardening, cooking, key work activities, and a take-away night. Outside activities include some people going to Moonrakers workshop, (although this is soon to close down) the Tom Metcalf centre, shopping, going out with a befriender, as well Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: as relatives and friends. One person attends college and has achieved 3 certificates. They are now being supported to find voluntary work in an office. People have regular outings with their key-worker, and the house has begun a recycling project, where glass and paper, amongst other things, is kept for recycling. Of the two residents who wrote to us, both said they made their own decisions about what to do each day. One said: I have a good routine, work three days a week and go out with my befriender once a week. Other days are put aside for personal grooming and keeping my room nice and tidy. Another said: I receive excellent support from my key-worker. They like me to be as independent as possible, which involves doing my own laundry. However, laundry arrangements could be more flexible with the times we can use it during the day. Residents have as much or as little contact with family and friends as they want. Some families visit or have their relative to stay, and three people have a befriender. Residents responsibility for housekeeping tasks, such as doing their laundry or tidying their room is specified in their care plan. Some residents take great pride in keeping their own rooms neat and clean, and some help with the communal areas too. One bedroom has been designated as a room where the person may smoke. A risk assessment is in place regarding this, and the room has fire retardant bedding and curtains, a metal bin and an ashtray. There is a further designated communal smoking room, as well as a large seating area outside. The menu supplied in the home is varied and nutritious, and residents decide on a daily basis what the main meal will be. There was a good supply of fresh fruit and vegetables, and juices and yoghurts were also available. Staff have records of the food likes and dislikes of all residents, and healthy eating options are encouraged. Vegetarian options are available at all meals. There is a small kitchen which residents can use to prepare light snacks and this is equipped with a fridge, a microwave and a toaster. There is also a larger kitchen which has been newly renovated, in which staff prepare main meals, helped by residents when they are able to do so. Some residents are cooking for themselves. The main meal is usually in the evening from Monday to Friday, but at lunchtime on weekends. Staff have had training on diet and nutrition. Care Homes for Adults (18-65 years) Page 15 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents personal support needs are recorded in care plans so that they can receive this support in the way they wish, and their physical and emotional health needs are met. Residents are supported to self-medicate where possible, and are protected by the homes medication policies and procedures. Evidence: Although Glanmor is registered for people with mental health needs, some of the residents develop healthcare problems too, and at such times require personal support. Many of the residents require prompting, guidance and support in relation to personal support, although some direct physical care is sometimes be needed. Personal care is offered in a sensitive and careful manner, with detailed care plans in place, outlining individuals preferences, and how their personal care is managed, whilst helping them to remain as independent as possible. People receive support from staff to maintain their health care needs and there was evidence of further support from GPs and community mental health teams. The care plans recorded input from community psychiatric nurses, psychiatrists, GPs, general Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: medical appointments, opticians and dentists. People who have diabetes have routine blood sugar monitoring. One resident is extremely anxious about attending the dentist, so is able to have some medication which is prescribed for occasional use (PRN) and to be accompanied on the visit. . When we asked if the care service seeks advice and acts upon it to manage and improve individuals health care needs, the care professional said: Sometimes. They often seek advice regarding health care needs, but I sometimes feel they lack confidence in acting upon it. Medication records examined were in good order. The home has a policy in place for all medication, including homely remedies, and all staff have medication training. When PRN medication was given, it was seen to be recorded both in the communication book and in the diary sheet. One resident has need of strong pain-killing medication, and there are good procedures in place to see that this medication is stored correctly and is signed for by two people when it is given. There were good, robust systems in place, and regular stock checks are done, when all medication is counted Some residents are being supported with self-medication. One person looks after all their own medication, and keeps their own dossette box. Another is gradually increasing the number of days they do so. When we asked the care professional if the care service supports individuals to administer their own medication, or manages it correctly where this is not possible, they said: Usually. They described how the agreement for one person to self-medicate was: Clearly set out in a care plan. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents views are listened to and acted on. The policies and procedures the home has in place try to ensure that residents are safeguarded from abuse and harm. Evidence: Weekly resident meetings are held, and people are encouraged to voice any concerns they may have. There is also a complaints book and a suggestions book available for residents. The home has a formal complaints procedure which outlines the steps to take if there are any complaints, and this has just been reviewed and updated. It gives details of how service users and families can contact the Care Quality Commission (CQC). No complaints had been received by CQC about the home. Of the two residents who wrote to us, both said that they knew who to speak to if they were not happy, and that they knew how to make a complaint. One person said: I feel happy with the support I get. I am happy with life, but know that I can confront the management with any complaints that I have. Another said: I have had to complain once about the behaviour of other residents towards me. My complaints were taken seriously and the matter was dealt with promptly and sensitively When we asked if the care service responded appropriately if they or the person using the service have raised concerns about their care, the care professional said: Usually. Meetings are often called if a matter has been highlighted by the team or the resident. Action plans and goals are set. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: The home has copies of the local No Secrets document, as well as the organisational policy and procedure on responding to allegations of abuse. Most staff have had training in safeguarding vulnerable adults, with new staff yet to do so, and are encouraged to report any incidences of poor practice. A Whistle Blowing procedure is available for all staff. One staff member who wrote to us said they know what to do if a service user or a relative or friend has concerns about the home. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a homely, comfortable and safe environment, which is clean and hygienic, although some repairs and refurbishment are needed. Evidence: Glanmor is a detached house converted from two semi-detached homes. It is a comfortably furnished home with large airy rooms. Residents bedrooms were homely and each contained individual personal items. One resident has a play-station so that he can enjoy playing computer games. Most residents have television and stereos in their room. Residents who have small bedrooms have the benefit of another room which can be used as a sitting room. There is a smoking room available, and the main lounge is non-smoking. There is a large, secluded garden to the rear of the house, with a patio area and a car park. Some decorating has been done since our last visit. There has been a new kitchen, boiler and utility room fitted. One bedroom was decorated for the new resident moving in, and another two have been painted and the residents are being consulted about new carpets for their floors. All bathrooms and WCs now use single soap and hand towels. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: Some carpets in the hallway and stairs very dirty and worn, leaving the main entrances looking shabby. The downstairs toilet floor has cracked and has torn lino and paint peeling of the walls. It also has a broken toilet roll holder. This could leave residents open to any cross infection. The dining room walls were peeling paint and dirty. The manager explained that there is a cyclical programme of renovation, and that some of this work is done by ABLE and some is done by the housing association. The manager has been told to replace the carpet and the lino and to have the rooms with the peeling and dirty walls painted, so that residents can live in a homely, comfortable environment which is free from any risk to infection. Of the two residents who wrote to us, one said the home was always fresh and clean, and the other said: usually. One person said: We have a cleaner to keep the communal areas clean and tidy. I am responsible for my own room, with excellent support from the staff. Someone else said: During the week the home is usually clean, but at weekends staff dont do so much. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents individual and joint needs are met by staff who have had induction training, are undertaking NVQ, and are well supervised. They are supported by competent and qualified staff, and by the homes recruitment policy and practices. Evidence: There has been some turnover in the staff team since our last visit, but the home is almost fully staffed, and they are waiting for one person to have their checks done. Some of the new staff have come to work at Glanmor already having their NVQ in place. One staff member said there were usually enough staff to meet the individual needs of all the people who use the service. This supports the comment made by the manager about how difficult it has been as a staff team. She was highly complimentary about how staff have been able to cover all the shifts, without them having to have agency staff employed. When we asked if staff treat them well, one person who wrote to us said: always and the other said: usually. One resident told us: The relationship between staff and residents is very good. I receive positive input and support in everything I do. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: Another one said: Sometimes staff get cross with me when I am angry and shouting, but usually they treat me very well and are very supportive. When we asked if care staff have the right skills and experience to support individuals social and health care needs, the care professional who wrote to us said: Sometimes I feel they lack confidence to deal with matters. There was evidence that new staff have induction training when they start to work at Glanmor. Two new staff members spoken to confirmed that they had had induction training. One staff member who wrote to us said: Since I started, an induction pack workbook has been introduced. Examination of staff file showed this to be the case. One staff member also had certificates relating to English for Speakers of Other Languages (ESOL) from Cambridge University. These showed competence in speaking, listening, reading and writing English. Other staff training has included health and safety, food hygiene, care and administration of medicines, diet and nutrition, care planning, key working and safeguarding children and vulnerable adults. Future training is planned in equality and diversity, awareness of mental health. The staff member who wrote to us said that they are given training which is relevant to their role, helps them understand and meet the needs of residents, and keeps them up to date with new ways of working. All prospective staff are invited to visit the home prior to being interviewed, in order to get a feel of the home and to enable staff to receive feedback from residents. The person is then interviewed and two references are obtained. Staff sign a declaration of criminal convictions prior to the completion of a CRB and POVA check. The management now ask for written feedback after a potential staff visits the home, in order to test written skills. All staff receive a copy of the code of conduct and terms and conditions, and have a three-month probationary period. The home has introduced a system where the main office notifies them when a staff member has had their CRB and POVA check done, whether an enhanced check has been done, the reference number and the date of the check. It is no longer a legal requirement that passport and driving licence details are kept, and these should not be stored on personnel files. Glanmor staff have regular staff meetings and supervision sessions. Supervision records were clear and the meetings had taken place on a frequent basis. The staff member who wrote to us said the manager meets with them regularlyto give them support and discuss how they are working. Another said: I feel able to go to my manager at any time for advice and support. Care Homes for Adults (18-65 years) Page 23 of 29 Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well run home, and their views underpin all self-monitoring and development in the home. The training, policies and procedures in place promote and safeguard the health, safety and welfare of the people using the service. Evidence: The manager was registered with us since 2005. She has completed her Registered Managers Award since then, as well as her NVQ Level 4 in Health and Social Care. She has had experience of working with people with mental ill health and with older people. She has recently had training in manual handling, basic emergency aid, transactional analysis, managing stress, leadership skills and the Mental Capacity Act (MCA). She takes part in an on-call managers rota every one week in three, with the other two people being managers of ABLEs other services. There are regular meetings which discuss service provision, including staff meetings, and psychiatric reviews about individual residents. Residents meetings are also held on a weekly basis. An annual questionnaire is issued to residents, families and outside Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: agencies, seeking their views on the service and asking how it might be improved. This is due to be sent out in the Autumn. As part of the audit process, one of the responsibilities of the senior managers of registered care homes is to visit the home on a monthly basis and to write a report about what they looked at and to whom they spoke. This is to ensure that they are monitoring both the health and safety of the residents as well as the quality of the service offered. The reports completed by the management at Glanmor are of a good quality and identify issues which need to be addressed, not only good practice matters. Of the two residents who wrote to us, one said that staff always listened to them, and another said: Usually. This person said: Sometimes the staff are too busy to listen to what I want to say, but usually they act on what I say if they are not too busy and have got the time. There is a regular routine of health and safety checks in the home. Some checks are done daily, some weekly and some monthly. Fire extinguishers were checked recently. There is a policy of three monthly fire drills, and this was last done on 10th June 2009. The home also has a fire risk assessment with an evacuation procedure in place. Paper hand towels have replaced the use of linen towels in lavatories, in order to lessen the chances of any cross-infection. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 The providers should develop a standard assessment form tailored to the questions they wish to know about a potential new resident. It is no longer a legal requirement that passport and driving licence details are kept, and these should not be stored on personnel files. 2 34 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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