Care Home: Glebe House

What the care home does well This home provides a safe, comfortable, clean and homely environment for residents. The gardens and grounds are well kept and offer an attractive outdoor space for residents to enjoy. Staff are kind, patient and attentive to residents. The staff work hard to put into practice the organisations stated aims and objectives of care for the people who live here. Residents are encouraged to give their opinions about how the home is run; including the meals and activities provided, and the manager and staff act on peoples` suggestions. The home has a good training and development plan for staff and staff are encouraged to learn and share their experiences with others, to improve the quality of care for the people who live here. Glebe House is part of the local community and there are good links with other organisations so that residents are able to maintain their interests and contacts. A range of activities and outings (using the homes minibus) are offered, giving people interesting and stimulating things to do. The home has good support from local doctors` surgeries, NHS and social services so that residents` health care needs are met. What has improved since the last inspection? There is a programme of continuing redecoration. New furniture has been provided in all the dining areas, and communal areas and several rooms have been re-carpeted. The front area of the home has been landscaped. Staff have had additional training in caring for people living with dementia and this has helped them to develop `person-centred` care and improve communication with residents and their families about the best way to support and care for residents with poor memories. The way in which peoples care plans (the information about each resident`s care and support needs) are written is being improved, to make sure that each person`s likes and dislikes and the way they want to be supported and helped, is clearly set out for care staff to know what they need to do. What the care home could do better: CARE HOMES FOR OLDER PEOPLE Glebe House 8 Mill Street Kidlington Oxfordshire OX5 2EF Lead Inspector Delia Styles Unannounced Inspection 6th March 2008 11:00 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 Glebe House DS0000013155.V359338.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. Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glebe House Address 8 Mill Street Kidlington Oxfordshire OX5 2EF 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) 01865 841859 01865 841194 manager.glebehouse@osjctoxon.co.uk www.oxfordshire.gov.uk The Orders Of St John Care Trust Acting manager Care Home 40 Category(ies) of Past or present alcohol dependence over 65 registration, with number years of age (3), Dementia - over 65 years of of places age (18), Learning disability over 65 years of age (3), Old age, not falling within any other category (40), Physical disability over 65 years of age (10) Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 40. 11th July 2006 Date of last inspection Brief Description of the Service: Glebe House is a purpose built care home providing personal care and accommodation for 40 older people. The single storey building provides single rooms with shared bathroom facilities and the care home is divided into five wings. Each wing has a small lounge/dining area and there is also a large communal dining area. The home is set in its own grounds within a quiet residential area of Kidlington, although local facilities are within walking distance, and the home has transport available to enable the residents to access the wider community. The home is very much part of life in the local community of Kidlington, and the majority of residents has family or other links with the area. The fees currently range from £600 to £700 per week. Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection of the service was an unannounced ‘Key Inspection’ during which we assessed a number of the standards considered most important (‘key’) by the Commission out of the 38 standards set by the government for care homes for older people. The inspection visit took place over 7 hours and was a thorough look at how well the service is doing. We took into account detailed information provided by the service’s managers in the form of the Annual Quality Assurance Assessment (AQAA) - a self-assessment and summary of services questionnaire that all registered homes and agencies must submit to the Commission each year; and any information that we have received about Glebe House since the last inspection. A number of our questionnaires (surveys) were delivered to the home for people to have the opportunity to share their views about the home with us. The results of the surveys were not received in time for inclusion in this report. A tour of the building, and inspection of a sample of the records and documents about the care of the residents and the recruitment and training of staff, were part of the inspection. Talking with a number of residents, visitors and staff gave us information about the home and peoples’ opinions about what it is like to live here. The home’s manager was available during the inspection and an operations manager from the Orders of St John Care Trust was present for the first part of the day. Feedback was given to the manager at the end of the visit. We would like to thank all the residents, manager and staff for their welcome and assistance both on the day and in taking time to complete surveys. What the service does well: This home provides a safe, comfortable, clean and homely environment for residents. The gardens and grounds are well kept and offer an attractive outdoor space for residents to enjoy. Staff are kind, patient and attentive to residents. The staff work hard to put into practice the organisations stated aims and objectives of care for the people who live here. Residents are encouraged to Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 6 give their opinions about how the home is run; including the meals and activities provided, and the manager and staff act on peoples’ suggestions. The home has a good training and development plan for staff and staff are encouraged to learn and share their experiences with others, to improve the quality of care for the people who live here. Glebe House is part of the local community and there are good links with other organisations so that residents are able to maintain their interests and contacts. A range of activities and outings (using the homes minibus) are offered, giving people interesting and stimulating things to do. The home has good support from local doctors’ surgeries, NHS and social services so that residents’ health care needs are met. What has improved since the last inspection? What they could do better: We found that the home meets the needs of the people who live here well. The manager and home owner (the Orders of St John Care Trust – OSJCT) are committed to maintaining and improving the standards further and have identified and planned how they will do this. There were a few good practice recommendations made at the inspection The new care plans should be further improved by describing in more detail what actions staff need to take to best support and help residents; and to what extent residents feel the care they receive is effective – and if not, what changes will be made to improve this. The system of admitting people for short ‘respite’ stays has changed, with people being referred and allocated by social services. This means that the staff do not always have as much information about people and their care Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 7 needs before they come to stay at the home. This should be reviewed so that the staff can be confident they know what kind of support and care is needed and the planned discharge arrangements, before the person is admitted. The home should provide more storage space for equipment – such as hoists, wheelchairs and activities materials – so that bathrooms and other communal space used by residents is not taken up for storage. 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. Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 8 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 Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 9 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. Standard 6 does not apply, as the home does not provide intermediate care. Quality in this outcome area is good. Personalised assessment of care needs means that prospective residents’ diverse needs are identified and planned for before they move in to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager confirmed that a full needs assessment of prospective residents is undertaken by a suitably qualified staff member (a Care Leader with NVQ Level 3 or equivalent). Peoples’ preferences about their care and other information from professionals such as nurses, GPs and social workers are taken into account during the assessment. Overall, the sample of residents’ care records seen showed that the assessment process is satisfactory and that new residents are admitted for a Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 10 trial period of four weeks so that both the resident and the home can decide whether Glebe House can meet their assessed support and care needs. It was less clear whether the home’s staff have sufficient assessment information for people coming into the home for planned short ‘respite’ care periods. The manager explained that the system of respite care provided through social services has changed and that now people not previously known to the home may be allocated to come in to Glebe House. Staff have to rely on information provided by care managers. It appears there is a potential for the manager and staff of the home to have insufficient information about shortstay residents’ care and support needs and this may compromise the standard of care that the resident receives. The home should review the procedures in place for accepting respite admissions, to ensure that the staff have the necessary information about peoples’ care needs and can prepare and plan their care as far as possible before admission. Glebe House DS0000013155.V359338.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. The health needs of residents are well met with evidence of good multi disciplinary working taking place on a regular basis. The systems for the administration are good with clear and comprehensive arrangements being in place to safely meet residents’ medication needs. Personal support in the home is offered in a way that promotes residents’ privacy, dignity and independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection further work has been done to develop and improve the way in which residents’ health and care needs are set out in written plans of care. A sample of the new format care records was looked at; these are in individual folders for each resident, and are well organised. The care records seen contain a lot of assessment information – e.g. how much staff care/support the person needs, risk of developing pressure-related Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 12 skin damage (‘bed sores’/’pressure ulcers’). However, many of the actual plans of care were not detailed enough to show what actions staff need to take to meet the assessed care/support need of the resident. The care records show evidence of a monthly review, but this was generally a date and comment ‘no change to care plan’. There was little evidence of evaluation of the care provided or that the resident’s opinion is invited when the care plans are reviewed. It was clear when speaking with the manager and staff that they have a clear understanding of individual residents’ cares needs and preferences in practice. This ‘person-centred’ approach to care should be reflected in the way the care records are written and evaluated. The manager said that they are developing the way in which ‘life story’ information – for example, previous employment, hobbies and interests - is gathered from residents and their families to help staff get to know residents and their likes and dislikes more effectively. The manager confirmed that since the last inspection, staff have had training in, and use a recommended method of assessing peoples’ nutritional status (the Malnutrition Universal Screening Tool – MUST). If people are found to be ‘at risk’ of being undernourished, the staff will take action to try and improve their diet and, if necessary will refer to the GP and dietician for advice and diet supplements. The home has good working relationships with the local GP’s (from 4 local medical practices) and community nurses and they visit residents regularly as needed. There was evidence that people are supported to access and receive dental care, podiatry, sight and hearing tests. A district nurse was visiting to provide care for three residents during the morning of the inspection. The nurses maintain their own records of care for residents that are held in the clinical room. We recommend that the home staff should write in residents’ care records when a community nurse has provided treatment for an individual and cross-reference to the nurse’s records, so that the resident and staff are clear about the treatment plan. The staff follow the policies and procedures for the safe storage and management of medicines in the home, so that residents receive their prescribed medicines correctly. A check of the medicines storage area and a sample of residents’ Medicines Administration Records (MAR) charts showed that these are well managed and up to date. A local high street pharmacist, who dispenses and supplies residents’ prescribed medicines, undertakes regular visits to the home to check that the organization and systems are satisfactory. Care staff who have responsibility for administering medicines to residents have attended the recommended accredited course in safe Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 13 administration and handling of medicines. Observation of interactions between staff and residents showed that residents feel comfortable and relaxed in the home and able to influence their care and ‘do their own thing’ as far as possible. From discussion with residents and relatives and observation on the day of the inspection it was evident that residents do feel respected and their individuality is recognised and supported by staff here. As is the case in many hospital and residential care environments, staff come from more varied racial and cultural backgrounds than residents. The OSJCT ensure that staff are aware of issues relating to equality and diversity and antidiscriminatory and oppressive practices. From the evidence seen and comments received, we consider that this home would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. Residents have a good range of activities and social opportunities available that suit their preferences. The meals in this home are good, offering choice and variety to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Situated in a large village, residents have access to local shops, garden centre, pubs, churches and a library. Glebe House has a minibus and this is well used for taking people out and about to local events ad places of interest. The home employs a part-time activities organiser who is planning to increase her hours to full time. Photo displays on notice boards around the home and a folder of photos for residents and families show that the range of activities and social events enjoyed in recent months. Each resident now has a folder of activities – a photo record of activities they have been involved in – to share with families and visitors. Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 15 The activities organiser plans to improve the range and choice of activities, based residents’ suggestions about what they would like, and working with volunteers from the local community and the League of Friends for the home. Examples of recent developments in links with the local community were seen in the artwork (a striking wall tapestry) on display in the dining room that was created by local school children and residents at Glebe House. A ‘Men’s Club’ has been set up so that some of the men living here go out for lunch at a local pub and play pub games. The homes’ own Resident Quality Questionnaire carried out in 2007, showed that, in relation to Activities, 15.9 of the people who completed questionnaires felt that activities were ‘excellent’; 46 stated ‘good’ and 38.1 ‘adequate’. The daily programme of activities is displayed on notice boards within the home, informing people about organised activities available through the week, and care staff inform residents on a daily basis of the activities for that day. Activities include art and crafts, bingo, quizzes, a number of games, shopping trips and outside entertainers who visit to provide entertainment. During the afternoon of the inspection a musician entertained and invited peoples’ participation in songs and playing instruments. This is part of a countrywide scheme of bringing music into residential settings and this session (one of a series held in the home) was much enjoyed by residents. The dining room is bright and spacious with residents seated at tables for a maximum of four. Residents who prefer to can take their meals in their own room or the smaller lounge/dining rooms on each unit. The homes AQAA states that cook and chefs have attended more training and have improved and reviewed the menus (in consultation with residents). The home plans to improve the meal service, for example, by providing more cutlery and serving dishes so that people who are able can help themselves to vegetables at table, and introducing a ‘sweet trolley’ so that people can see what is on offer and make their choices. The staff regularly do ‘spot checks’ to gauge residents’ opinions of the food through completing ‘meal satisfaction’ records. On the day of the inspection residents spoken with said their lunch was good and they usually enjoy the meals. The homes’ own most recent (2007) Residents’ Quality Questionnaire results for Catering showed that 27.6 considered it ‘excellent’, 59.3 ‘good’, 12.3 ‘adequate’ and 2.5 ‘poor’. Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 16 The home has no restrictions on visiting, and several visitors were seen in the home during the day. The inspector had conversations with two visitors who said that they were made welcome by the staff and how they appreciated the care and attention their relatives received in the home. Residents are able to receive visitors in their own bedrooms or in the communal lounges. From what was observed on the day and residents and staff comments it is clear that staff always make visitors feel welcome. Again this was shown in the homes own survey results (2007): the welcome from staff, refreshments and facilities offered to visitors and communication with staff was rated by 41.2 as ‘excellent’, 43.3 as ‘good’, 12.4 as ‘adequate’ and 3.1 ‘poor’. Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is good. The home has a satisfactory complaints system and the practices and procedures in place ensure that residents feel their views are listened to and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The OSJCT complaints policy is clearly written and provides clear stages and timescales for investigation of complaints by the home and responses to complainants. A summary of any complaints or compliments received is available and updated each month. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection and the manager confirmed that she has not received any complaints. All the homes staff have had training about how to identify and report suspected abuse (Safeguarding of Vulnerable Adults). As part of their induction new care staff have training about safeguarding of adults that meets the Skills for Care standards. All new staff receive copies of Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 18 the General Social Care Council (GSCC) Codes of Conduct that set out the standards expected of employers and employees involved in social care. All staff are also given a copy of the organisations ‘whistle-blowing’ policy that explains their responsibility to report any poor or abusive practices that they witness and the organisations comittment to support them to do this, in order to protect vulnerable people in their care. Regular updates in safeguarding issues are part of the ongoing training and development of staff. Feedback on all aspects of the service are encouraged and actively sought through regular review meetings with individual residents, their family member(s) or representative, and the manager. Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. The standard of the environment both in and outside this home is good, providing residents with an attractive and homely place in which to live This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector walked around the home: all areas of the home were clean, tidy and fresh smelling. Residents and visitors were particularly complimentary about the standard of cleanliness and the upkeep of the home and gardens. Since the last inspection, the programme of re-decoration and replacement of old furniture and carpets has improved the home in a number of areas, for example, new flooring and furniture in communal rooms in all 5 units and dining rooms and redecoration and refurbishment of a number of bedrooms. The former staff ‘sleep-in’ room has been converted to a meeting room where private review and supervision meetings take place. The grounds at the front Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 20 of the home have been landscaped as part of the on-going development of the gardens. Future plans for improvement in the next plans are to upgrade the bathrooms throughout the home and the hairdressing room. The home has limited space for the storage of equipment such as hoists, wheelchairs and materials needed for activities, so that bathrooms and the meeting room are used. This means that residents’ access is limited in some rooms. The home should review and improve the amount of storage area available for aids and equipment. The homes own quality questionnaire for 2007 showed that just over 50 of people considered that their private bedrooms and communal facilities are ‘good’; 25.9 of people thought their private rooms were ‘excellent’ and 30.3 that this was so for the communal facilities. Outside, the garden and grounds are very well maintained and attractive, with lawns, flower borders and container plants and a rose garden. Each unit overlooks a small patio area and garden, with garden seating and shades, so that residents can enjoy the use of the grounds fully. A fishpond is another attraction in the patio garden next to the entrance to the rear garden. The homes AQAA states that, by ‘reorganising personnel’ the laundry service has improved. Residents’ clothing looked clean and well pressed and bed linen and covers were in good condition. A relative spoken with was complementary about the way in which staff make sure that residents ‘always look nice and have clean clothes’. Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome area is good. There is a good match of well-qualified staff offering consistency of care to residents. The recruitment and training practices of the home are good, so that residents are safeguarded from potential risk from unsuitable or poorly trained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Analysis of the duty rota, and checks of the numbers of staff working on the day of the inspection, showed that the number and skill mix of staff appear to meet the needs of the residents. Despite a relatively high turnover of staff in the past 12 months the manager said that recruitment has been successful and the home does not use agency staff. The manager said that there are 2 care staff on duty over night, but this would be increased to 3 from April 2008. The homes AQAA states approximately half of the residents have dementia and a third of all residents need at least 2 members of staff to assist them day and night. An increase in the number of night staff should improve the availability of staff and care for residents overnight. Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 22 The homes 2007 Quality survey shows that people are very satisfied with the overall standard of care provided by staff – 51 considered it ‘excellent’ and 45.5 ‘good’. A sample of 3 staff members’ files was looked at and showed that there are thorough systems in place for the recruitment and screening of new staff before employing them to work at the home so that residents are protected as far as possible from unsuitable employees. Induction training for new care staff consists of a day of ‘e-learning’ – working through a computer programme with assistance – and a day of corporate training. New care staff also ‘shadow’ an experienced member of the care team for as long as necessary so that they are confident, safe and competent in their work with residents. New staff have to satisfactorily complete a 6-month probationary period. Records show that all staff have regular formal supervision meetings and an annual appraisal, so that they have support and training to achieve the expected standard of work and opportunities to progress in their career. Care staff are encouraged to do National Vocational Qualification (NVQ) training in care. Six of the 28 care staff have NVQ Level 2 and 4 Team Leaders have achieved NVQ Level 3. A further 5 care staff are working towards Level 2. This means that the home should soon achieve the recommended proportion (50 ) of care staff with NVQ Level 2 qualification. OSJCT has an established programme of staff training and its own dedicated training staff, including an NVQ centre, so that all staff have access to training and development. All care staff have attended a two-day training course about caring for people living with dementia; this has been very successful in helping staff to improve their understanding and care of residents with failing memory. Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 23 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 Quality in this outcome area is good. The system for consulting residents and their representatives about the way in which the home is run, and the care and facilities, is good and shows that residents’ opinions are both sought and acted upon. The health, safety and wellbeing of residents and staff is protected by the homes policies and procedures. This judgement has been made using available evidence including a visit to this service. Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 24 EVIDENCE: The current manager of Glebe House has a Bachelors degree in Management and Marketing and is currently working towards NVQ Level 4 in Management and the Registered Managers Award (the formal qualifications required by the for managers of services registered by the commission) She has applied to the commission to become the registered manager for Glebe House. The manager has worked for more than 6 years in residential care services and appears competent and knowledgeable. Care Leaders and an administrator support the manager in her role. We discussed the management of residents’ personal allowances and the systems in place that ensure that residents’ are not at risk of financial abuse. Those residents who are no longer able or do not wish to, manage their own money have relatives or an appointed person to do this on their behalf. Each resident (who chooses to) has a personal named account with a local high street bank. Small amounts of cash held in the home on residents’ behalf, can be made available to the resident on request from the care leader or administrator. The OSJCT sends out a ‘Resident Quality Questionnaire’ each year. The questionnaires are analysed by the OSJCT Quality Assurance Manager who arrives at an overall quality rating for each of the care homes. The results of the questionnaires are set out in a report that is made available to the residents in the home. An action plan is drawn up by the home to follow up any specific problems or suggestions made in the questionnaires. Residents and their relatives are invited to discuss the questionnaire with the home manager or another person from OSJCT. The overall quality rating for glebe House following the 2007 Questionnaire showed that 83.3 considered it to be ‘excellent’, 11.1 ‘good’ and 5.6 ‘poor’. The manager has an ‘open door’ policy and residents are encouraged to discuss their views. The manager also goes around the home on a daily basis to chat with residents and listen to any concerns they may have. The home also has unannounced visits from a senior OSJCT manager (as required by us under Regulation 26 of the Care Standards Act 2000) and also from a manager/colleague from another OSJCT home (part of a ‘cluster management’ arrangement). The OSJCT County surveyor and Catering Advisor also visit and provide monthly reports. This means that OSJCT carries out ‘spot’ checks to make sure that the standard of care and facilities for residents is being maintained. The homes Health and Safety policy and procedures are available to all staff and there is regular mandatory training and updates in fire safety, first aid, Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 25 care of substances hazardous to health (COSHH), moving and handling, food hygiene, and infection control. Spot checks of the fires safety and accident records showed that these were up to date. Staff have attended fire safety instruction and drills and several have attended certificated ‘fire marshal’ training with the specialist company used by OSJCT for training. The same company has recently undertaken a fire risk assessment of the property and their report and recommendations are being considered by the OSJCT. There was evidence from conversation with staff, and from the homes staff training and supervision records, that the manager and staff put theory into practice so that residents can be confident in the safety arrangements in place in the home. Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Refer to Standard OP7 Good Practice Recommendations * Ensure that the assessment and care needs of people admitted for short-stay (respite) care are sufficiently detailed and accurate, so that care staff can plan and provide care that safely meets the person’s current care needs. * Ensure that the care plans are sufficiently detailed about the actions staff need to take to meet the assessed care needs and goals of residents. Care plans should be evaluated and changed if necessary so that they remain relevant and up to date. Provide adequate storage space for aids and equipment so that residents’ living and leisure space is freely accessible. 2. OP22 Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Glebe House DS0000013155.V359338.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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