Care Home: Glebefields Care Home

What the care home does well The home is comfortable friendly and safe, and people told us that they receive good health and personal care from the `friendly, well trained staff`. We noted that care is planned around the individual`s needs, and that individual differences are valued and supported. People living in the home are able to make their views known, and know their concerns will be responded to. People with dementia are supported by a familiar environment, and by trained caring staff. A range of suitable activities are provided for all the people who want to take part, and people are encouraged to be independant. Good staff training is provided, and the home`s robust recruitment process helps to keep people living in the home protected from harm. There are good systems in place to help the home to continue improving, and to keep the home safe. The home`s registered manager is skilled and experienced, and there are good systems in place to help her manage the home. One person said the best thing about the home was the way she was able to make friends quickly, and others told us that the food was good, and that the home `does everything well`. What has improved since the last inspection? Our requirement about having photographs of all the staff available has been met. The home`s maintenance and renewal programme has continued and checks on equipment and services improved. There is a group of volunteers to help support the staff team to provide activities and entertainment, and this programme has expanded. Willow Lane, the new unit for people living with dementia has opened, and provides good accommodation and care for the people living there. Several pets are kept and provide a homely touch and companionship for several people. What the care home could do better: The registered manager has identified in the AQAA what the home intends to do to continue the improvements to the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Glebefields Care Home Stratford Road Drayton Banbury OX15 6EH     The quality rating for this care home is:   three star excellent 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: Kate Harrison     Date: 1 9 0 1 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 Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Older People Page 2 of 24 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Glebefields Care Home Stratford Road Drayton Banbury OX15 6EH 01295738133 01295738766 glebefields@majesticcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ross Healthcare Ltd Name of registered manager (if applicable) Mrs Philomena Morton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 48. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Glebefields Care Home is situated in Drayton, a village near to the market town of Banbury, and is owned and managed by Glebefields Ltd, part of Ross Healthcare Ltd. The home provides personal and nursing care for 48 people aged from 60 years. Registered nurses are on duty 24 hours a day. The home is a converted Victorian house and has accommodation on three floors with a lift. Views from most windows are across open countryside. Three bedrooms are Care Homes for Older People Page 4 of 24 care home 48 Over 65 0 48 48 0 Brief description of the care home available as double rooms. En-suite facilities are available in all bedrooms on the ground floor and in all except one in the new extension, Willow Lane. There is a garden, which is accessible to residents. Car parking is available at the front of the home. Care Homes for Older People Page 5 of 24 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was an unannounced Key inspection and was conducted by one inspector over 7 hours during one day. It was a thorough look at how well the home is doing, and took into account detailed information provided by the home through the Annual Quality Assurance Assessment (the AQAA) and any other information we received about the home since the last inspection. We saw documents and records about the care provided and discussed the running of the home with the registered manager. We saw all areas of the home used by the people living there, we looked at how the home manages peoples medication, and we observed lunchtime in the dining room. We spoke to several people living in the home and to staff members and visitors about their experience of the home. We looked at how the home is meeting the standards set by the government, and in this report we make judgements about the Care Homes for Older People Page 6 of 24 standards of the service. The date of the last inspection of the home was 27th March 2007. The fees range from GB pounds 550 to GB pounds 900 per week. What the care home does well: What has improved since the last inspection? What they could do better: 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. The individual needs of the people requesting admission to the home are assessed to make sure that the home can meet their needs. The home does not provide intermediate care. Evidence: The registered manager or her deputy carry out the preadmission assessments, and use the homes document to record the preadmission information. We saw three preadmission assessment documents and talked with the individuals. The registered manager told us that the home sends a letter to the individual to confirm that their needs can be met at the home, and we noted that the home is meeting the needs of the individuals. Care Homes for Older People Page 10 of 24 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of individuals living in the home are known and are met by trained staff members in an attentive, respectful way. Evidence: We saw how health and personal care is managed in the home, including in Willow, the dementia care unit. We noted that a proposed care plan is developed after the preadmission assessment is completed, so that the care staff are able to meet the needs of the individual from the admission date. Risk assessments are completed for health and personal care topics, so that all the necessary information is available when care plans are developed. Care plans are developed to promote self esteem and a feeling of well being, through the psychological assessments, and all the homes staff are trained to look after people with dementia. Everyone living at the home is registered with a general practitioner, and we saw that other healthcare professionals are involved, such as the community psychiatric nurse and podiatrist, and a record is kept of professional visits. Some of the registered nurses take a special interest and training in a specific topic such as prevention of falls and wound care, and are able to Care Homes for Older People Page 11 of 24 Evidence: provide information about best practice to the staff team. The care plans we saw were tailored to the individual, and gave good detail to the care staff so that they know how to look after the individual, for example regarding how one person likes to take medication likes to chew the tablet with a biscuit, and regarding personal care for another person prefers to shower. In the Willow unit risk assessments are also targeted on the individuals vulnerability because of dementia, and risk reduction plans are developed to minimise the risks. Strengths and abilities are recorded, so that the focus is on positive aspects of the individual, and this respects the dignity of the individual. There are policies and procedures to help staff manage medication, as nobody living in the home manages their own medication. We saw that there is a system in place for the ordering and recording of medication, and we checked the medication for one person and saw that it was recorded appropriately. We noted that people are treated with respect by the staff team, that individuals are known to the team and that time spent chatting to people is seen as therapeutic. All the care staff team receive training about the privacy and dignity needs of the people living in the home, and several people told us that they felt respected by the staff team. Care Homes for Older People Page 12 of 24 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported to live daily life as they want, through the homes recognition of their individual needs and preferences. Evidence: Several people told us that they could spend the day as they wanted, getting up and going to bed as they choose. Another said that, as she/he depended on staff to take them to the toilet, at times she/he had to wait. She/he was being supported by the home to move into another room, where access to the toilet will be easier, and she/he knew that more staff were being recruited. We saw that there is a programme of activities planned weekly and monthly, and people living in the home have opportunities to say what needs to be included. One individual is responsible for planning activities and has help from two people working part time and volunteers who come to the home regularly. The activities for people with dementia are organised to meet the individual needs and the individuals supporting them have training about dementia. The staff team also help with activities and recently put on a production of Stars in their Eyes. Group and individual activities are organised, and good use is made of community facilities and opportunities, so that people living in the home are able to attend community events regularly. People living Care Homes for Older People Page 13 of 24 Evidence: in the home have recently attended local pantomimes and the mayors reception, used local taxis and dial a Ride transport for shopping and other activities, and attended entertainment provided at the home. Individuals told us they enjoyed the pantomime very much. Individual activities are arranged to the persons choice, such as pampering sessions, and memory books are completed with the help of families and friends. People are supported to continue practising their religion if they want to, and ministers of religion are welcome at the home. We saw that visitors came to the home during our inspection, and visitors are welcomed and are invited to join supportive groups if they want to. People living in the home told us that usually the food is good. We saw the days menu, showing a choice of dishes, displayed at the entrance to the main dining room. Some people said that they would like more choice, and after discussing with the chef and with the registered manager we understand that people have opportunities, through Residents Meetings and other means, to have their say about food preferences and that changes are made because of their comments. We observed how staff members relate to individuals with dementia, and noted that they respond well to their changing needs. Care Homes for Older People Page 14 of 24 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. People living in the home are protected through the homes systems, and they and their relatives know they can make complaints if they want to. Evidence: The home has a complaints policy and procedure, and the procedure is displayed in the hall. The registered manager said she would amend the procedure to reflect recent changes to our contact details, and this has been attended to. The home keeps a record of complaints and we saw from the record that complaints are responded to within the required timescale of 28 days. One relative described how the home responded positively to the familys complaints, and though the process came to a better understanding of their relatives changing capacity. We received information about complaints referred to the home since our last inspection, and noted that the regulations were met. We asked people living in the home and the visitors we met about how they would make a complaint if they wanted to, and all knew whom to approach. The homes AQAA states that there are procedures in place to respond to suspicion or evidence of abuse, and these procedures have been used since our last inspection to refer suspicions of abuse to the Safeguarding manager at Oxfordshire County Council. All the staff team have attended safeguarding training and have six monthly refreshing of the training, and new staff receive training through the induction training programme. Care Homes for Older People Page 15 of 24 Care Homes for Older People Page 16 of 24 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, 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. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe, very comfortable and well maintained. Evidence: We saw all communal areas and some private rooms in the home. The home is well decorated, comfortable and homely and equipped to meet the needs of the people living in the home. There is an awareness of how the environment can be used to help people with dementia, and efforts are made to use space effectively to give good visual help. There is a system in place to make sure that equipment such as hoists and wheelchairs is checked and maintained routinely. A named person is responsible for the general maintenance and safety checks on equipment, to meet a recommendation made at our last inspection. Several people said that they enjoy living in the home, as their rooms are comfortable and the views are very good. There are policies and procedures in place to manage the control of infection, and training for staff about infection control is provided regularly. There are facilities provided in the laundry room for hand washing and drying, and a housekeeper and dedicated staff are available to manage the homes laundry and cleaning. There are systems in place to carry out regular audits of the safety checks and cleanliness of the home. Care Homes for Older People Page 17 of 24 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. People living at the home say the homes staff team is friendly, and the staff team is safe and well trained. Evidence: We saw the staff rota and discussed the staffing issues with the registered manager. Currently two carers are being recruited, and a part time registered nurse, and the home will be fully staffed when these posts are filled. The homes staff usually fill the vacant staffing hours and the home uses a particular agency to find nurses if necessary. On the day of our visit an agency nurse who had already worked at the home was on duty and knew the home well. We saw three staff files to check the recruitment procedure, and all the information was available about the individuals we checked, including checks that individuals were not on a list of people banned from working with vulnerable people. The organisation supports the home to manage staff training, and has a staff training and development plan. All the mandatory training is provided and everyone at the home has had training about dementia, including the individuals managing the activities programme. The home provides extra training for the care staff about how to care for people with dementia, and one staff member is taking the dementia diploma. Some nurses take a special interest in different subjects, for instance preventing falls, and are able to share best practice information with their colleagues in the home. The home supports individuals to gain the National Vocational Care Homes for Older People Page 18 of 24 Evidence: Qualification (NVQ) Level 2 and 3 in Care, and also supports the catering staff to gain NVQs. People living in the home told us that the care team are very friendly, all good people, and very good and well trained. Care Homes for Older People Page 19 of 24 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent 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 in the best interests of the people living there, by a trained, skilled and experienced management team. Evidence: The registered manager has been at the home for many years, and is qualified, experienced and skilled. She has an open approach to managing the home, and encourages people living in the home, staff and visitors to be involved in life at the home. As a result, life in the home is vibrant and inclusive, and the majority of people living there are comfortable, at ease and secure. She completed the AQAA and met the requirement and recommendations from our last report. She has effective systems in place to manage the staff team and staff shortages, and makes herself available to support the staff team. The home has good quality assurance systems in place, and the results of surveys are analysed, actioned and fed back to the groups who completed them through meetings and the homes newsletter. The home manages petty cash for some people living in the home, and transactions are recorded and Care Homes for Older People Page 20 of 24 Evidence: receipts given. The organisation has a health and safety department to help the home manage all the health and safety topics, and staff receive training on the subject. There is a fire risk assessment in place, and a contract with a fire consultancy to carry out fire risk assessments . The safety checks are carried out by contracted companies and by the person responsible for maintenance at the home. The home has a health and safety policy statement and provides health and safety training for the staff team. The registered manager is considering how to integrate and consolidate the management of the homes health and safety, by developing a health and safety committee based at the home. The organisations operations manager makes unannounced visits to the home every month to conduct quality checks, and is available to support the homes manager when necessary. Recently the organisation recognised the need for the directors to be more closely in touch with the needs of the home, and now a buddy system is in place so that the home has a direct link to a named director for help and advice. This system has improved the quality of support available to the manager, so that the home benefits more from her time and energy. People living in the home told us that the home is well run, and one comment was that the home does everything well. Care Homes for Older People Page 21 of 24 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 Older People Page 22 of 24 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 Care Homes for Older People Page 23 of 24 Helpline: 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 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). 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. 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