Care Home: Glen Arun

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What the care home does well People are assessed prior to admission. Care needs are assessed, kept under review and met. There is an excellent activities programme in the home There is effective communication to residents, relatives and friends. There is Weekly publication of the activities programme and menus. People confirmed that they have a choice of good food. What has improved since the last inspection? This was the first visit of a newly registered service. What the care home could do better: The new provider has identified areas that need redecoration or refurbishment and is working towards completion of this work. Key inspection report Care homes for older people Name: Address: Glen Arun 9 Athelstan Way Horsham W Sussex RH136HA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sheila Gawley     Date: 2 5 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 22 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 22 Information about the care home Name of care home: Address: Glen Arun 9 Athelstan Way Horsham W Sussex RH136HA 01403253881 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Lifestyle Care UK Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 35 The registered person may provide the following category of service; 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; Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Glen Arun is a care home providing personal and nursing care for up to 35 older persons. It offers accomodation in single rooms, seven of which have ensuite facilities. It is arranged over 2 floors and has lift access. It is owned by Lifestyle Care Uk Ltd and the responsible individual is Mr Ian Wootton. A manager has been appointed who has yet to register with The Commission. The fees charged range between £595 and £750 per week. Care Homes for Older People Page 4 of 22 Over 65 35 0 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 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 site visit as part of the inspection process was carried out on 25/08/09. It was undertaken by a lead inspector from the Care Quality Commission and was facilitated by the manager Prior to the visit all files held by the commission, complaints and safeguarding issues were reviewed. The home had sent us their Annual Quality Assurance Assessment for the inspection, which gave us the information we needed on the home and any documents required on the day were made available. We were in receipt of six surveys from people who use the service, two from staff and two from professionals. All expressed satisfaction with all aspects of the home. People who use the service and staff were spoken with on the day and surveys undertaken by Care Homes for Older People Page 5 of 22 the home were available. People who use the service spoken with stated that they are happy in the home and that they enjoy the lifestyle and the food. There is a varied activities programme in the home and people expressed satisfaction with the activities on offer. people did say they are getting used to the changes in the home since the new provider took over. Staff spoken with on the day stated that they were happy working in the home and that the management was supportive. Care Homes for Older People Page 6 of 22 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 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 Older People Page 7 of 22 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 8 of 22 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. People have the information they need to make an informed decision and needs are assessed prior to admission. Evidence: People who use the service are fully assessed prior to admission to the home. All medical, nursing and personal care need is assessed and recorded. This includes health needs, continence, mobility, and communication. Social need is recorded. Four people who use the service were case tracked and their pre admission assessment was present in the care plans. The AQAA stated that they continue to meet this standard on pre admission assessment and that there is a policy in place for emergency admissions. People and/or their representative are encouraged to visit the home prior to admission. An up to date statement of purpose and service user guide is available. Care Homes for Older People Page 9 of 22 Evidence: The home does not offer intermediate care. Care Homes for Older People Page 10 of 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care needs are assessed, recorded and met. Evidence: The AQAA states that care planning has been reviewed and improved. The home has a residential unit and a nursing unit. Four people who use the service were case tracked and their documentation was inspected. All had a plan of care to meet assessed need which was clear. Assessed need covered wound care, body map, weight chart and all daily personal and nursing care. Professional visits are recorded. There are daily records and monthly review. Surveys received from people expressed satisfaction with the home. People spoken with on the day expressed satisfaction with the care offered in the home. Concern was expressed by three people who use the service that some people with greater need than the home can manage had been admitted. This was discussed with the manager, who was aware of these concerns and was addressing them. One person was found to Care Homes for Older People Page 11 of 22 Evidence: have greater need once admitted and this person was moving to another home on the day of the visit. One other person had a period of confusion due to illness and was now improving and this had been discussed with the people raising concerns. The manager will again speak to the people to further reassure them. Peoples preferred form of address is recorded. Risk assessment is recorded such as the risk of pressure wounds and use of bed rails. There are suitable pressure relieving equipment in place. The home has recently purchased new slings for moving and hoisting and also purchased new air mattresses. Medicines are received, administered, and returned correctly. Medicine administration charts (MAR) inspected were mostly up to date with all medicines signed for except one which the registered nurse confirmed had been given that morning. There are policies and procedures in place for the management of medicines. Controlled drugs were correctly stored, recorded and were correct. There is a drugs fridge in place and temperatures are recorded. That care needs to be taken to ensure the fridge door is kept closed was discussed with the manager. Care Homes for Older People Page 12 of 22 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. The lifestyle in the home suits the people who live there. They enjoy a full activities programme and a varied menu. Evidence: There are two activities coordinators in the home which ensures there is always one in the home including weekends. The activity programme is varied and includes in house activities and external involvement and outings. The activities rota is posted in several areas around the home. It includes bingo, a knitting circle, lunchtime crosswords. The home had an Easter bonnet competition and photographs were on display. There was a strawberry tea in June and the home had a fete at the weekend. There is a weekly church service and a communion service on Sundays. There are frequent bus trips out with one planned for next week - a trip to the seaside and lunch out. The home hires a bus for this. There is a weekly mens club where they go to the pub and there is an ongoing sunflower growing competition. A new large screen television has been purchased and satelite television has been installed for access to the sports channels which the people who use the service had requested. Care Homes for Older People Page 13 of 22 Evidence: People can choose when to get up and when to go to bed. There is a varied menu in place and choice id offered. The menu is on display.All surveys received and all people spoken with on the day expressed great satisfaction with the food. One person stated that the chef is very kind and listens to requests The meal seen served today was appetising and was enjoyed by the people using the service. People requiring help were offered this in a respectful manner. Drinks and snacks are available at all times.There will be a food and menu survey in September to plan menu changes for the winter. A recent food standards agency visit rated the catering service as excellent. Care Homes for Older People Page 14 of 22 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. Complaints are listened to and people are protected from abuse. Evidence: There is a complaints procedure in place and it is on display. The service user guide also contains a copy of the complaints procedure. Complaints and actions are recorded. People spoken with on the day stated that they rarely had to make complaints but that they could and had made concerns known to the staff and the manager was currently addressing concerns that had been raised. There are frequent meetings for people who use the service to elicit their needs and wishes. There are policies and procedures in place in line with West Sussex Safeguarding Adults policies and procedures. All staff have had safeguarding adults training and staff spoken with demonstrated an awareness of procedures Care Homes for Older People Page 15 of 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and comfortable environment. Evidence: The accommodation is as described in the statement of purpose. People were observed sitting in clean and comfortable surroundings. Bedroom are personalised according to peoples wishes. There is a comfortable sitting room. There is a sun room which is used primarily for activities. There are well kept accessible gardens and grounds. New ramps and grab rails have been built at the two entrances to improve access for people who use the service and their visitors. There are grab rails throughout the corridors and there is a passenger lift. There is a rolling programme of redecoration of bedrooms. Water temperatures are regulated and are tested. There are suitable laundry, bathing and toilet facilities. Toilets are well signposted. People who use the service spoken with stated that they are happy with the facilities. People were observed making their way around the home in a confident manner. Care Homes for Older People Page 16 of 22 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. Peoples needs are met by suitably recruited, qualified and trained staff. Evidence: There were suitable numbers of staff on duty to meet the needs of people who use the service. There is always a registered nurse on duty. There is kitchen, housekeeping , laundry and maintenance support. Extra staff are on duty for outings as many people who use the service need one to one support to go out. Staff files inspected had evidence of identity, Criminal Records Bureau clearance and POVA first. Two files inspected only had one reference on file. The administrator had been chasing the second references. Two other files looked at did have two references on file.The Nursing and Midwifery Council (NMC) Personal Identification Number was on file for registered nurses. Surveys received and people who use the service spoken with all stated that the staff are kind and caring. There is a training programme in place and evidence of staff training was seen. Induction is in place. As well as mandatory training additional training on diet and nutrition and wound care has been offered and there is some dementia training planned. Thirteen of the 22 carers have attained the National Vocational Qualification in Care level 2 or above Care Homes for Older People Page 17 of 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the best interests of the people who use the service. Evidence: There is a manager in post since May but she has yet to submit an application for registration to The Commission. She has the application documents and will be submitting them in the next few days. She is a Registered Nurse, has completed the Registered Managers Award and has several years of experience in working in care homes. She has clear lines of accountability in the organisation. There are effective quality assurance measures in place in the home to gather the views of people who use the service and stakeholders. The collated results of a survey completed in July were seen. The majority of people asked were very happy with the home. There are monthly audits in place on medicines care plans, environment, admin and Care Homes for Older People Page 18 of 22 Evidence: catering. The new organisation is working through an improvement plan that they have prepared to improve the decor and maintenance of the buildings. Many improvements have been completed to date as stated in the environment section. A company has been employed to monitor health and safety issues. Monies for people who use the service is held securely and is recorded and receipted. The home does not manage any bank accounts for people who use the service. There is a residents fund into which is paid funds raised at events such as the fete. This money is used for the benefit of the people who use the service such as providing entertainment or outings. Staff supervision is in place and staff spoken with confirmed this. There are service and maintenance contracts in place for all equipment and utilities. Care Homes for Older People Page 19 of 22 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 20 of 22 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 21 of 22 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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