Care Home: Glen Lee

What the care home does well The service provides a comfortable, clean and safe environment for people who live there and uses regular maintenance and forward planning to ensure the building is well maintained and that facilities are suitable for people. The admission process identifies the needs of service users thoroughly and the care planning process responds clearly to those identified needs. Staff are well trained and supported and are skilled in communicating with the people who live in the home. They are also clear about peoples needs and energetic in responding to them. The medication system in the home is very thorough, safe and well managed and the service identifies and responds to the healthcare needs of people living in the home. Activities in the home are planned in response to the needs of service users and staff provide a good level of stimulation for service suers throughout the day. The home is well managed and has its own system for identifying and responding to ways in which the service may be improved. What has improved since the last inspection? The service had addressed the two requirements made at the previous inspection, regarding care plan reviews and recording of medication. The service has also improved as a result of consulting with service users, including the introduction of a wider range of activities within the home. There continue to be improvements to the environment and the facilities within the home, as described in the environment section of this report. What the care home could do better: No requirements or recommendations were made as a result of this inspection. We did discuss with the Manager the need to review the organisation`s medication policy against the Royal Pharmaceutical Society guidance for handling medication in care homes to ensure that the identification of controlled medication was accurate and that suitable recording and storage systems were put in place where certain mediation was identified as controlled. We also discussed the fact that service user questionnaires about their views on the service ought to be dated to demonstrate when they were completed. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Glen Lee Wavell Road Bitterne Southampton Hampshire SO18 4SB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Nick Morrison     Date: 2 6 0 2 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Glen Lee Wavell Road Bitterne Southampton Hampshire SO18 4SB 02380473696 02380476734 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southampton City Council care home 34 Number of places (if applicable): Under 65 Over 65 0 dementia Additional conditions: 34 The maximum number of service users to be accommodated is 34. The registered person may provide the following category/ies of service only: Care home - to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Date of last inspection Brief description of the care home Glen Lee is a purpose built local authority home managed by Southampton City Council and is located in the residential area of Bitterne, a suburb to the east of Southampton city. The home is designed over two storeys, was built in 1964 and offers accommodation in 34 single bedrooms with a lift access to the first floor. Glen Lee provides care and support for people over the age of 65 years with dementia. A community day centre operates from an area of the home that also offers respite services and is run by Southampton Care Association. Care Homes for Older People Page 4 of 28 Brief description of the care home The building is detached in its own grounds and gardens with a housing estate surrounding the property. Garden furniture is placed in a covered patio area, which is used as the residents smoking area but can also enable other residents to enjoy the grounds and gardens. Residents are responsible for paying for their own toiletries, hairdressing, chiropody and items of a personal or luxury nature. Care Homes for Older People Page 5 of 28 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 report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 26th February 2009 and lasted five hours. During this time we looked around the premises, looked at five service users files and met with five people living in the home. We also met with the Manager and spoke with three other members of staff. All records and relevant documentation referred to in the report were seen on the day of inspection. We have also referred to the Providers Annual Quality Assurance Assessment (AQAA). Current fees within the home are £460.39 per week. Care Homes for Older People Page 6 of 28 Care Homes for Older People Page 7 of 28 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.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 8 of 28 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 28 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. Service users benefit from having their needs assessed prior to moving into the home. Evidence: The home requires full assessment for all service users prior to deciding whether or not they can meet the persons needs in the home. Service users files showed that these assessments were in place and had been completed prior to the person moving in. Assessments were comprehensive and contained details of all needs. There was also a part of the process that included relatives in writing a personal history of the person so that staff were aware of their history and the things that were important to them. This included information on their preferred daily routines, including whether they wanted a newspaper. Clear information about the service was available to all people moving into the home and each person had a copy of the Service User Guide in a folder in their room so that they and their relatives could refer to it at any time. Care Homes for Older People Page 10 of 28 Care Homes for Older People Page 11 of 28 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. Service users benefit from having their needs identified in a care plan and from having their healthcare needs met. They are protected by the homes medication policies and procedures and are treated with dignity and respect. Evidence: Each service user has a Care Plan in place. The care planning process was thorough and staff are receiving training in person centered planning. Care plans contained clear and specific information as to how each persons needs were to be addressed and the action staff needed to take in addressing them. All care plans seen were kept under regular review and had a written paragraph on progress for each month. There was also a night care plan in place for each person. The care plans were comprehensive and covered a wide range of needs. The health needs of people living in the home were monitored well. Records were kept on service users files about their current health needs and records also showed that needs were responded to in a timely manner and that people were supported to access Care Homes for Older People Page 12 of 28 Evidence: the healthcare services they needed. There was evidence that the home contacted the emergency services when necessary, even for minor wounds. The service liaises with the families of service users to ensure they are kept informed about their relatives health needs. Observation throughout the day of our inspection visit showed that people living in the home were well presented and had support to maintain their own appearance where necessary. Medication in the home was well managed. They use a monitored dosage system and keep good records of all medication coming into and going out of the home as well as good, clear records of all medication administered to people living in the home. All staff who administer medication had received appropriate training. The medication in the home was stored safely in a locked room. Staff used this room when administering medication so that they were apart from what was going on in the home and could concentrate on ensuring that the medication was administered correctly. During the visit we observed a member of staff administering medication over the lunch time period. The member of staff checked the medication against the records and checked that the dose was correct. She then put the appropriate medication in a pot for the person and went to where they were eating their lunch. They gave each person an explanation of the medication they were having and what it was for. They ensured that this was done discreetly. The member of staff observed the person taking the medication then came back to the room and recorded that the person had received their medication before moving on to the next persons medication. Each person had the opportunity to refuse the medication if they wished and the member of staff explained to us that if this was a regular occurrence the home would contact the persons doctor for advice. The process was methodical, safe and carried out well by the member of staff. The home also has its own seventy-three point monthly audit of medication administration. We discussed with the Manager the need to be clear in identifying which medication was defined as controlled and to ensure that the homes policy was clear as to how such medication should be recorded. Feedback from all service users and staff spoken with and observation on the day of the inspection visit showed that people living in the home were treated with respect and dignity at all times. The home had introduced pictures and diagrams to support service users in making decisions for themselves. On the day of the inspection visit we observed staff using these with service users and being patient enough to spend as much time as possible with people to ensure that they made the decision they wanted to. Care Homes for Older People Page 13 of 28 Care Homes for Older People Page 14 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from being able to exercise choice and control and have stimulating activities. They also benefit from good support in maintaining contact with friends and families and a good, balanced diet. Evidence: The home provides a range of activities to ensure that people living there receive stimulation and are able to interact with others. Records were kept of all activities including who attended, whether or not they enjoyed the activity and whether or not the persons aims were achieved during the session. Records also identified the occasions where service users chose not to do activities so that this could be monitored. On the day of the inspection visit the activities on offer included ball throwing and catching (including identifying the name of the person the ball was thrown to), hand massage and singing and dancing. Staff involved in facilitating the activities were energetic and active in encouraging people to take part. Staff were also clear about the specific aims for each person joining in with the activities, such as encouraging Care Homes for Older People Page 15 of 28 Evidence: arm movement, interacting with other people and remembering peoples names. Records showed that other activities in the home included music, puzzles, a pamper afternoon, films on local history, gentle exercise and discussions. Knitting had recently been introduced as an activity and was proving to be popular among a number of service users. Some people had regained the knitting skills they previously had and were now able to knit without staff support at any time they wanted to. Observation during the inspection visit showed that staff were aware of the need to interact with people living in the home throughout the day. They were skilled in communicating with people and there was a system in place so that staff were able to use visual aids to communicate throughout the day with people who were deaf or hard of hearing. People living in the home were supported to maintain contact with their families and friends. Records showed there were regular visits and that staff kept in touch with families to ensure they were kept up-to-date with what was happening with their relative. Service users spoken with confirmed that they saw their relatives regularly and that they were able to meet with them in private. They also told us that relatives were able to have meals with them at the home. Families and friends were encouraged to visit the home at any time that was convenient to them and their relative. The initial assessments highlighted the importance of maintaining contact with friends and families and identified the people that were important to the service user. The food in the home was of good quality. The food storage area showed that only good quality food was purchased for the home and menus showed that a range of nutritious meals were available. There was a menu on the wall in the main corridor. This was in large print and also contained photographs of each meal. We observed staff on the day of the inspection visit supporting service users to look at the menu and decide what they wanted to eat that day. Service users spoken with told us that the food in the home was good; one person said the food could not be better. Staff served meals to service users at their tables and ensured that the meal they had was the one they wanted. Where people needed their food cut up, this was done. Oneto-one support was also available throughout the mealtime to people who needed it. The mealtime we observed was a relaxed and enjoyable time for service users. There was soft music on on the background and plenty of discussion. Staff initiated and encouraged discussion between service users. The kitchen area was well managed and kept very clean. The cook understood the different preferences and needs of people living in the home and all individual diets were catered for. Care Homes for Older People Page 16 of 28 Care Homes for Older People Page 17 of 28 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. Service users benefit from a clear and effective complaints procedure and are protected by the homes adult protection procedures and practices Evidence: The home has a Complaints Policy in place and this has been made available to all service users and their families. A copy of the policy was also kept in the Service User Guide in each service users room. People told us they were aware of how to complain if they thought they needed to. This was also evident from the fact that the home had received eight complaints in the previous twelve months. These included disagreements between service users and all complaints and expressions of dissatisfaction were taken seriously. There was a system in place to ensure that all complaints were recorded and responded to in line with the Complaints Policy. This included the date, the nature of the complaint, who received the complaint, the action taken in response and the signature of the Manager. These records demonstrated that the home responded quickly to complaints and took action to resolve them to the complainants satisfaction. The home ensured that the rights of people living there were respected. The Service User Guide gave information on advocacy services available to people and actively encouraged people to use them. One of the complaints recorded demonstrated that the service user had been supported to use an advocacy service in pursuing their Care Homes for Older People Page 18 of 28 Evidence: complaint. There were Mental Capacity assessments in place where necessary and these demonstrated which decisions people were able to make for themselves and recorded how they needed to be supported to do so. Systems were in place through policies and staff training to ensure that people were protected from abuse. Staff were aware of their role within this and the Manager was aware of the local reporting procedures for any suspected incidents of abuse of any kind. Records showed that the home reported incidents that may be considered abuse issues and that these concerned disagreements between people living in the home. Care Homes for Older People Page 19 of 28 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. Service users benefit from living in clean, safe, well-maintained environment. Evidence: The home is kept clean throughout and there are effective infection control procedures in place. The laundry area is well managed and well equipped. Cleaning schedules were in place and cleaning staff observed on the day of the inspection visit were conscientious and thorough. Service users spoken with told us their rooms were kept clean and observation of the communal areas showed that cleanliness of the building was an important aspect of the service. The home recently had thorough deep clean. At the time of the inspection the electrics in the home were being updated and improved. This included new wiring to each room where integrated television, call alarm and television points were being installed along with accessible power sockets. This work also included new switches for lamps situated above the bed and automatic lights in each room. A new shower room and accessible bath have recently been added to the home. Further work is planned in the home, including new double-glazed windows throughout, a sensory room, a new reception area and a further new accessible bath. The home has three lounge areas along with further seating areas throughout the building for people who want somewhere quieter to sit. There is also a conservatory. Care Homes for Older People Page 20 of 28 Evidence: The dining room is situated next to the kitchen and tables are arranged in small groups to encourage a choice of where to sit and to promote the opportunity for people to have discussions with each other at mealtimes. The garden area is well planned so that service users can make good use of it and some people living in the home have recently been involved in planting raised flower beds. There is a system in place to identify maintenance issues that require attention and records showed that these are responded to in a timely manner. Care Homes for Older People Page 21 of 28 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. Service users benefit from being supported by adequate numbers of sufficiently trained staff and are protected by the homes recruitment policies and practices Evidence: There are two Care Coordinators on duty with five care staff throughout the day. On Tuesdays and Thursdays there are six care staff. This is in addition to the Manager and administrative, kitchen and cleaning staff. At night there is one Care Coordinator and two care staff. At present the home is using some agency staff to cover vacancies that have been advertised and will be recruited to in the next few months. The home tries to achieve some consistency by using the same agency staff as much as possible and by including them in staff meetings and handover meetings. The recruitment records showed that all necessary pre-employment checks are undertaken prior to staff working in the home. In discussion the Manager demonstrated an awareness of ensuring the safety of people in the home by implementing a rigorous recruitment process. Records showed that support and supervision for all staff is being carried out on a regular basis. This was confirmed in discussion with staff. Staff also told us the support and supervision they received was helpful to them in their roles and that they were Care Homes for Older People Page 22 of 28 Evidence: able to get support and guidance from the Manager or senior staff at any time they needed it outside of the formal support and supervision sessions. Staff training in the home is well managed. Staff complete an initial Induction Programme which is checked and signed off by their Manager. The organisation has a set training schedule that addresses all the required training for people working in the home and systems within the home ensure that this training is kept up-to-date and that refresher courses are planned as necessary. In addition to this, further training needs are identified through support and supervision sessions and courses are planned to meet those needs. Some of these courses are specific to the needs of people living in the home and staff had completed training dementia, visual impairment and deaf awareness. Care Homes for Older People Page 23 of 28 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. Service users are protected by the way the home is managed, by the homes procedures and by the management of health and safety issues. Evidence: The Manager of the home is registered and has demonstrated that she has the skills, knowledge, qualifications and experience to manage the home. Systems within the home, the quality of care and feedback from staff and service users confirm that the Manager is well thought of and appreciated. Staff told us the Manager is very supportive and provides good leadership and guidance to them. There is a good quality assurance system in the home based on an annual cycle of improvement in response to the views of people using the service as well as the views of staff and other people with an interest in the service. The system also takes account of the needs of the organisation, requirements from inspections and best practice guidance. The home is able to demonstrate continuous improvement in response to all Care Homes for Older People Page 24 of 28 Evidence: of these requirements and there is clear evidence that the views of service users are listened to and acted upon. The Providers monthly visits to the service, under Regulation twenty six of the Care Homes Regulations 2001, are methodical and thorough. They clearly state the positive aspects of the service and, where necessary, identify areas that require attention. They also act as a good ongoing record of how areas requiring attention are dealt with. Health and safety issues in the home are taken seriously and are well managed. Chemicals that may be hazardous are regularly assessed and there is information for staff on those chemicals and how to use them safely. There are general workplace risk assessments in place that are regularly reviewed and specific risk assessments in place where necessary. These included pregnancy risk assessments for staff and a risk assessment relating to the electrical work that was being undertaken in the home at the time of the inspection visit. All staff receive training in health and safety matters and this is kept up-to-date through the training planning system. No outstanding Health and Safety issues were identified throughout the course of the inspection process. Care Homes for Older People Page 25 of 28 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 26 of 28 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 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!