Care Home: Glenarie House Nursing Home

What the care home does well People told us that their home is comfortable and clean and that there is a relaxed atmosphere. They said they had no complaints about the care and support they receive. They said they are able to make informed choices and have developed friendships in their home. There is a low staff turnover and most of the staff have worked in the home for a number of years which has given continuity of care for the people living in Glanarie House. Staff have obtained more information about the social, cultural and leisure needs of people living in the home. This means that they have the information they need to make sure the care and support provided is right for that person. What has improved since the last inspection? The home is in good condition and there have been ongoing improvements to the decor, building and fittings. This means that the home is fit for purpose and suitable for the people who live there. We found that there is an ongoing training programme for staff which means there is continual growth of their skills and qualifications. The AQAA informs us about improved contact with the families and representatives of people who live in the home and that, in support of their relatives they are increasingly attending care reviews and functions in the home. Also, to give a more personalised service, each person living in the home is allocated a member of staff called a key worker. The key worker has overall responsibility for supporting the person`s rehabilitation and general wellbeing. What the care home could do better: We found that risk assessments are not always in place for people who self-medicate off the premises. Risk assessments are needed in these situations to help ensure that the person is able to take their medication safely when not being supervised by staff, and that their medication will be kept secure when they are not in the home. When we spoke with people who live in Glenarie House they asked for arrangements to be made for more residents` meetings to take place so that they can discuss what they think about their home as a group more often. People were generally very satisfied with the home environment, however, those who use the smoking lounge asked for a music system to be installed in this room to give a more relaxed atmosphere. Conditions in the kitchen were found to be hygienic and well organised, however a fly screen is needed on the exterior kitchen door to avoid the risk of food contamination. We found that the laundry was well equipped with good systems for infection control, however staff need to take more care not to place laundered items over the tumble dryer as they could cause a fire risk. The manager was absent when the inspection took place and we could not see all the records we need to look at because they were locked away in keeping with the home`s policy on confidentiality. We made arrangements for access to records during a second visit to the home and the records were found to be satisfactory. However arrangements should be in place for the commission to have access to records at any time we may need to visit, including when the manager is not on duty. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Glenarie House Nursing Home 26 Prescot Drive Newsham Park Liverpool Merseyside L6 8PB     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: Patricia Thomas     Date: 1 7 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 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 Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Glenarie House Nursing Home 26 Prescot Drive Newsham Park Liverpool Merseyside L6 8PB 01512287440 01512541943 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) : Glenarie House Nursing Home Limited care home 20 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 20 The registered person may provide the following category of service only: Care home with nursing - Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - Code MD. The maximum number of service users who can be accommodated is: 20 Date of last inspection Brief description of the care home Glenarie House is situated in Newsham Park in a busy suburb of Liverpool. The house is a modernised Victorian style house, which overlooks parkland. The majority of people who live in this home have their own single bedrooms. There are two double bedrooms and those who share have consented to do so. The home has parking to the front of the building and there are steps to the front door. There is a passenger lift to upper floors and a designated area for smoking. Glenarie House is registered to accommodate twenty people. All those who live in this home have a designated psychiatrist, and social worker who stay in contact with them and regularly review their progress. Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home Care Homes for Adults (18-65 years) 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two stars. This means that people who use this service experience good quality outcomes. This visit was just one part of the inspection. Before the visit took place, we (the commission) asked the manager to complete a questionnaire that we call an Annual Quality Assurance Assessment or AQAA for short. It gives us information about how the home is meeting the needs of the people who use the service and includes plans for further development. During our visit we walked round the home and we checked various records to see what care people living there receive. We spoke with people who live at the home and they told us what they thought about it. We also spoke with staff and with the manager Care Homes for Adults (18-65 years) Page 6 of 28 who gave us their views about Glenarie House. We have included their views throughout the report. We use a method called case tracking. This is a way of inspecting that helps us to look at services from the point of view of some of the people who use them. We track peoples care to see whether the service meets their individual needs. The weekly charges for the service range from £430 - £531. References to we or us represent the Quality Care Commission. 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. Care Homes for Adults (18-65 years) Page 8 of 28 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given information and have their needs assessed before deciding to move in to Glenarie House so they know that their needs can be met there. Evidence: Standards 1 and 2. We looked at the care files of two people who had recently moved in to Glenarie House. We found that there is a good system to introduce people to the home with information given and needs assessments done, so they know that their needs can be met in the home. We found that peoples needs assessments had been carried out by trained professional staff who recorded a lot of detailed information on which to base their care plans. People are invited to visit the home before they decide move in to give them a chance to look around, meet the other people who live there and staff. There is a brochure given to them providing a lot of information about what to expect from the service. This means they are helped to make an informed decision about whether this will make a good home for them before moving in. Care Homes for Adults (18-65 years) Page 11 of 28 Care Homes for Adults (18-65 years) Page 12 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The way in which peoples needs are met means they can make choices and maintain their independence. Evidence: Standards 6,7. and 9. Care plans had been written with the person who receives support and gave staff clear guidance for staff about peoples needs and choices and any risks to their health and wellbeing and how these should be avoided. This meant that staff knew what they needed to do give support in the way the person prefers. We saw evidence that care plans had been regularly reviewed and changed if necessary, and focussed on what people are able to do for themselves which helps them to stay as independent as possible through receiving the right level of support. People told us that the staff are helpful and always available if they need any help and they were satisfied with the service in the home. There is was evidence of systems in Glenarie House to protect peoples rights under Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: current legislation and best practice guidance. This means that their rights will not be unduly restricted while they are living in the home and they will be protected through the safeguarding measures in place. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People received the support they needed to live their chosen lifestyles. Evidence: Standards 12,13,15,16. and 17. We saw that people who live in the home are offered choices about what they want to do. Records showed us that people have access to educational and day services and are encouraged to keep links with the community, for example by going to local churches and keeping in touch with family and friends. When we read care files we saw that staff had obtained information about the social, cultural and leisure needs of people living in the home. This means staff have the information they need to make sure the care and support is right for that person. We were told by staff arrangements are made for religious ministers to visit the home to give spiritual support and communion to people who want to follow their beliefs. We Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: saw that the home caters for people who need special diets and provides balanced and nutritious meals for all the people who live there. People told us the food was good and they are asked about what they like to eat and given what they ask for. There is a pleasant dining room which is furnished in a domestic style and is suitable to accommodate all the people who live in the home. During our visit we observed that meals and drinks were served in a relaxed and unrushed manner, and that people were offered choices. There is an activities room and we saw that a programme of activities and outings are arranged for people, they go out to visit family and friends and regularly go out shopping. We met with some people in the smoking lounge which they told us had just been decorated. In general, people said they were satisfied with the environement, however they told us they would like a music system in the smoking lounge. They said they have made good friendships in their home and enjoy each others company. They said there is a good atmosphere and people dont have to join in with activities if they dont want to. They said they know the staff well and find them easy to talk to. They told us they would like more residents meetings to give them a chance to discuss their home as a group. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are treated with dignity and respect in this home. Their health, personal and social care needs are taken seriously. Evidence: Standards 18,19 and 20. We carried out case tracking for two people and found that the promotion of their health was taken seriously through regular health checks and access to a range of community health services for them. There are systems in place for reviewing peoples condition, amending their care plans and assessing and eliminating risks to their health and welfare. This gave staff plenty of guidance about how to support people properly and safely. There is good consultation with people about how their care and lifestyle in the home will be arranged and staff showed awareness of how to promote peoples dignity and independence through offering choices and promoting their daily living skills. There are good systems to manage peoples medication in the home and we found the storage and records to be satisfactory. For the people whose care we tracked, there were stocks of their prescribed drugs in the home, and people we asked about this Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: said they get their medication every day and they thought that staff were managing this well. People who leave the home to go on visits are able to take their medication with them, however we found that there are not always risk assessments in place for people who taking medication out of the home. This could place the people who selfmedicate off the premises at risk if for example, their medication was not taken or was to go missing. Staff should, as far as possible, identify the risks to those who selfmedication off the premises and take action to eliminate risks where possible. Care Homes for Adults (18-65 years) Page 18 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service were protected by the complaints and safeguarding procedures, which were understood by staff. Evidence: Standards 22 and 23 We looked at the complaints, suggestions and compliments procedure which is given to people when they move in to Glenairie House so they know their complaints and comments will be taken seriously. We have not received any concerns or safeguarding referrals since our last visit to Glenarie House. Staff who were asked about safeguarding procedures understood the indicators of abuse and what action to take to report suspected abuse of a person living in the home. They confirmed that there are safeguarding and whistle-blowing procedures in the home and that they have received training in this. We found that staff had up to date knowledge on the Mental Capacity Act and Deprivation of Liberty guidelines, which means they are aware of peoples rights and how they should be promoted and protected in the home. Care Homes for Adults (18-65 years) 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, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. To ensure people feel safe and comfortable in their home, a clean, pleasant and comfortable environment is provided. Evidence: Standards 24 and 30 Glenarie House is a converted dwelling house situated in a park and the building is spacious and well maintained. The AQAA informs us the aim is to provide a non institutional environment for the people who live there and we saw the home was comfortable and furnished in a domestic style. There are sixteen single and two double bedrooms in this home with views of the surrounding park and the gardens. There is off street parking at the front of the home. There are several communal areas for people who live in Glenarie House, including a spacious and comfortable lounge next to the dining room, an activities room and a smoking lounge. There are toilets and bathrooms throughout the building and a passenger lift to all floors. The home is well maintained and a number of improvements have been made recently to the buidling, decor and fittings as part of an ongoing programme. The kitchen and laundry were well equipped and well organised however we advise that a fly screen be fitted to the external kitchen door to keep this area free of insects which may contaminate food. People living in the home told us they were comfortable and that their home is always Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: clean. Domestic staff are employed during the day shifts and they have procedures to follow for infection control and COSHH (control of substances hazardous to health). They told us they have access to protective clothing and gloves and that there is always plenty of cleaning materials in the home. The home was clean and hygienic during our visit and the grounds were in good condition. Care Homes for Adults (18-65 years) 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, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Glenarie House receive care and support from staff who have the skills to support them correctly. Evidence: Standards 32,34 and 35. To check staffing arrangements, we looked at the staff rosters, training records and staff files. We found that people employed to work in Glenarie House have the skills and qualifications to support the people who live there. The records showed us that there is an ongoing training programme and that staff receive regular support from management through supervisions and appraisals to progress with their professional development. There is a rigorous recruitment programme which includes taking up satisfactory POVA (Protection of Vulnerable Adults) and CRB (Ciminal Records Bureau) checks on staff before they are employed. This will help to ensure that only those who are suitable will be employed to support the people who live in the home. People we spoke with expressed no concerns about staff conduct or skills, saying the staff are great and helpful. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed with systems, policies and procedures in place to ensure the health and safety of staff and people living there will be promoted and protected. Evidence: Standards 37,39,41 and 42. A new and experienced manager with relevant nursing qualifications has been appointed since our last visit. The manager informs us she has applied for regististration with the Care Quality Commission. The manager filled out the AQAA and returned it to us when we asked for it. We think this has been filled in honestly and that a lot of time and effort had been taken with it. This gave us clear information about how the manager thinks the service is meeting the needs of the people who use it and includes plans for future developments. There is a deputy manager in post which means the manager is supernumerary to staffing levels, can delegate roles and give time solely to managerial duties. To ensure that standards are maintained in the home methods are employed such as reviewing the policies and records and distributing surveys to residents, relatives and staff for their opinions on the service. There is a complaints, suggestions and compliments form in place. This Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: informs the reader that their feedback is a valued source of information about the quality of service and a primary source of information regarding possible abuse. Records show the outcomes of quality assurance monitoring will be used to make any improvements where service shortfalls are identified as part of the service development plan. We found there are good systems for record keeping in the home and confidentiality of documents is maintained as these are stored securely under policy guidance. The manager needs to ensure that when she is absent from the home, arrangements be made for access to staff records, which should be available for CQC inspectors. On our second visit, we were given access to the records (staff files), which were found to be satisfactory. To ensure the building is safe for people who live and work there, a series of checks is carried out on the building and equipment. We looked at the records and certificates for these checks and they were found to be up to date. On checking the laundry, we found there were good systems for infection control in the way laundry is managed. However,staff need to take care not to place laundered items on top of the tumble dryer as these could fall behind the appliance and cause a fire hazard. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 41 17 (3) (b) Records maintained in the 09/09/2009 home must be available for inspection at all times so that evidence is available to show that the home is being run in a manner that ensures the safety and well being of the people living there. Care Homes for Adults (18-65 years) Page 25 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 1 20 13 Risk assessments should be carried out for people who self-medicate off the premises. In meeting the requirement, the home will identify the risks involved in managing medication outside the home, and as far as possible eliminate them, to protect peoples welfare 11/09/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 16 To offer people more opportunity to discuss their home as a group, arrangements should be made for more residents meetings to take place To provide a music system for the smoking lounge to make it more relaxed and enjoyable for the people who use it. It is recommended that laundered items are not placed on top of the tumble dryer to avoid the risk of fire. That the manager makes alternative arrangements when Page 26 of 28 2 3 4 16 38 41 Care Homes for Adults (18-65 years) absent from the home, for access to staff files. Care Homes for Adults (18-65 years) 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. 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