Care Home: Glenarie Manor

What the care home does well People told us they think their home is comfortable and clean and that staff and management support them well. They said that the food is good and they are offered choices and alternatives to the main menu. They said they have single bedrooms and their privacy is respected when they have visitors. They told us they are helped to attend day centres, colleges and to look for employment and that they like the local area where there are shops, restaurants and a park. They said they are able to follow their chosen religion while living in the home and keep up their interests and hobbies. During our visit, we found the home to be comfortable, well maintained and very clean. In surveys people confirmed to us that the home is always kept to these high standards. What has improved since the last inspection? The AQAA gave us information about a number of areas where improvements have been made in relation to national minimum standards as part of the home`s development plan. These include further training and improved National Vocational Qualifications for staff. To keep up with latest guidance on deprivation of liberty safeguarding, staff have received training and have guidance to follow about how to make deprivation of liberty safeguarding referrals to the local authority. This means they have awareness of how to promote and protect the rights of people who live in the home and take action where their rights may be compromised. What the care home could do better: We found that staff have awareness of the ways by which equality and diversity should be promoted in this home. Interpreters are sought for people whose first language is not English. We found that more work is needed to have information about the home translated into people`s first language and written down to keep them fully informed. Likewise, although the complaints procedure is given out and displayed in the home, a person who returned a survey, told us they did not know about how to make a complaint. We recommend that the complaints procedure be given out to people, if necessary in formats they are able to understand. This means everybody will have equal access to a complaints procedure and be informed about their right to make complaints if they are not satisfied with any aspect of the service in their home. People who live in the home told us staff help them with budgeting. One person told us in a survey that they would like their personal allowance increased. We recommend that people`s budgeting plans be reviewed with them, to make sure they are able to manage on the money available to them and that they are in agreement with the arrangements in place. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Glenarie Manor 15 Aigburth Drive Sefton Park Liverpool Merseyside L17 4JG     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: 2 0 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 27 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 27 Information about the care home Name of care home: Address: Glenarie Manor 15 Aigburth Drive Sefton Park Liverpool Merseyside L17 4JG 01517260814 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.manor@btconnect.com Colin McCabe care home 26 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 26 The registered person may provide the following category/ies 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: 26 Date of last inspection Brief description of the care home Glenarie Manor is a large well maintained three storey Victorian house situated in Sefton Park in Aigburth, which is a suburb of Liverpool. There is off street parking at the front of the building and a well maintained garden at the back. The care home can accommodate twenty six people, mostly referred from various Primary Care Mental Health Trusts. All people who live in the home have their own single bedrooms, which have been personalised by them according to their cultural preferences and choices. The home has easy access to buses trains, local bistros and pubs. Care Homes for Adults (18-65 years) Page 4 of 27 Care Homes for Adults (18-65 years) Page 5 of 27 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. The 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. It gives us information about how the home is meeting the needs of people who use the service and includes future plans for further developments. We felt this form was filled in honestly and that a lot of time and effort had been given to filling it in. During our visit, we walked around the home and we checked various records to see what support people living there receive. We spoke with people who live in the home and they told us what they thought about it. We also spoke with staff and with the Care Homes for Adults (18-65 years) Page 6 of 27 home owner and the deputy manager, who gave us their views about Glenarie Manor. We have included their views throughout the report and also the comments we received in four surveys returned from people who live in the home. We use a system 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 fees for this service range from £431 to £500. 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 Adults (18-65 years) Page 8 of 27 Care Homes for Adults (18-65 years) Page 9 of 27 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 27 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 thinking of moving in to Glenarie Manor received sufficient information to help them to make a decision and staff received enough information to understand the persons needs. Evidence: Standard 2. We looked at the records for three people who live in the Glenarie Manor. We looked at how they had been introduced to this service and at the amount of information recorded about the persons needs before they moved in. We saw records of peoples needs assessments which had been carried out by relevant health and social services professionals. We looked at the information given to people about the home and whether they visited before they moved in to view the accommodation and meet with people who live and work there. Three of the surveys we received from people living in Glenarie Manor told us they had enough information in the homes brochure and two people told us they visited the home before moving in. This gave us evidence that there is a good system to introduce people to the home, with information provided and Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: needs assessments done so they know their needs can be met at the home. Care Homes for Adults (18-65 years) Page 12 of 27 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. There are systems to support peoples independence through taking responsible risks and making decisions about their lives within a risk management framework. Evidence: Standards 6,7 and 9. We looked at three care files. There were clear care plans in place to meet the needs recorded in each persons needs assessments and risk assessments. This information is needed to guide staff about how to support the person. The care plans had been regularly reviewed and changed if needed so that people would receive the right level of support and stay as independent as possible. Care files contained information about the social, cultural and leisure needs of each person. This means that staff have the information they need to make sure the care and support provided is right for the person. There was evidence that the home works closely with health and social services professionals to review peoples care needs and take the action needed to support people as their needs change. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: Although it is not common for people who do not speak English to move in to Glenarie Manor, there was evidence of input from interpreters for people whose first language is not English. There was no evidence that information about the service have been translated into peoples first language and written down. In arranging for interpreters to do this, the home will ensure that the equality and rights of people who do not speak English as a first language, will be promoted and protected as they would have written information on which to base their decisions about their life in the home. We saw in care files that information is kept about peoples spiritual needs so they can be given the opportunity and any help they need to continue to follow their faith if they wish. We asked people about decision making in the home and we read risk assessments which may influence decision making. People told us that they have a say in decisions which affect them and in four surveys we received, they informed us they usually make decisions about what they do each day. We found that mental capacity assessments had been carried out for people to help ensure their rights will not be unduly restricted while they are living in the home and that they have access to social workers and independent representatives to act on their behalf if needed and contact with family. Staff have done a training course on deprivation of liberty safeguarding and have guidance to follow where a deprivation of liberty safeguarding referral may be necessary. People told us that staff help them with budgeting. One person told us in a survey, they would like their personal allowance increased. We recommend that peoples budgeting plans be reviewed with them to make sure they are able to manage on the money available to them and that they are in agreement with the arrangements in place. Care Homes for Adults (18-65 years) Page 14 of 27 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. There are systems in place to support peoples social, educational and leisure needs and they are provided with a wholesome and nutritious diet. Evidence: Standards 12,13,14,15,16 and 17. We read in care files and the AQAA that people are encouraged to attend college courses and day centres and helped to find employment or voluntary work. The AQAA informs us that a number of people have moved on to more independent living settings following periods of rehabilitation in Glenarie Manor. Individual care plans show the actions to be taken to encourage people to develop social and educational skills and stay in touch with their family and local communities. People confirmed that they are able to stay in touch with family and friends and that their privacy with visitors is respected in Glenarie Manor. So that people are able to retain and develop their daily living skills, there is a fully fitted re habilitation kitchen Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: on the premises for people to use to make meals, snacks and drinks. We spoke with the chef in the main kitchen where most of the meals are prepared, and looked at menus and catering records. We found that people are offered a varied and nutritious diet and that choices and alternatives to the main menu are offered. Peoples special dietary needs, were being catered for at the time of the visit and records showed us their weights are monitored and healthy eating plans developed for them as needed. There were good stocks of food in the stores and catering records were well maintained. Meals are served in a pleasant dining room, which is next to the kitchen. People we spoke with said the food is good, satisfactory, they are offered choices and are regularly served drinks. Care Homes for Adults (18-65 years) Page 16 of 27 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. Peoples health and personal care needs were met in a way they preferred. Evidence: Standards 18,19 and 20. We found that there are care plans to guide staff about how to assist with peoples personal care and health care needs and these included peoples preferences in the way they should be supported. The plans focussed on what people are able to do for themselves, which helped them to stay as independent as possible. There was evidence that people have access to support from health care professionals and paramedical services while they are living in Glenarie Manor and records are kept of the treatment they receive from doctors and psychiatrists. In this way, people will stay as healthy as possible and have access to a range of community health services. To help them stay as independent as possible, people have the opportunity to manage their prescribed medication, subject to risk assessment. Those who self-medicate have a locked drawer to secure their prescribed drugs. Medication looked after by staff was found to be well secured and the records were up to date. The are systems for auditing medication stocks and for the disposal of unwanted medication to provide an audit trail Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: and ensure that all medication accepted into the home will be accounted for. Care Homes for Adults (18-65 years) Page 18 of 27 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. Glenarie Manor has a complaints procedure which is given to people when they move in and displayed in communal areas of the home. In this way people will know their complaints will be listened to and acted upon. The home has safeguarding and whistle-blowing procedures and records show that staff have received training in this. Staff who were spoken with confirmed they had received the training and showed awareness of the indicators of abuse and the systems in place to report suspected abuse. Staff records showed us there is a rigorous recruitement procedure followed so that only those who are suitable will be employed to work in the home. In the four surveys we received three people told us they knew how to make a complaint, however one person answered no to this question. To ensure that everybody is aware of the complaints procedure, this should be distributed to people who live in the home in a format they are able to understand. Care Homes for Adults (18-65 years) Page 19 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in suitably adapted, clean, comfortable and very pleasant surroundings. Evidence: Standards 24 and 30. Glenarie Manor is a converted dwelling house set in parkland. The home provides single accommodation for people and some bedrooms have en suite facilites. There is a range of communal areas and a smoking lounge and dining room. People who live in the home have a choice of bathing facilities and there are toilets throughout the building. There is a passenger lift to all floors. The garden is well maintained with grassed areas and flower beds and a patio with built-in seating and tables. People told us they enjoy the garden and said their home is comfortable and well kept. In four surveys we received, people told us their home is always fresh and clean. Domestic staff and a full time maintenance person are employed and records showed us there are systems for infection control and for the control of substances hazardous to health that staff have received COSHH training to give them guidance on how to use and store cleaning agents safely. During our visit we found the home to be clean and odour free and very well maintained. Care Homes for Adults (18-65 years) Page 20 of 27 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. The people living at Glenarie Manor are supported by a well trained effective staff team who have gone through a thorough recruitment process. This helps to ensure that peoples needs will be met and they are safe from possible harm or poor practice. Evidence: Standard 32,34 and 35. A roster is kept of staff on duty and there was a good skill mix of nursing, care and ancillary staff on duty on the day of our visit. Training records showed us that staff have National Vocational Qualifications, mandatory and service specific training and are given the opportunity to develop their skills and qualifications through ongoing training and appraisals. New staff receive induction training and shadow experienced staff when they first take up their posts. We looked at staff files which gave us evidence of the recruitment procedures in place which includes interviewing staff and providing successful candidates with contracts of employment. The records showed us that criminal records bureau clearances are obtained for all staff employed, in addition to satisfactory employers references. In this way only people who are suitable will be employed to work in the home. People told us they were satisfied with staff conduct and in the surveys they returned to us they said that support staff and managers always or usually treat them well Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: and listen to what they say. During our visit we saw staff spending time with people who live in the home and offering them choices about what they would like to do. Care Homes for Adults (18-65 years) Page 22 of 27 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. Glenarie Manor is being run in the best interests of the people who live there and their welfare is promoted and protected. Evidence: Standards 37,39 and 42. The manager is experienced and qualified and a deputy manager takes over in his absence. We found there were good management systems in the home during our visit and information was well organised and accessible. We saw that the people who live in Glenarie Manor feel free to go to the office to speak with managers and there was good rapport seen between staff and the people in residence. To obtain the views of people who live in the home there is a quality assurance system based on seeking peoples opinions through the distribution of annual surveys. The outcomes are then used to develop and improve the service in accordance with peoples wishes and preferences. A lot of attention is given to keeping the building and equipment safe and maintenance certificates and checks on the fire system were up to date at the time of our visit. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Records showed us there are systems for reporting incidents and accidents and for assessing and eliminating risks to health and safety. Care Homes for Adults (18-65 years) Page 24 of 27 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 Adults (18-65 years) Page 25 of 27 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 1 7 Information about the home should be translated into peoples first language and written down. In meeting the recommendation, the home will help promote equality, rights and decision making opportunities for people whose first language is not English. Peoples budgeting plans should be reviewed with them, to make sure they are able to manage on the money available to them and that they are in agreement with the arrangements in place. To ensure that everybody who lives in the home knows how to go about making a complaint, it is recommended that the complaints procedure be distributed to people in a format they can understand. 2 7 3 22 Care Homes for Adults (18-65 years) Page 26 of 27 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. 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