Care Home: Glencoe Care Home

What the care home does well The home provides a good level of care in comfortable and homely surroundings. Each person has an assessment of their care needs before they are offered a place at the home to make sure the home can meet their needs. A plan of care is written down and regularly updated, with individual assessments of risk and the involvement of health care professionals and other specialists as needed. People are treated kindly and with regard to their privacy and dignity and are offered opportunities to have the daily life they prefer. Staff assist people to make choices about daily living. Visitors are made welcome. The food is of a good quality and people have an assessment of their nutritional needs to make sure they receive the right diet for their health. Complaints are well handled and people are protected by safe recruiting of staff and good training in abuse awareness. The home is well staffed and staff are well trained to carry out their role. The home is well managed by a qualified and competent manager. What has improved since the last inspection? At the last inspection the inspector observed a person being transferred from one part of the home to another in a bathing chair. There was a requirement at the time for all people who need a wheelchair to have their own and for the use of bathing chairs in this way to cease. The manager stated that everyone who needs a wheelchair has one and that bathing chairs are not now used for transporting people around the home. People have individual assessments regarding pressure vulnerability. People now have the pressure relieving equipment they need according to individual assessment. The environment has improved, with all rooms and communal areas redecorated since the last inspection. New carpets have been fitted throughout all communal and most bedrooms. The manager stated she also has plans to redecorate corridors to make them brighter. What the care home could do better: Assessments could be improved to include details of how dementia affects individual needs so that these can be written into care plans. People who require help with feeding should be assisted appropriately by one member of staff who sits with the person whilst helping them. The registered providers must make their regular monthly regulation 26 visit reports available in the home for examination. The quality assurance system should be developed to include a wider survey of opinions regarding care and an annual plan of improvement based on the findings of surveys and internal audits. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Glencoe Care Home 10-11 Chubb Hill Whitby North Yorkshire YO21 1JU     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: Karen Ritson     Date: 2 1 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 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 25 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 25 Information about the care home Name of care home: Address: Glencoe Care Home 10-11 Chubb Hill Whitby North Yorkshire YO21 1JU 01947602944 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) : Endeavour Care Ltd care home 19 Number of places (if applicable): Under 65 Over 65 0 19 dementia old age, not falling within any other category Additional conditions: 19 0 The maximum number of persons who can be accommodated is 19 The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP and Dementia - Code DE Date of last inspection Brief description of the care home Glencoe is registered to provide care and accommodation for up to 19 older people who may have dementia. The manager is Mrs Linda Magill and Endeavour Care Ltd owns it. It is an adapted property and is situated on three floors. There are thirteen single and three shared bedrooms, one of the single bedrooms has ensuite facilities. A passenger lift provides access to all floors. The dining room and two lounges are located on the ground floor. Care Homes for Older People Page 4 of 25 Brief description of the care home The home is located close to the town centre of Whitby and its leisure facilities and amenities. The premises a large detached house has newly provided off street parking for up to 4 cars at the front and a ramped patio area at the back of the house with a range of seating. Access to the front of the house is via a flight of steps. There is a newly constructed ramp to the side entrance to the home. Additional charges are made for hairdressing, chiropody, toiletries, papers and magazines. The home provides beauty therapy, manicures and foot spas fee of charge. Information about the services provided are made available in the homes Statement of Purpose, Service Users Guide and through published CQC inspection reports available from the home and on the CQC website www.CQC.org.uk. Care Homes for Older People Page 5 of 25 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: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection for this service took twelve hours. This includes time spent gathering information, examining documentation before and after a site visit. It also includes the time taken to write the report. The site visit took place on 21st July 2009 between 9:30 and 14:30. Information for this inspection was gathered from the following: 1. A visit to the home. 3. Speaking with staff. 3. Case tracking three people on the day of the site visit. 4. Reading survey forms from people living at the home and staff. 5. Looking at information provided by the manager prior to the site visit. 6. Notifications sent to the commission from the home since the last inspection. 7. Examining policies, Care Homes for Older People Page 6 of 25 procedures and records kept at the home. 8. Examining information regarding the home on the file kept by CQC. All key standards were looked at during this inspection. The manager was available throughout the day of the site visit. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations -but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. 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 25 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 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs assessed, but more information about how dementia affects care needs is required to ensure a holistic assessment of needs can be made. Evidence: Assessments carried out by the manager cover most areas of care. This includes a life history which families fill in so that staff can begin to understand the person and their interests. A photograph of each person will be kept on file, and there is an admission sheet, which lists information such as GP and next of kin. This is useful, easily accessible information for staff to use. The assessment includes all areas of physical, social and recreational needs. All risks are assessed and these are specific to the individual. This ensures peoples individual needs are well assessed, and that there is information for developing a care plan. The assessments could contain more information on how dementia affects care needs, this would focus attention upon how these specific needs may be met. The home does not offer intermediate care. Care Homes for Older People Page 10 of 25 Care Homes for Older People Page 11 of 25 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. People have their care needs met. Medication is well handled. People are mostly treated with courtesy and respect, but people should be given the attention they require at meal times. Evidence: A care plan is drawn up, this gives detailed instructions on how to offer the correct care for each person. The plan includes such areas as weight, tissue viability, continence, moving and handling and nutrition as routine. Each person also has a personal history which is sufficiently detailed to give staff enough information to chat with people about their lives. Risk assessments are included in all areas which give concern, to ensure people can carry out their daily routines whilst being protected from harm. A district nurse said that the home worked well with them. They had regular contact with staff as they called into the home each day. One person had a pressure sore and the nurse stated: Staff manage this really well. They do what we ask to make sure she has the right care. Notes are written three times daily and give useful and relevant information about each person and this information is passed Care Homes for Older People Page 12 of 25 Evidence: across at each new shift. Each care plan is regularly reviewed with involvement from the person living at the home where possible, family or others and health care professionals where necessary. This ensures that staff are given information about each persons changing care needs and know what care is needed. Each care plan includes advice from health care professionals where necessary and a separate record of health care professional visits gives clear information about each persons health and how this is being monitored. All staff who handle medication are qualified through in house training, which is externally accredited. Medication is safely kept, handled and disposed of according to policy and procedure, so that people get the medication they have been prescribed. Throughout the day of the site visit, the staff were observed treating people with care and courtesy. The home has a policy and procedure on privacy and dignity which staff cover in their induction. Visitors said that all the staff were very courteous and kind. It was clear from observing interactions between staff and people living at the home that there was a friendly and open atmosphere. One visitor said: They are all very kind and good with my (relative). However, there was one instance where a member of staff was assisting two people with their feeding and was standing behind the person being assisted so that it was difficult for the person to see who was helping. Staff should assist those people who require help ona one to one basis, sitting down so that they can talk to them and give the person the correct attention. Care Homes for Older People Page 13 of 25 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. People have their social and recreational needs met. Visitors are made welcome. People receive a varied diet they enjoy. Evidence: The home assesses the recreational and social needs of each person. Until recently , there was an activities organiser in post. The home is advertising for a new one. All activities are recorded and include reminiscence, which sometimes includes looking at photographs to prompt discussion. Dancing and exercise is regularly offered and pamper sessions, where people can use a foot spa, have hand massage or a manicure. The home has arranged occasional outings to local places and the home has books, Cds and Dvds for entertainment. Most of the staff have received dementia awareness training and this has helped them to understand which activities enhance well being. One visitor said that her mother had settled very well at Glencoe. She said: At home, she hardly had any exercise and her quality of life was not good. As soon as she moved here there was a vast improvement because there are people around her all the time and theres always a smiling person to talk with her. She also gets lots of exercise going from one room to the other for meals and coffee breaks. There are soft toys around the home and other interesting objects for people to hold and talk about. Care Homes for Older People Page 14 of 25 Evidence: The manager discussed how she was planning to access more outside activities for people who use wheelchairs. The home has an open visiting policy, but request that people do not visit at meal times or late in the evening. One visitor said: We are always made to feel welcome. People are assisted to choose their meals with picture menu boards. Menus are devised with personal preferences in mind. A number of people have pureed food and require assistance with feeding. These people are assisted by staff either in the dining room or in the lounges. A meal time was observed. All the staff assisting people to eat did so in a friendly manner, however, the comment about feeding from the previous outcome area should be taken into consideration.The quality of food was good and all food is sourced locally, with plenty of fresh fruit and vegetables to ensure people receive a nutritious and varied diet. One visitor said: Its proper traditional food. Each person has a nutritional assessment which is kept under review to ensure that dietary needs continue to be met. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their complaints properly dealt with and they are protected from abuse. Evidence: The home has a complaints procedure and policy. This is available at the entrance to the home. There have been no formal complaints since the last inspection. Staff have all received abuse awareness training during induction and again at foundation level. Many staff have also covered this in their NVQ training. The manager is to receive training in the Mental Capacity Act and the Deprivation of Liberty Safeguards and is planning a training session for staff, so that people living at the home have their rights to liberty protected and their capacity to make decisions assessed to ensure independence is promoted. People are kept safe by the good recruitment practices in the home, which ensures only suitable staff are taken to work at the home. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe well maintained environment. Evidence: The home is well decorated and presented. Most bedrooms and communal areas have been refurbished since the last inspection. The doors of residents room are locked during the day, but the manager has ensured that people continue to have access to their rooms whenever they request or if they wish to sit in their rooms when visitors call. All communal areas and corridors are odour free. There was minimal odour in one of the bedrooms. This is being managed by thorough cleaning and where necessary, the renewal of carpets. The home has an infection control policy and it complies with the requirements of the fire authority. This ensures that people live in a well presented, safe and pleasant environment. The laundry is located at the rear of the home in a separate out building. Although at present this is adequate for the needs of the home, the manager said that it was due to be demolished and replaced, as damage had been caused by a tree from the neighbouring property. The laundry assistant was spoken with. She said there were occasionally problems with name tags coming out of clothes and people getting the wrong clothing back, but that this was soon put right. A visitor said that as soon as she pointed out that an article of clothing did not belong to her relative, something was done about it straight away. Care Homes for Older People Page 17 of 25 Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by well recruited and trained staff in sufficient numbers. Evidence: The home is well staffed. There are now two night staff on duty, and three care staff and the manager during the day. There are also three domestic staff and a chef on duty each day. This allows staff to spend time with people without rushing. Visitors said the staff always had time to chat and were all kind. One person said Every one of the staff are nice and good with (my relative). Staff are well recruited, with a Protection of Vulnerable Adults check and a Criminal Records Bureau check carried out. This makes sure people who are unsuitable to work with vulnerable people are not recruited. Two references are also taken up. Staff receive a good induction, and foundation training is regularly updated. All staff have achieved at least NVQ level 2 or are working towards NVQ level 3. This means staff have the skills necessary to offer good care. They also have dementia awareness training. Staff spoken to were well motivated and were enthusiastic about offering good care. Many staff have been working at the home for a number of years and turnover of staff is low.One visitor said, (My relative) does not know the names of the staff, but she knows their faces and that she can trust them. This ensures people receive consistent care from knowledgable staff. Care Homes for Older People Page 19 of 25 Care Homes for Older People Page 20 of 25 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. People benefit from a well run, safe home. Quality assurance systems should inform a plan of improvement for the home. Evidence: The manager is suitably qualified for her role. Staff said she was a supportive and encouraging manager and that they had all worked well together for a number of years. The manager has an open door policy and one visitor commented that: I can always come in and say anything I need to about the care and she listens and does something about it. The owners of the home carry out monthly visits to the home but do not provide a report for the manager to show at inspection. Regulation 26 reports should be kept at the home for examination. The home has sent out surveys to people who have an interest in the home but has received few responses. The manager ensures quality of service through thorough risk assessing of the environment and regular checks to ensure equipment remains safe to use. However an annual plan of improvement based on the quality assurance findings Care Homes for Older People Page 21 of 25 Evidence: has not been drawn up, so that it is difficult to see how the information gathered has informed practice. The personal allowances are kept for a number of people. These are kept separately and all transactions are recorded. A check of records was made. All records were correct and tallied with cash kept. This ensures peoples money is kept safely. People are also kept safe by the health and safety policies and procedures of the home, good staff training and risk assessments. Care Homes for Older People Page 22 of 25 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 23 of 25 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 26 Regulation 26 reports must be made available at the home, to give evidence that there is a good oversight of the home to ensure high standards of care. 31/08/2009 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 3 The manager should develop assessments to include more detail about how dementia affects care needs, so that these specific needs may be addressed in the care plan more thoroughly. Staff should always assist people to eat from a seated position where they can be seen, so that people feel they are being treated with dignity and can engage with the member of staff helping them. 2 10 Care Homes for Older People Page 24 of 25 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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