Care Home: Glenesk Care Home

What the care home does well The home is well managed by 2 people who have many years of experience in the care of older people. They are keeping fully up to date and there is strong evidence that the ethos of the home is open and transparent. The views of both people who use the service and staff are listened to, and valued. The staff team are trained in their role and have achieved nationally recognised training standards in the care of older people, ensuring that the care delivery is safe. There are plentiful staff available at all times to support the needs, activities and aspirations of people in an individualised and person centred way. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The well-maintained environment provides specialist aids and equipment to meet their needs. What has improved since the last inspection? Staff now have name badges, which state their name, position and role clearly for people to recognise them. Monthly senior care meetings, which are recorded, and the minutes are made available for all to see. Staff now complete a checklist of basic accessories as part of the review of care plans so they can monitor more closely what people are short of rather than out of. After consulting with people in the home, the manager has purchased further large print board games, and a 50" plasma television. What the care home could do better: Ensure that controlled medicines are stored and recorded as required by law. CARE HOMES FOR OLDER PEOPLE Glenesk Care Home The Cresent, Queen Street Retford Nottinghamshire DN22 7BX Lead Inspector Mary O`Loughlin Unannounced Inspection 22nd August 2008 09:30 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Glenesk Care Home Address The Cresent, Queen Street Retford Nottinghamshire DN22 7BX Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01777 702 339 F/P 01777 702 339 kayakbar@hotmail.co.uk Mr Mohammed Akbar Mrs Barbara Khan Miss Kaneez Fathma Akbar Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th April 2007 Brief Description of the Service: Glenesk care home provides, permanent or respite, personal care and accommodation for 22 older people, male and female, who have diverse care needs. Privately run, and managed by two registered managers, the home does not provide nursing care. The home is an extended, adapted house with 18 single and two double bedrooms. There is a wheelchair accessible private garden. Situated near the centre of Retford, Glenesk is off the main road in a quiet residential area. There is car parking space at the front of the home. The fees charged range between £294 and £360. Glenesk have developed an informative statement of purpose and service user guide, which are available within the home, containing the information required to support choice. Copies of the last inspection report are made available. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. A review of all the information we have received about the home was considered in planning this visit including the Annual Quality Assurance Assessment (AQAA), and this helped decide what areas were looked at. The main method of inspection used was called ‘case tracking’ which involved selecting the care plans of 3 people and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. Members of staff, people who use the service and their relatives were spoken with as part of this visit. A partial tour was undertaken, which included looking at people bedrooms and communal areas of the home. The quality rating for this service is 2 star this means that people who use the service experience good quality outcomes. What the service does well: The home is well managed by 2 people who have many years of experience in the care of older people. They are keeping fully up to date and there is strong evidence that the ethos of the home is open and transparent. The views of both people who use the service and staff are listened to, and valued. The staff team are trained in their role and have achieved nationally recognised training standards in the care of older people, ensuring that the care delivery is safe. There are plentiful staff available at all times to support the needs, activities and aspirations of people in an individualised and person centred way. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The well-maintained environment provides specialist aids and equipment to meet their needs. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3-6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are only admitted to the home following a thorough assessment of their needs. Intermediate care is not provided. EVIDENCE: We examined the records of a person who had recently been admitted to the home and found that the manager had visited the person in hospital to assess their needs and ensure that the home could meet her needs properly. The relatives of one person said that “ they had been fully consulted throughout the process of admission, were treated very well and it was well organised.” Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 9 The home does not offer intermediate care but are part of the Primary Care Teams rapid response resources. The manager told us that she is available over each 24hr period to assess any urgent referrals for temporary care. The AQAA tells us that the main aim of the admission assessment is to achieve positive outcomes for people and takes into account their equality and diversity needs. People are supported to make informed choices about their placement and care and are introduced to their key worker. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7-8-9-10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are involved in planning and agreeing their care. The storage of controlled medicines is unsafe. EVIDENCE: Each person has an individual care plan that they have been consulted about. Staff have made improvements necessary to ensure that all of the health and personal care needs of each person are fully recorded so they know how to provide the right care. The staff files show that they receive training in specific illness’s to enable them to have appropriate understanding of the people they care for. 1 Person said they get to see the doctor if they are unwell and staff always put fresh fruit or snacks for her to encourage her to eat. Her care plan reflected Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 11 that she had seen a dietician and had been prescribed diet supplements if required, staff were weighing her regularly and this was recorded in the weight book. 2 Relatives told us they were kept fully informed of any changes in condition and that they felt the staff did a good job. “ The care is excellent here” The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records are fully completed, contain required entries, and are signed by appropriate staff. All staff that deal with administration of medicines have external training and regular supervision by managers. People told us they always receive their medicines on time. The management of controlled medicines did not comply with safe storage or recording to ensure there is no misuse. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12-13-14-15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are involved in meaningful daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. They have been fully involved in the planning of their lifestyle and quality of life. EVIDENCE: An activities person is employed and the home aims to provide a full and stimulating lifestyle within a family like setting. We spoke to 5 people at the home and all said that they were able to receive visitors at any time and were able to take trips out with their families when they wished. People are able to participate in a range of activities and those we spoke with told us they were satisfied with the activities on offer. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 13 There are frequent Bingo sessions, flower arranging using fresh flowers each week and weekly church services. Everyone we spoke with said the food was varied and good and choices are available. We saw the report of the most recent Environmental Health Visit from April 2008, which shows that all food hygiene obligations are met and that food hygiene standards are good. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16-18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are listened to, taken seriously and staff are trained to ensure that people are fully protected from abuse. EVIDENCE: People are provided with a complaints procedure that is clearly written and easy to understand. The Commission have not received any complaints about the home since the last inspection. We found that the staff continue to manage concerns at an early stage, taking people seriously and acting on what they say. Staff told us that the manager always reacts positively to any concerns that people have, using the information to improve the service offered. People said, “ it’s a good home we are looked after well here and I feel safe” “ I always know who to speak to if I’m worried and staff always have time to listen” Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 15 Staff training records show they have been trained in protecting people from abuse, how to alert the appropriate authorities and safeguard people at the home. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19-26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a safe, well-maintained and comfortable environment, with personal possessions around them. EVIDENCE: The home is well lit, clean and tidy and smells fresh. We looked at individual private rooms that were personalised and homely. One person said, “ I have been able to bring in my own furniture including curtains, I love my room, it feels like home” The main lounge area is fitted with a large plasma screen television so people are able to see it more easily. It has recently been decorated and looked very well maintained. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 17 Each individual room was nicely furnished and in good clean decorative condition. There is level access to the gardens and a passenger lift is in operation to assist those with disabilities. We saw that there was appropriate protective equipment in place to reduce any risk of cross infection and staff training records show us that they are trained both at induction and at intervals of the importance of good hygiene in controlling infection. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27-28-29-30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People benefit from a robust recruitment procedure and a trained staff team. EVIDENCE: At busy times such as mornings when people want help getting up, the manager has ensured that there is more staff on duty to meet people’s needs in a timely fashion. The AQAA tells us they have long serving staff and do not use agency staff, as they believe in providing consistent and personal care, which we identified during the inspection. Records show they have senior staff on duty at all times, as described in the AQAA, these seniors are carefully selected by management giving great consideration to their experience, performance, training, qualifications and competence. The staff team are recruited safely; they have criminal record checks before starting work to ensure they are suitable to work with vulnerable adults. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 19 Improved records of references and full recruitment checks were seen and staff confirmed they have now received contracts of employment. Over 60 of staff have National Vocational Qualifications in care to level 2. Each staff member is trained to National Standards and they are receiving training in the specific needs of older people to ensure that people are in safe hands. Staff are supervised beyond the National Minimum Standards in their practice to ensure that any gaps in their knowledge are discussed and training planned if necessary. All the people we spoke to said that staff were knowledgeable about them and knew how to care for them. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31-33-35-38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and run in the best interests of the people accommodated. EVIDENCE: Two managers job share the role and both have many years experience in the care of older people. There are no ongoing concerns about how the home is run. 2 relatives and 5 people living at the home all confirmed that they liked the managers and felt the home was well run. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 21 From speaking to people and looking at records we found that the managers spend a lot of time consulting with people from the point of admission through ongoing care reviews, referral to external specialists, always informing people of any changes and meeting regularly with staff, people living at the home and their relatives to ensure a quality service. The AQAA tells us that they have introduced monthly senior carer meetings to discuss any issue, which may need addressing, and to ensure ongoing equality and diversity of each individual is met. The managers also send out surveys by which relatives can anonymously addresses their concerns. Recent surveys done by the home indicated that people wanted a better television so they purchased a large plasma screen. The management of health and safety shows that staff continue to make the required checks in all areas that may present a risk to people at the home. There have been no significant accidents in the home and the management of falls risks are good. The people case tracked all managed their own finances; the manager confirmed that she is not an appointee for anyone at the home. The AQAA contains excellent information that is fully supported by appropriate evidence. It includes a high level of understanding about the importance of equality and diversity and a wide range of evidence showing how they have listened to people. The managers demonstrate a high level of self-awareness and recognise the areas that it still needs to improve, however they were not aware of the legal requirement of the revised safe custody of controlled medicines. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 4 X 3 Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 Requirement Ensure that controlled medicines are stored and recorded as required under the Misuse of Drugs Act (Safe Custody). Timescale for action 30/11/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 1. Refer to Standard OP9 OP9 Good Practice Recommendations Obtain a bound book or register for recording all controlled medicines that has numbered pages. Obtain a formal confirmation from the supplier of a controlled drug cabinet that states it meets the legal requirements. Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Glenesk Care Home DS0000008681.V370519.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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