Care Home: Glennfield Care Centre

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What the care home does well The environment of the home is newly built, modern and spacious as well as being clean and well maintained. Staff treat people with respect and were observed to communicate well. People told us, "staff are always friendly and kind"; "I could not wish for better care for my mother"; "Glennfield is a fantastic place"; "they take time to get to know the relatives and friends of residents and support them in anyway they can". Staff are rigorously recruited. The management team at the home are focused on improving and providing good quality personal care. The home has promoted safeguarding and have made written information about this subject available to visitors to the home. They have pro-actively promoted the prevention of abuse by timely and appropriately reporting all concerns. What has improved since the last inspection? The two requirements made at the last inspection have been met. Care plans have been improved. Safeguarding has been promoted. The Skills for Care Council`s Common Induction Standards are used to induct new care staff. An experienced and suitably qualified acting manager has recently been appointed. What the care home could do better: The service has improved the promotion of Safeguarding and they should continue to do so. The Statement of Purpose could inform people of their policy to ensuring people are safeguarded from abuse. The home realizes the attention that is needed to improve fire safety and have already agreed with Cambridgeshire Fire & Rescue Service how they will respond to the matter of fitting suitable self-closing devices to people`s doors. Key inspection report Care homes for older people Name: Address: Glennfield Care Centre Money Bank Wisbech Cambridgeshire PE13 2JF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Don Traylen     Date: 0 9 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Glennfield Care Centre Money Bank Wisbech Cambridgeshire PE13 2JF 01945581141 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): jude.reeve@excelcareholdings.com Glennfield Healthcare Ltd trading as Glennfield Care Centre Name of registered manager (if applicable) Manager Post Vacant Type of registration: Number of places registered: care home 84 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 84 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Glennfield Care Centre is a care home registered to provide for up to 84 people with needs associated with old age, or Dementia, or who have been assessed as needing nursing care. Glennfield Heath Centre is owned by Glennfield Healthcare Ltd, a subsidiary of Excel Care Limited The home is set in a residential area of Wisbech and Care Homes for Older People Page 4 of 23 Over 65 0 84 84 0 Brief description of the care home was purpose built in 2008 as a residential care home. The home is on two floors, is spacious and has an enclosed central garden. All rooms are single and each persons room is fitted with full en-suite facility with shower. There is ample private car parking within the confines of the home. The fees for care and accommodation range from £347 to £750 per week. Inspection reports are available at the home or from the CQC website. Care Homes for Older People Page 5 of 23 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 last key inspection was carried out on the 17/04/2009. This inspection was carried out on the 09/04/2010. We commenced at 10:45 and finished at 18:30. We visited the care home to assess National Minimum Standards. We asked for an Annual Quality Assurance Assessment, which we received prior to the inspection. We sent ten surveys to people using the service, of which three were returned. We looked at the assessment and care plans prepared for three people as well as their anciliary records for medication and essential care records relating to their diet and their skin care. We spoke to two care staff, the care manager and the acting manager who was present throughout the inspection. There were concerns relating to the prevention of fire. The local Fire Safety Officer of Cambridgeshire Fire & Rescue Service attended for part of this inspection. We spoke to various people living at the home and two visiting relatives. We observed some of the leisure activities going on during the day. Some of the homes policies and procedures were read. Care Homes for Older People Page 6 of 23 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 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 7 of 23 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 8 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured their needs can be met by the home and are given adequate information about the service prior to deciding to live there. Evidence: The home has an appropriate Statement of Purpose and Service User Guide. There is a useful amount of published information in the reception area of the home that informs people about funding for care, Safeguarding, Mental Health Advocacy services, the entertainments and events list/diary and what kind of service the home offers. There was evidence that people visit the home before choosing to live there, when during the inspection a relative telephoned to arrange such a visit. Assessment detail were seen for three people. These had each been conducted by Cambridgeshire Primary Care Trust Care Managers and hospital discharge teams. Two of them were comprehensive assessments. However, the detail in one of the three assessment documents was not comprehensive and further details of the persons Care Homes for Older People Page 9 of 23 Evidence: needs had been assessed by the home after the person had moved into the home. The assessment documents had a clear link to the subsequent care plans the home had prepared. Care Homes for Older People Page 10 of 23 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 are assured they have a comprehensive plan of care and their medication is safely managed. Evidence: At the time of inspection there were 46 people living at the home. Care plans for three people were read. The plan for one person who was confined to bed and cared for from bed had a satisfactory care plan for all identified needs. Oral health care was mentioned but without a specific routine being detailed. Turning charts and fluid or hydration intake and body charts to record pressure sore areas had all been recorded. There were suitable instructions for these topics of care for staff to follow and for catheter care. There were risk assessments in place for skin integrity, moving and handling and the use of bed rails. There was a detailed plan for a Percutaneous Endoscopic Gastronomy (PEG) feeding regime. The care plans for two other people showed attention to risks for falls, continence, mobility, and pressure sore possibility. Health Service professionals, the GP and Community Nurses had been involved and their input had been recorded. Care Homes for Older People Page 11 of 23 Evidence: The medication stock and records were assessed. Medication amounts were accurate and had been accurately recorded in the MAR charts. There was some PRN, or as required medication in the home that a carer worker said were no longer required. It was discussed with the acting manager that the one medicine that was no longer wanted by the person should be reviewed and returned to the pharmacist, if no longer necessary. Care Homes for Older People Page 12 of 23 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 are assured they receive nutritional meals and can engage socially on a level that suits them. Evidence: The home has arranged a monthly calendar of entertainments and events. Meals appeared to be nutritious, well balanced and fresh vegetables used. A mealtime was observed and people were relaxed and enjoyed their food. Assistance with eating was observed and there were sufficient staff to manage this. A number of visitors were seen and two were spoken to. They stated that they frequently visited the home. One visitor brought a dog with her which was welcomed by a number of people living at the home. The home has also provided sanctuary to cat who has chosen to visit. This animal was well known to many people and was clearly a friendly and welcome visitor that was visibly a beneficial experience for all who came into contact with him. Care Homes for Older People Page 13 of 23 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 are assured they are safeguarded. Evidence: The home had a suitable safeguarding/preventing abuse policy and a whistle blowing policy. Safeguarding has been further promoted. There were leaflets and other literature in the reception area about Safeguarding and where to report this, should anyone be concerned. All Staff had been trained in Safeguarding. The home has a suitable complaints policy which is detailed in their Statement of Purpose. Although the policy stated that, if the complainant remains dissatisfied they will be advised to pursue the alternative channels available and could refer their complaint at any time to CQC or the Local Authority (LA) Social Services Department. The contact information for the LA Ombudsman was not included. Care Homes for Older People Page 14 of 23 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 are assured they are living in a safe, clean and well maintained home. Evidence: The home is a new and purpose built service. It is generously decorated and furnished, is spacious and has suitable equipment and adequate facilities for residential and nursing care. The reception area is large and inviting and is a valuable communal area because of the reception staff, the manager and/or deputy manager and administration staff are in close proximity and easily accessible to all visitors. There is a gym, various dining rooms with kitchen area on the two floors, an internet cafe where playstations and Wii videos gaming consoles are planned for the future. The home has extensive and secure garden areas. During the inspection it was necessary to contact the Cambridgeshire Fire & Rescue Service regarding the self closing device fittings to doors. As a result of these concerns, the Fire Protection Officer visited the home during the inspection. He discussed the specific aspects still to be carried out from a previous assessment of the premises dating back to 12/11/2008 and informed the acting manager of the timescale for this to be complied with. It is anticipated the home will comply with the Regulatory Reform (Fire Safety) Order 2005 timescale set by the Fire Protection Officer. Care Homes for Older People Page 15 of 23 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 assured that the staff who care for them are recruited in a careful and rigorous approach and receive suitable training. Evidence: There were 32 full-time care and nursing staff and 16 part-time care staff employed at the time if this inspection. We looked at the recruitment details of one recently employed nurse. Suitable process had been followed to ensure a rigorous recruitment. The person had been employed after two satisfactory references, a Criminal Records Bureau disclosure and Independent Safeguarding Authority check had all been received. An induction in the Skills for Care Common Induction Standards had been completed and assessed by the acting manager. The AQAA informed us that 48 staff have completed the Skills for Care Common Induction Standards, although this figure appears to include some care staff who no longer work at the home. Staff are offered and have attended, free literacy and numeracy courses, whenever this has been necessary. All Staff had been trained in Safeguarding. The acting manager has been able to train people in this topic after completing a specific trainers course, provided by another local authority and is having this training endorsed by Cambridgeshire County Council Safeguarding trainers, so that her previous training is recognised within Cambridgeshire. Care Homes for Older People Page 16 of 23 Evidence: Training in managing medication had been provided by a local pharmacy. The acting manager said she would consider the training in Safeguarding and in the Safe Management of Medicines, that is provided by Cambridgeshire County Council training department, as further training for staff. It was agreed that there are different and higher levels of staff training in Safeguarding that would ensure greater knowledge of the safeguarding process. Some staff had also received training in care planning. The acting manager stated that a complete training analysis matrix, or plan, was being made. The AQAA showed that 26 staff, which equates with 50 of care staff, have an NVQ qualification in care. Care Homes for Older People Page 17 of 23 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 are assured the management of the home is professionally sound and is focused on providing good quality care. Evidence: The home had recently appointed an experienced and suitably qualified manager. She is a trained nurse, although she has not retained her registration with the Nursing & Midwifery Council (NMC) and has some 15 years experience in management of care services. She informed us that she will shortly be applying to become registered with the Commission. The managers office is also a valuable resource library, with written information about Dementia Care, Nutritional Care and Safeguarding matters. A complaints log book is kept for all known complaints. There was an audit and control record of the risks of Legionella and the weekly, monthly and quarterly checks carried out for this. There were records of the fire training and fire drills and testing carried out weekly and monthly and a fire evacuation plan and fire risk assessment, which went as far as recording the level of understanding of each person living at the home. Care Homes for Older People Page 18 of 23 Evidence: Emergency lighting tests had been recorded for the weekly tests carried out, although there was not a record of an annual test certificate for the emergency lighting system. This was discussed with the acting manager when the Fire & Rescue Service Officer attended. The acting manager agreed to deal with this immediately. The Annual Quality Assurance Assessment we asked the home to complete was informative and clearly related to the evidence of the action undertaken by the home. The internal auditing carried out by the acting manager and the assistant manager focused on the essential elements of care, such as observing staff for moving and handling skills, questioning staff for their knowledge about safeguarding and keeping ordered records of the key health and safety management aspects of the home. Staff that we spoke to told us that the manager and deputy manager were approachable and their presence within the home was practical and had a role that allowed them time to be with staff. Regular staff meetings are held and recorded. A visitors support group has been started that can, if they choose, inform the management of their views. Supervision of care staff and team, or unit leaders, is arranged on a regular basis. The home has always reported matters expected under the Care Homes Regulations 2001, Regulations 26 and 37. Care Homes for Older People Page 19 of 23 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 20 of 23 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 19 23 The registered provider must comply with the Fire & Rescue Service report relating to the self-closure devices that are required to be fitted to the doors identified by the Fire Protection Officer. So that people are protected from fire. 08/07/2010 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 2 1 10 The Statement of Purpose should include information about the homes intentions to Safeguard people living there. Unwanted and no longer required medication should be returned to a pharmacist within a suitable timescale, after it has been reviewed that a person no longer needs their medication. The complaints policy should include the address of the Local Authority (LA) Social Care complaints department and the LA Ombudsman, if they are dissatisfied with the homes response to a complaint. Page 21 of 23 3 16 Care Homes for Older People 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 4 30 More in depth and developmental training in the Safe Management of Medicines and in Safeguarding Vulnerable Adults should be considered for all staff. The home should have evidence of an annual check, or test certificate, issued by a suitably qualified person, to ensure the emergency lighting system is satisfactory. 5 38 Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. 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