Care Home: Glenside Residential Care Home

What the care home does well People using the service are afforded the right to privacy and dignity by a staff team that is very dedicated to their work and consistent in their approach. People using the service will be enabled to maintain their skills with choices being an integral part of the philosophy of the service. The service is always run in the bets interests of people living at Glenside. The loyal staff team was very knowledgeable about the needs of people using the service and demonstrated that they had a good understanding of the homes policies, procedures and good practice at the home. A staff team that has been appointed through a robust recruitment and selection process supports people living at the home. There is a range of activities/facilities available at the home to enrich the lifestyle of people using the service. The home is maintained to a good standard with a range of communal areas to choose from and a garden to sit in when the weather permits. What has improved since the last inspection? No requirements were made at the last inspection. What the care home could do better: No requirements were made at this inspection. We did make two recommendations on monitoring odour within the communal areas and storage of accident records in line with data protection guidelines. Key inspection report Care homes for older people Name: Address: Glenside Residential Care Home 179-181 Weedon Road Northampton Northants NN5 5DA     The quality rating for this care home is:   three star excellent 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: Judith Roan     Date: 0 1 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 26 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 26 Information about the care home Name of care home: Address: Glenside Residential Care Home 179-181 Weedon Road Northampton Northants NN5 5DA 01604753104 01604750760 enquiries@glensidecarehome.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Glenside Care Home Limited Name of registered manager (if applicable) Mrs Sandra Elaine Gamble Type of registration: Number of places registered: care home 30 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: 30. The registered provider may provide the following category of service only: Care Home - Code PC To service users of the following gender: Either Whose primary care needs on admision to the home are within the following categories: Dementia - Code DE Old age, not falling within any other category - Code OP (5) Maximum number 5 Date of last inspection Brief description of the care home Glenside is a residential care home that provides care and accommodation for 30 older people over the age of 65 with dementia. It is owned by Glenside Care Home Ltd, directors Mr T and Mrs S Hutchinson. The home is located in a suburb of Northampton, close to the St James shopping centre, public houses, post office and other amenities the town centre and amenities are close by, the home is easily accessible by public Care Homes for Older People Page 4 of 26 Over 65 0 5 30 0 Brief description of the care home transport. The premises consist of a large extended detached house, which is setback from a main road and to the rear of the property there is a large conservatory that overlooks a pleasant paved patio area and a landscaped fully enclosed garden. To the front of the property there is a private car park that has disabled access to the home. Care Homes for Older People Page 5 of 26 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: three star excellent 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 3 star. This means the people who use this service experience good quality outcomes. The focus of inspections undertaken by the Care Quality Commission (CQC) is upon outcomes for people who use the service and their views of the service provided. This process considers the services capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was case tracking which involved selecting three people who use the service and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. The homes registered manager also completed an Annual Quality Assurance Assessment (AQAA) a questionnaire required to be completed by CQC. We received 9 surveys from people that use the service and 9 from staff. The inspection was Care Homes for Older People Page 6 of 26 unannounced over two days and took 8.5 hours. The current fees range is available from the manager at the care home. People using the service said: I like the food it is always good to eat They support me well with personal care Any problems and they sort it out The staff surveys all said: That they have information about the people they support All employment checks are carried out Induction is completed well there is regular support They know what to do if they have a concern. There is always enough staff to meet the needs of people living at Glenside. individual comments from staff on what the home does well: offers person centre care Provide a safe environment that is homely Provide freshly cooked food Cater for everyones need Managers/Directors are supportive Provide all the training that is needed Care Homes for Older People Page 7 of 26 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 8 of 26 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 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information and pre-admission assessment ensures that the personal care needs of peoples using the service can be met. Evidence: Copies of the statement of purpose and service users guide are available within the home. New residents and their relatives are made aware of these documents or are given copies to read prior to admission. On speaking with a relative they confirmed that they had received extensive information about the home prior to their family members admission. All new service users are welcomed into the home by key staff. Staff assist new residents to familiarise them to their surroundings by providing reassuring prompts. In viewing the care file on a new resident we found that a full assessment of need had been completed prior to their admission. Extensive information is gained about the social background of individuals moving into the home from relatives and others that Care Homes for Older People Page 10 of 26 Evidence: know them well. Staff said that they were very satisfied with the information gained within the assessments, as it gave them a good pen picture of the persons needs. In reviewing the care files an assessment of need was undertaken prior to admission gaining information about their needs and social history. The care file also contained a signed contract. Care Homes for Older People Page 11 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can expect that their health and personal care needs will be fully met. Evidence: The care plans of three people that use the service were case tracked. Plans are developed from the assessments of need undertaken on admission and or via the review process used within the service. Preferences in relation to gender of the carer to support with personal care is promoted and respected. Evidence was found on files that plans are reviewed monthly or more often as required. In case tracking one person who has high needs, we found that the care plans had been updated since a recent incident and gave good instructions to staff on how to meet the persons additional needs. Care plans are supported by risk assessments that are fully completed and provide staff with actions to take to minimise risks. Quality assurance systems within the home ensure that plans are reviewed. We also found evidence across the files that falls, pressure area care, nutritional and fluid intake was all being monitored. Care plans are person centred as they contain full Care Homes for Older People Page 12 of 26 Evidence: information of each persons preferences. It was evident that health care needs of people using the service are met . The files seen provided evidence provided that the service has a positive working relationship with local healthcare professionals who visit people at the home at an individuals request or when a staff member has identified concerns/needs. In observation of care practices during the inspection carers were seen to be respectful in their approach and supported people to maintain their dignity by being discreet in how they approached people when personal care was being offered. In speaking with relatives of people that use the service, all commented that the staff were professional and maintained the privacy of individuals. Staff were fully aware of the needs of people they supported and aware of good practice in relation to personal care. Medication profiles are in place and managers monitor administration practice to ensure that medication is handled, stored and administered in accordance with the Royal pharmaceutical society guidelines. We observed medication being administered and checked records held, which were all correctly kept. Good infection control was maintained by the staff member using PPC (gloves) during the task. Care Homes for Older People Page 13 of 26 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 using the service have a choice of activities that promotes an enriched lifestyle within their disability. Evidence: The range of activities open to people living at Glenside is wide with individuals having a choice of both private and communal areas to spend their day. In observation of people throughout the inspection they were seen to be supported with choice of which lounge they wanted to sit in, where they can choose music, watching TV or be in a quiet area to read. There is a programme of events throughout the month which individuals can choose to join in with. There is a lively atmosphere within the home that is promoted by staff attitude and approach. The AQAA confirms that at Glenside Our care plans have dedicated sections to deal with all aspects of daily life and social activities. For example, these include food and diet, personal relationships, daily activities and personal history. We have regular external entertainers coming into the Home. These include old time music, musical interaction where the Residents are given instruments to join in, PAT pet therapy, reminiscence therapy and armchair exercise. We have our own internal activity programme including video times, bingo, crafting, gardening, cooking and newspaper Care Homes for Older People Page 14 of 26 Evidence: reading. Once a month we have songs of praise afternoon. On separate occasions we have a monthly church service and communion hosted by the local Church of England vicar. The service is tailored to suit all denominations. Residents are assisted and encouraged to maintain contacts with families and friends. Families are always welcome into the home and often called several times a week. In discussion with one relative they said that their family member was happy at the home and there was always something to do. Relatives confirmed that there were no restrictions to visiting and that they were made welcome. There are extensive and well maintained gardens at the home. These provide a safe circular route to enable individuals to a have points of interest whilst walking through the various levels in the garden. A healthy menu is available for people that use the service. All meals are served in the dining room or on a tray in their room. The dining rooms are light airy and pleasant areas to enjoy a meal. Catering staff freshly cook meals each day.The menu is drawn up by taking personal preferences taken on admission. An alternative menu is always available. Soft diets were well presented. Thee home has gained the four star award from environmental health for healthy menus. Drinks are available throughout the day. Residents confirmed that they had enjoyed their meal on the day of the inspection. Additional drinks are available on request twenty-four hours days. Fluid and food intake charts are kept for people assessed as in need of additional support with nutritional intake. Care Homes for Older People Page 15 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Practices within the service protect people who use the service and ensure that they are listened to. Evidence: People spoken with said that they felt safe living at Glenside. Relatives were clear about who do speak to if they had a concern or felt that there relative was not being treated appropriately. Carers also said that they would report any concerns and knew that there is a whistle blowing policy in operation at the home. The home has received two complaints over the past twelve months. One deprivation of liberty referral has been made to protect an individual at the home and this has been granted by the local authority. A complaints policy and procedure is in operation at the home with the AQAA and managers confirming that: We try to have a relaxed relationship with Residents and their representatives so that they come to us at any time to discuss matters. Access to the Safeguarding Adults or Protection of Vulnerable Adults documentation is available to all in our office. As our Residents suffer from dementia we review them during our quarterly Self Assessment plan and include discussions around this topic. We consider carefully the implications of the Mental Capacity Act and our actions within it. We use advocacy services from IMCA (Independent Mental Capacity Advocates) Service and Age Concern where necessary. One Director has taken accredited training with Action on Elder Abuse to be able to do in-house staff training on the subject. Care Homes for Older People Page 16 of 26 Evidence: The services recruitment systems ensures that staff working at the home are subject to robust employment checks, that include, employment history, references and criminal record disclosure checks. A copy of the local safeguarding protocol and procedure is held at the home. Care Homes for Older People Page 17 of 26 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. The home is well maintained providing a homely environment. Evidence: The front door of Glenside opens into a hallway which has two lounges/dining rooms to the left and right. Further along the hall are the offices where day to day records are stored. The hallway continues with bedrooms and bathrooms on each side eventually leading to another large lounge that has doors leading to the extensive and safe grounds. The first floor assessed by lifts accommodates more bedrooms. The second floor provides offices and a training room for in house training of staff. In touring the building all areas were seen to be clean, hygienic and maintained to a high standard. Housekeeping staff have a well planned routine. On the first day of the inspection staff were undertaking a deep clean of one of the lounges. The communal areas were clean and furnished to a good standard with homely touches throughout the home. The communal areas facilitate the company of peers or quiet areas where people can sit and enjoy the views into the garden. The gardens are well maintained, with a range of mature plants and shrubs. The security at the home has been reviewed since a recent incident where a resident climbed through a ground floor window and scaled the fences/hedges in the rear Care Homes for Older People Page 18 of 26 Evidence: garden. The AQAA supplied information prior to the inspection about the frequency of safety checks and the maintenance of the home. On reviewing these at the home all were in order. There is good domestic routine within the kitchen to ensure that food hygiene practices are maintained. All areas throughout the home are maintained to a high a standard of cleanliness. Two complaints have been received by CQC about odours within the home from a relative that visits. This issues was fully discussed with the provider and agreement made that they would increase their monitoring of this part of their service. The provider and manager would welcome feedback from anyone visiting the home to inform them of any situation that arose of an area not being clean. With the needs of the people that the home supports it is important to be proactive to accidents and to maintain positive support with personal hygiene. Whilst at the home we noted only one area, the lift, that had an odour. This was swiftly dealt with by staff at the time. We noted good hygiene practice of carers and looked at records relating to infection. These records gave no cause for concern. We have not received any notifications in relation to illness or infection within the home over the past year. A programme of redecoration and refurbishments is ongoing within the home and people using the service confirmed that they are always consulted about changes. Bedrooms contained personal items of furniture and electrical equipment such as TVs, video and DVD players, Radios and CD players, personal paintings and photographs. Care Homes for Older People Page 19 of 26 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 excellent 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 are safe as a result of the robust recruitment procedure and support from a competent staff team. Evidence: Glenside has a thorough recruitment procedure and files seen confirmed that required employment checks, application form, two references, criminal records bureau disclosures and interviews have taken place. The staff team have a sound knowledge base about the needs of people that use the service. Through observation during the inspection they showed that they had a range of skills to support individuals and were proactive in maintaining everyday living skills. In addition to carers catering staff and domestic staff have access to with most attaining a National Vocational Qualification (NVQ) in their areas of expertise. Staff are supported by the Registered Manager and directors of the service with regular supervision and yearly appraisal development meetings. The provision of ancillary staff enables residents to receive uninterrupted and focused care from care staff. Carers are offered a range of opportunities to train. Of the care staff team of seventeen, fifteen have achieved National Vocational Qualification at level two or above. This is above the required National minimum standards (NMS) of 50 of staff being qualified. The manager and one of the directors has completed the Registered Care Homes for Older People Page 20 of 26 Evidence: Managers Award (RMA) and NVQ 4 in Care and Health. The other director completed NVQ 3 in Direct Training and Support. He has also obtained the RMA and is in the process of completing NVQ 4. Carers spoken to have a good knowledge of the needs of people using the service and were committed to providing a good service. They felt supported received formal regular supervision. Carers have access to a wide range of training topics that includes Health and safety, Fire, safety, Food Hygiene, infection control, safeguarding, healthy eating, activities for residents, and dementia awareness. Training records confirm that all staff had completed manual handling training and undertake annual refresher training. Records seen were up to date and comprehensive. Discussions with staff and the viewing of staff records confirmed that all newly recruited staff undertake a detailed induction and foundation training programme within the first six months of employment, the level of training provided is reflective of that which is expected by Skill Council. The programme of induction and foundation training covers five areas of expertise, focusing on the principles of care, the role of the worker within the organisation, maintaining safety at work, communication and recognising and responding to abuse or neglect. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is managed in the best interests of people living at the home. Evidence: There is good clinical governance within the service that ensures that people living at Glenside have their needs met and reviewed. There are good records of ongoing monitoring of the care being delivered at the home. Staff meetings are held on a frequent basis to discuss practice issues. All staff felt that they were supported by managers and had the opportunity to discuss issues arising in the work place. The staff rota is developed to ensure that there is a balance between direct work with people using the service and administrative tasks. The AQAA confirms the following in relation finances of people that use the service, Currently the Home does not look after any Residents finances. This is done by Care Homes for Older People Page 22 of 26 Evidence: Representatives who have power of attorney or in some case appointed by the Court of Protection. When it becomes necessary for the Home to act on behalf of the Resident procedures are in place to deal with this. All accidents and incidents are recorded and audited. The storage of these records were all in one file and do not meet Data protection guidelines. Health and safety procedures are in place with regular fire and health and safety checks being undertaken. The Pre Inspection Questionnaire submitted prior to the CQC site visit detailed the regular maintenance of health and safety systems within the home, including fire systems and equipment, environmental health visits, central heating systems and emergency call systems. There is a good quality assurance system in place with the use of surveys and regular meetings with the representatives of people that use the service. These meeting are fully recorded and available within the home. Care Homes for Older People Page 23 of 26 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 24 of 26 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 2 26 37 It is recommended that monitoring is undertaken to ensure that odours within the home are kept to a minimum. It is recommended that the recording of accidents is undertaken to ensure it is line with data protection legislation. Care Homes for Older People Page 25 of 26 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. Copyright © (2009) Care Quality Commission (CQC). 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. 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