Care Home: Glenwood Nursing Home

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What the care home does well There is a satisfactory admission assessment process in place at Glenwood, helping to give an assurance that peoples` needs, wishes and aspirations will be met. Peoples` care plans are clearly person centered, which helps give the assurance that peoples` wishes, aspirations, likes and dislikes are central to their support. It was evident that the key-worker system helps to promote confidence and trust between service users and their key-worker. The key worker system helps to more quickly identify each persons changing needs. It was evident that if possible people living at Glenwood are enabled, empowered and supported to be involved in community participation and community presence. There is a good atmosphere in the home. This is just one example of one of the comments received, "It is a very happy working environment, which in turn provides a happy living environment for the people who we support" There is a thorough whistle blowing procedure in place, giving the assurance that any issues raised will be immediately dealt with. This helps to guarantee that as much as possible is done to protect vulnerable people. There is a thorough and robust recruitment process in place at Glenwood, helping to show that as much as possible is done to ensure that people are protected. Glenwood is very well managed. This helps to demonstrate that service users receive a well run quality service. What has improved since the last inspection? The recently revised Statement of Purpose was observed to contain up to date and detailed information. This concise document is also available in a pictorial format. The previous Inspection report recommended that a more accessible style be initiated. There is now a six monthly quality monitoring system in place, with monitoring forms being completed. The monitoring forms are completed with service users` families, staff member, manager, key worker or the service users named nurse. The manager was successful in being registered (January 2010) with the Care Quality Commission (CQC). What the care home could do better: Although all of the files examined contained up to date information and guidance to provide a good service, it was apparent that files were disorganised. It was suggested to the registered manager, that it would be beneficial to carry out an audit of documentation, in order to archive out of date information. It is recommended to have complaint/concerns forms more readily available. This would give people the opportunity to anonymously (if needed) raise any issues they may have. Overall the environmental standards of Glenwood are in need of some improvements, particularly regarding some areas of redecoration and the outside grounds, needing some work, in order to make them safer, pleasant and more accessible. Key inspection report Care homes for adults (18-65 years) Name: Address: Glenwood Nursing Home Liverpool Road Widnes Cheshire WA8 7HJ     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: Phil McConnell     Date: 2 3 0 3 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 Adults (18-65 years) Page 2 of 29 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 Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Glenwood Nursing Home Liverpool Road Widnes Cheshire WA8 7HJ 01514205945 01514205945 ashwood@c-i-c.co.uk www.c-i-c.co.uk Community Integrated Care Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Vivienne Mary Gorman Type of registration: Number of places registered: care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 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: Learning disability - Code LD The maximum number of service users who can be accommodated is: 12. Date of last inspection Brief description of the care home Glenwood is a care home with nursing care being provided for 12 people who have a learning disability / physical disability. Glenwood is owned and managed by Community Integrated Care, which is a non-profit making organisation. The home is located in the Ditton area of Widnes, near to shops, pubs, post office, and other local amenities. It has a small parking area and a garden area with patio to the rear of the property. The home comprises of two purpose built dormer bungalows with link corridor and office facilities on the first floor. All the bedrooms are on the ground floor and all have fitted furniture and a wash hand basin. Care Homes for Adults (18-65 years) Page 4 of 29 12 Over 65 0 Brief description of the care home Six bedrooms have overhead fixed hoist tracking fitted. There are no en-suite facilities, but there are 4 assisted bathrooms and separate toilets on the ground floor. Also on the ground floor are two large lounge dining rooms, two kitchens and utility rooms. Both lounges have fixed overhead hoist tracking fitted. The home is in a local bus route and close to two local railway stations. The present fees are between £695 - £1,067 per week, depending on individual needs. Information about Glenwood can be obtained directly from the home or from the owners website. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Various information was gathered in order to be able to assess the National Minimum Standards for Care Homes for Younger Adults, including: The Annual Quality Assurance Assessment, this is a document which the registered manager completes every year and it contains information about the service being provided. We use this information, in part to focus on our inspection activity. An unannounced Key Inspection, was carried out on the 23rd March 2010 by the Care Quality Commission (CQC). The registered manager Vivienne Gorman was present throughout the inspection visit. There was the opportunity to observe and speak to some of the people who live at Glenwood, speak to some visitors and discussions also took place with some of the staff team. Peoples files were examined, with all relevant documentation being in place including, initial assessment documentation and care plans. However it was observed that the general organisation of the files looked quite untidy. This was raised with the manager and it was suggested to have a complete audit of the files. A number of the staff files Care Homes for Adults (18-65 years) Page 6 of 29 were examined and they also contained all of the necessary documentation needed for inspection purposes including, recruitment information and evidence of relevant training that has been provided. Throughout the inspection visit there was the opportunity to observe the support and care that was being provided to individuals, which was done in a caring, appropriate and professional manner. The organisations policies, procedures and the health and safety documentation were examined and they were found to be up to date and satisfactory. A full tour of Glenwood was carried out and generally it was found to be of a good standard. (see environment section). Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Although all of the files examined contained up to date information and guidance to provide a good service, it was apparent that files were disorganised. It was suggested to the registered manager, that it would be beneficial to carry out an audit of documentation, in order to archive out of date information. It is recommended to have complaint/concerns forms more readily available. This would give people the opportunity to anonymously (if needed) raise any issues they may have. Care Homes for Adults (18-65 years) Page 8 of 29 Overall the environmental standards of Glenwood are in need of some improvements, particularly regarding some areas of redecoration and the outside grounds, needing some work, in order to make them safer, pleasant and more accessible. 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 Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a satisfactory admission assessment process in place at Glenwood, which helps give assurance that peoples needs, wishes and aspirations will be met. Evidence: The policies and procedures for Glenwood Nursing Home were checked and they were observed to be up to date and thorough. Four of the service users files (two from each unit) were examined. Each persons file contained a photograph of the person. This is particularly beneficial to new members of staff and generally helps to avoid any errors or mistakes occurring. The files contained specific detailed information including, care plans, medical care plans, essential lifestyle plans, risk assessments, medical guidance to prevent hospitalisation, detailed Health Action plans, epilepsy nursing assessments, daily records, daily record of activities, resident care agreements, terms and conditions agreements and specific information regarding, Next of Kin and each persons GP. The recently revised Statement of Purpose was observed to contain up to date and Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: detailed information. This concise document is also available in a pictorial format. The previous Inspection report recommended that a more accessible style be initiated. This recommendation has clearly been addressed, helping prospective service users and their families make a more informed choice about whether to go and live at Glenwood. The admission assessments examined, demonstrated that peoples health, care and support needs are clearly identified. Although all of the files examined contained up to date information and guidance to provide a good service, it was apparent that files were disorganised. It was suggested to the registered manager, that it would be beneficial to carry out an audit of all documentation, in order to archive out of date information. This would help ensure that the most recent and necessary information is more readily accessible. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care plans are clearly person centered, which helps give the assurance that peoples wishes, aspirations, likes and dislikes are central to their support. Evidence: The care plans of four people were examined (two from each bungalow) and they all contained sufficient information to give guidance to the nursing and care staff to enable them to provide the care and support that was needed. The homes statement of purpose says, We are committed to the development of individual care plans for each of the people we support and supporting the best practice to improve independence and wellbeing. There were records indicating, that the care plans had been reviewed on a monthly basis and updated where needed. The care plans were Person Centered, which shows that the focus is on the service user and their needs. Peoples plans included information regarding, their daily activities and routines, their wishes, their likes, Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: dislikes, specific health needs and because the people living at Glenwood are generally unable to vocally describe how they feel, there is very detailed and clear information for each person indicating, when for example, a person may be showing signs of agitation or that they may be in pain. The Annual Quality Assurance Assessment (AQAA) states, A robust Key-worker system is in place to enhance, knowledge, communication, and trust. It was evident that the key-worker system does help to promote confidence and trust between service users and their key-worker. It also gives the assurance that each persons changing needs are more quickly observed and satisfactorily addressed. In observation during the inspection it was evident that trusting relationships exist between members of staff and the service users. Up to date daily records were also observed, which gave relevant and appropriate information, regarding a persons care and support that had been received. It was evident that people are supported to make decisions in their daily lives, with documents now accessible in pictorial format and feedback is regularly sought from service users, their relatives and their individual key-worker or named nurse. There were individual and corporate risk assessments in place, which helped to show that people are encouraged and empowered to be as independent as possible. This was evident in the way that individuals are enabled to access the wider community, with the necessary support. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. When possible, people are enabled, empowered and supported to be involved in community participation and community presence. Evidence: It was evident that a varied programme of activities are available for the service users living at Glenwood, with peoples care plans giving details of the different, varied and specific leisure pursuits and activities that people are supported to participate in. During the inspection visit people were observed being supported in various activities. The home has their own mini-bus,which enables people to access various places of interest. Some of the comments from relatives or peoples representatives were, Been on a lot of day trips and holidays over the years The staff and the service users are all well involved in daily living activities and I have a really good relationship with my Key worker. She helps me with most of my activities. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: The Annual Quality Assurance Assessment (AQAA) states, Key workers have sourced information to enable greater awareness of diversity of social events, which can be accessed by individuals and we can now offer a more varied choice of activities. Although it was evident that people are encouraged and supported to be involved in different activities, it was commented that people would like to have more going on in their lives for example, would like to go out more and would be nice to have more staff on duty, to have more one to one support. Overall the feedback was quite positive, with other comments being, It is a very happy working environment, which in turn provides a happy living environment for the people who we support and we put the needs of the people we support first at all times. It was evident that people are encouraged and enabled to maintain links with family and friends and visitors to the home are made welcome. Relatives and other visitors were observed during the visit, with the comments being, I am always made very welcome and the staff are friendly, helpful and always keep me informed of any changes. During the visit to the home staff were seen to knock on peoples bedroom doors before entering, helping to show that peoples rights and privacy are respected. Records of meals being provided were observed and it was evident that consideration is given to ensuring that varied, nutritional and appetising meals are provided. It was also apparent that individuals specific dietary needs are catered for. This could include,liquidising food or being aware of a persons dietary needs, for example if a person has diabetes. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users personal support and their health care needs are provided in a dignified, caring, professional and supportive way. Evidence: Four service users care plans were examined and they seen to be providing specific and appropriate information to help ensure that peoples personal care and support is provided in a dignified manner. Plans were detailed with specific outcomes for each person. There were accurate up to date records, with information and details from other health professionals who have daily or regular contact with the service users. It was evident that peoples plans are person centered and are focused on the person and their individual specific needs. Files contained evidence that peoples health care needs are being provided,with records of GP visits, hospital appointments and all other appointments and consultations with health professionals. People have health action plans in their files, giving specific and clear guidance about how to provide specific health needs to individuals. The feedback received from Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: service users representatives and relatives was positive about individuals health care needs. Some of the comments were, The care my relative receives is excellent I have been immediately contacted when he was unwell and from a visiting health professional We have a good working relationship with all of the staff. The nurses can be very busy and the work can be physically demanding. During the inspection visit one person was observed to be having an epileptic seizure. The staff were observed to be caring, sensitive and very reassuring to the person. It was clearly evident that members of staff are very well trained and confident in the management of somebody having a seizure. There was a policy, with clear procedures for the administration of medication. The storage of the medicines were examined and they were found to be very well maintained. The medication administration records (MAR) were examined and they were found to be up to date, accurate and and very well organised. One nurse commented, I have recently had refresher medication training with Boots and they come in and do audits of the medicines. Only qualified nurses administer medication. It was suggested to the registered manager to include photographs of each service user on their MAR sheets, this would help eliminate potential errors. There was up to date information available regarding, what medication had been prescribed for, with detailed information available about any possible side affects. The members of staff on duty during the inspection visits were observed demonstrating a caring and respectful approach to service users, and the feedback received from people was that respect and dignity is demonstrated at all times. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a thorough whistleblowing procedure in place, giving the assurance that any issues raised will be immediately dealt with. This helps to guarantee that as much as possible is done to protect vulnerable people. Evidence: No complaints have been received since that last inspection visit. There is a satisfactory policy in place. The previous report completed by the Commission for Social Care Inspection (CSCI) recommended that the complaints procedure should be more accessible to people who use services. This has been addressed, with a more accessible and pictorial complaints format in place. The complaints procedure is conveniently displayed in the home. However, in order for a person to access a complaints form, they need obtain one from the managers office. It was suggested to the manager to make forms much more accessible, enabling anyone who wants to raise any concerns the opportunity to do so anonymously if they wished. The manager was in full agreement and indicated that forms would be placed in strategic places in Glenwood. Five safeguarding referrals had been made since the last inspection visit, with one investigation being carried out. It is evident that the provider is committed to following their safeguarding procedures, helping to give the assurance that vulnerable people are protected as much as possible. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: The training for the safeguarding of adults was assessed to be satisfactory and appropriate. This has been demonstrated in the way that members of staff have had the confidence to raise any concerns they have had. One of the staff said, I recently did the Safeguarding training again, it was very interesting and it always makes you think more, it really makes you think. The AQAA states that support is provided to any whistleblowers. This also gives people the assurance that they will be listened to, with any issues they raise taken seriously. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some redecoration work is needed, in order to bring the home up to a better standard. This will help make Glenwood a more pleasant and comfortable environment to live and work in. Evidence: A full tour of Glenwood was carried out. The home comprises of two bungalows, with a corridor linking them both. The layout of the two bungalows is very similar, although it was apparent that there are differences. For example bungalow 1 was observed to be in a better state of decoration than bungalow 2 and the standard of cleanliness was also much better. This was discussed with the registered manager and an assurance was given that there will be an improvement in the cleaning schedule. We were informed by the manager that there are plans in place to carry out some redecoration within the home. This will consist of the redecoration of the lounge in bungalow 2 and other areas of the home, which will commence in April 2010. Some of the comments received stated, its a nice comfortable home to live in would like to see more modern decoration and the home always smells nice, but could do with some redecoration. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: Overall the environmental standards of Glenwood are in need of some improvements, particularly regarding some areas of redecoration and the outside grounds, needing some work, in order to make them safer, pleasant and more accessible. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a thorough and robust recruitment process in place at Glenwood, helping to give the assurance that service users are protected. Evidence: Four staff files were examined, including the last person to be employed at Glenwood and they contained all of the necessary information that is needed for inspection purposes. Each persons file contained a front page check list, which included individual records of received documents. These documents were checked against the check list and they were found to be accurate, with copies of application forms, health assessments and a copy of a job description for each person. There is a robust and thorough recruitment system in place, with staff files containing relevant and satisfactory evidence that the necessary information and checks have been obtained including, Criminal Records Bureau (CRB), application forms and two written references. It was apparent that correct procedures are carried out, which helps ensure that only suitable people are employed to support and care for vulnerable people. There were sufficient numbers of staff on duty including qualified nurses and it was commented by the manager , there is always at least one qualified nurse on duty and I am also a qualified nurse. Some of the feedback received regarding the staff was, the staff treat him very well they (staff) understand how I Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: am feeling ,even when I am unable to tell them and The staff are really good. Some of the comments from the staff were, We have a good staff team, we all pull together everybody cares a great deal for the people we support Its a lovely place to work in, its homely and nice and we work well as a team and at all times, we put the needs of the people we support. We have a good understanding of individuals personal needs. The staff files contained relevant training certificates and in discussion with members of staff it was apparent that people receive up to date, appropriate and relevant training. Some of the comments regarding the training was, I did my E- Learning at home I find the training that I have done recently has helped my practice in the work place and I have done Mental Capacity Act and DOLS training, it was interesting a full days course. It is evident that the level of training being provided, helps to give the assurance that vulnerable people are supported and cared for by well trained, qualified and experienced nurses and carers. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Glenwood is very well managed, helping to give the assurance that service users receive a well run quality service. Evidence: The registered manager of Glenwood has over 25 years experience in social and nursing care. She is a qualified nurse (RGN) and maintains her nursing registration. The manager was successful in being registered with the Care Quality Commission (CQC) in January 2010. She is applying to commence the National Vocational Qualification (NVQ) in care management. This helps to show that she is committed to maintaining and updating relevant training, in order to enhance her role as the manager. A good management system is in place, which includes the registered manager, deputy manager and qualified nurses. There is also a system in place that incorporates a team of three for each service user, which comprises of a named nurse, a primary and secondary key workers. Some of the comments received regarding the management were, there is a very good support system from both the management Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: and from other team members There is a very good manager, who is approachable and helpful. She has a genuine caring attitude toward service users and the staff Our manager is an excellent leader, friendly but firm, always has other peoples interests at heart and puts herself second and The manager is great , down to earth. She keeps me informed about my relative. In the feedback received from members of staff and from visitors, it was apparent that the manager has made some very positive changes in the home and she is highly regarded. There was documented evidence to show that six monthly monitoring forms are completed. The monitoring forms are completed with service users families, staff member, manager, key worker or the service users named nurse. The statement of purpose says, Our quality assurance monitoring surveys and reviews are used as a valuable tool to ensure continuity of the quality of care being provided. Monthly audits are undertaken by the service manager to monitor the standards of care, which are provided within the service. Records of these monitoring visits were observed and they were found to be informative, constructive, giving guidance and advice with the necessary action required to address any issue. The health and safety policies and procedures were examined and they were found to be up to date and satisfactory. The health and safety inspection certificates were checked and they were all up to date including, the gas service inspection, electrical circuits, portable appliance testing (PAT), emergency lighting, fire alarm and fire equipment and a satisfactory water testing certificate. It was evident that all health and safety checks and maintenance is carried out. This helps to give the assurance that people live and work in a safe and healthy environment. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 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 Individual files would benefit from being audited. This would help improve the organisation and the management of information. Individual photographs of service users on their MAR sheets would be beneficial. This would help reduce any possible errors. It is recommended to have complaint/concerns forms more readily available. This would give people the opportunity to anonymously (if needed) raise any issues they may have. The unwanted items situated in the outside grounds are in need of being removed. This would help ensure that the gardens are safely accessible for service users and staff. It is recommended that the planned redecoration programme is implemented as soon as possible. This would help enhance the decor in many areas of the home. A consistent and robust cleaning schedule should be carried out in both of the bungalows. This will help cleanliness throughout the whole service. 2 20 3 22 4 24 5 24 6 30 Care Homes for Adults (18-65 years) Page 28 of 29 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. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 29 of 29 - 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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