Care Home: Guide Lane Nursing Home

What the care home does well People have thorough assessments of their needs before a decision is taken about whether the home will be the right place for them to live. Following admission detailed care plans are drawn up to guide staff in what they need to do to meet the needs of each person. This is done in a person-centred manner, which means that each person is encouraged to express their preferences for how their care and support is to be provided. During our visit the people we spoke to were positive about the care and support provided in the home. A person accommodated in the home said, `Staff do more than they are expected to` and a relative commented, `Staff cannot be faulted. They are absolutely superb.` Another relative felt that her mother`s mood and motivation had improved as a direct result of the good care she had received. People living in the home are listened to and their views are taken into account in the planning of future service developments. Staff are particularly good at encouraging people to maintain the relationships that are important to them. This provides excellent outcomes for peoples wellbeing. Staff deal with complaints well and are knowledgeable about what they must do to keep people safe from harm. The home`s environment and equipment are regularly maintained and suitably adapted to meet the mobility needs of the people accommodated. Current best practice was identified in the measures taken to keep the home clean and hygienic as this ensures positive outcomes for peoples health and wellbeing. Staff told us that they received good support from the management and had regular access to a variety of training opportunities to update their knowledge and skills relating to the care of older people. The management of this home is open and transparent and the service is provided in the best interests of the people accommodated. What has improved since the last inspection? No requirements or recommendations for improvement were made at the last inspection. What the care home could do better: We made one good practice recommendation during our visit. This was to ensure that regular weight monitoring should be written in care plans for people who have been assessed as at risk of weight loss. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Guide Lane Nursing Home 232 Guide Lane Audenshaw Tameside M34 5HA     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Val Bell     Date: 3 0 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Guide Lane Nursing Home 232 Guide Lane Audenshaw Tameside M34 5HA 01613359989 01613350948 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southern Cross Care Homes No 2 Ltd care home 41 Number of places (if applicable): Under 65 Over 65 41 41 old age, not falling within any other category physical disability Additional conditions: 0 41 Manager to be supernumerary to the above staffing requirement. No service user under the age of 55 years of age to be admitted into the home. Service Users to include up to 41 OP, 41 PD (E) and up to 41 PD. Two registered nurses must be on duty throughout each 24 hour period. Date of last inspection Brief description of the care home Guide Lane is a purpose built home situated in the village of Audenshaw. The home provides nursing and personal care for up to 41 service users. The home is owned by Southern Cross Home Properties Limited, a private company, and is under the day-today control of a full time manager who is also a registered nurse. Accommodation is provided over two floors and consists of 37 single rooms, four of which offer en-suite facilities, and two double rooms for service users wishing to share accommodation. Two lounge/dining rooms and a smaller quiet lounge are provided offering choice to service users for socialising. A pleasant, well-tended garden is accessible to all service Care Homes for Older People Page 4 of 24 Brief description of the care home users. The home is on the main bus routes to Audenshaw, Ashton-under-Lyne and Manchester and is also close to Guide Bridge and Ashton-under-Lyne railway stations. The current fees charged for this service can be obtained by contacting the manager of the home. A service user guide is also available from the home. This document provides details of the services can can be provided. Care Homes for Older People Page 5 of 24 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: This was an unannounced key inspection, which means that the manager was not told beforehand that we were coming to visit. Our visit was just one part of the inspection. We also looked at other information we had about the home, including events that the manager had told us about since our last inspection. We spoke to staff, visitors and people living in the home to ask their views on the quality of the service being provided. We examined records held in the home, such as care plans, complaints and health and safety records and we looked round the home to assess the quality of the environment provided for the people accommodated. Care Homes for Older People Page 6 of 24 Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 Care Homes for Older People Page 8 of 24 7535. Care Homes for Older People Page 9 of 24 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 10 of 24 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. There are systems in place to asses and monitor individual needs, ensuring that a suitable service is provided based on personal needs and preferences. Evidence: We looked at care records belonging to three people living in the home. Two people had lived in the home for some time, while the third person had been admitted some weeks prior to our visit. We were also able to talk to this persons relative who was visiting while we were in the home. The relative told us that she was involved in her mothers assessment of need and was able to provide important information about how her mother would like her care and support to be provided. We found that these preferences had been written down. This provided evidence that people using this service were respected as individuals. The remaining care records showed that the two people had their needs reviewed on a Care Homes for Older People Page 11 of 24 Evidence: regular basis and any changes in their needs had been recorded and communicated to staff working in the home. The home did not offer an intermediate care service. Care Homes for Older People Page 12 of 24 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 living in this home receive the care and support that they need in the way they prefer. Evidence: We looked at the care records belonging to three people living in the home. Care plans contained clear and detailed information to guide staff on what they must do to meet each persons needs. Individual preferences had been written down about how people would like their care and support to be provided. This demonstrated that people were respected as individuals and that their care and support would be provided according to their preferences. Care plans had been consistently monitored and reviewed and records had been updated appropriately when their needs had changed. Detailed daily records had been kept of the actual care provided and each persons progress had been written down on a weekly basis. We found one minor shortfall in the care plan for a person admitted to the home several weeks before our visit. This person had been assessed as being high Care Homes for Older People Page 13 of 24 Evidence: risk in terms of potential weight loss and her care plan stated her weight must be monitored regularly. Only one weight was recorded at the time of her admission. We spoke to this persons named nurse and it was evident that she had monitored the persons weight, but had not written it down. Staff should consistenly provide written evidence that risks to peoples health and welfare are being managed according to their care plans. We spoke to a relative of this person during our visit. She praised the care her mother received and said there had been a noticeable improvement in her mothers health since she was admitted. She said, Staff are very friendly and helpful and I can rely on them to let me know if my mother becomes unwell. The medication records for these three people provided evidence that they were receiving their medication as prescribed by their doctors. Care Homes for Older People Page 14 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals are both well managed and provide daily variation and interest for people living in the home. Evidence: The home employs an activity co-ordinator who is responsible for organising the social activity programme for people using the service. A person living in the home told us about this. She said that day trips, bingo and painting sessions are some of the activities provided and that staff ask them about the things they like to do. Forthcoming activities were advertised on the homes notice board. Care plans also provided evidence that people are encouraged to choose their preferred activities and routines of daily living. We observed visitors coming and going throughout the time we spent in the home. We asked one of the visitors their views on the care and support provided in the home. She told us that her mothers mood and motivation had improved considerably since she was admitted and she attributed this to the good support provided by the staff. It was pleasing to see that staff continued to provide daily support to a person who used to live in the home. This enabled the people accommodated to maintain contact with a Care Homes for Older People Page 15 of 24 Evidence: valued friend. This was commended as evidence of best practice in encouraging relationships. We joined three people living in the home at their table for lunch. They described staff as helpful and friendly. One person said, You can choose alternatives to the menu and request your favourite food. Dining tables were attractively laid with tablecloths, serviettes and vases of flowers. The mealtime was relaxed and served as a social occasion for people living in the home. Staff were observed to provide encouragement and assistance to people in an unobtrusive manner. Care Homes for Older People Page 16 of 24 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. There are good procedures so people who live in the home are able to express their concerns and be listened to, their rights are protected and they are safeguarded from harm. Evidence: Suitable procedures for investigating and dealing with complaints were in place and this had been communicated to people using the service and their representatives. Three people living in the home told us that they were confident their concerns would be dealt with. One person said, I have no complaints. The staff do a good job and I am happy here, although I would rather be able to live in my own home. If I have any concerns I speak to staff and if they cannot sort it out they will discuss it with one of the senior staff. Suitable policies and procedures are in place at this home to protect people from harm. Staff have received training in this area and the staff we spoke to were able to confidently describe the action they would take if they suspected people living in the home were at risk of harm. During the previous twelve months no referrals had been made for investigation under the local authoritys safeguarding adults procedures. Care Homes for Older People Page 17 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in this home are provided with suitably adapted, clean, comfortable and very pleasant surroundings. Evidence: We looked round the communal space and visited several bedrooms during our visit. The environment was clean and hygienic and no unpleasant odours were present. Domestic staff produced evidence of an efficient recording system that ensured all areas of the home were kept clean and free from infection. This was commended as best practice in providing a healthy environment for people living and working in the home. One person living in the home told us that suitable adaptations had been made to ensure that her mobility needs were being met safely. We found further evidence of best practice in the way that the homes laundry was being managed. This ensured that people could be confident their personal clothing would be laundered with care. Care Homes for Older People Page 18 of 24 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. The people living in this home are supported by a team of staff who know their needs well and who have the skills, knowledge and experience to meet those needs safely. Evidence: The home was appropriately staffed on the day of our visit and rosters provided evidence that these staffing levels had been consistently maintained. We spoke to several staff and looked at training and recruitment records. Staff told us that they received good support and relevant training opportunities where needed. We saw written evidence of this in the file belonging to a newly recruited member of staff. Suitable pre-employment checks had been obtained prior to this person starting work in the home. This afforded protection to the safety and welfare of people using this service. Qualified staff had access to training in clinical procedures and support staff were able to undertake National Vocational Qualifications in care. Care Homes for Older People Page 19 of 24 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 home is managed well and is run in the best interests of the people who live there. Evidence: The registered manager has worked at the home for twelve years and was suitably qualified and experienced. The views of people using the service and their representative are important to her and she makes herself available so that people can express their views on the quality of the service being provided. A formal quality assurance system is in place to systematically audit the policies and procedures used in the home. Regular meetings are held with staff, people using the service and their representatives and their views are used to inform the future development of the service. We spoke to a number of staff, visitors and people living in the home and their opinion was that Guide Lane Nursing Home provides a good service. A person living in the Care Homes for Older People Page 20 of 24 Evidence: home told us that staff, Do more than is asked of them and a relative said, I cant fault them, theyre absolutely superb!. People living in the home are encouraged to manage their personal finances wherever possible, although support is available when they need it. The administration assistant explained the accounting procedures for managing the personal finances on behalf of service users. Full and accurate accounts are in place and individuals have access to their money at all times. We looked at a sample of health and safety records and found them to be accurate and up to date. No health and safety issues were identified during our visit. Care Homes for Older People Page 21 of 24 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 22 of 24 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 8 Staff should consistently provide written evidence to demonstrate that risks to peoples health and welfare are being managed according to their care plans. Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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