Glenlivet Gardens Care Home Care Home Service

Transcription

1 Glenlivet Gardens Care Home Care Home Service Glenlivet Place Darnley Glasgow G53 7LA Telephone: Type of inspection: Unannounced Inspection completed on: 1 September 2017 Service provided by: JSL Care Ltd Service provider number: SP Care service number: CS

2 About the service The Care Inspectorate regulates care services in Scotland. Information about all care services is available on our website at Glenlivet Gardens Care home provides accommodation and nursing care for up to 56 Older People. The home also provides intermediate care which facilitates discharge from hospital and supports return to the community. During the inspection the service had 38 residents and 13 service users receiving intermediate care. The building is purpose-built on two levels. All bedrooms offer single accommodation with en-suite facilities. There is parking and a garden area to the rear of the building. It is situated in a residential area of south Glasgow, near to public transport and community resources. What people told us Residents and their relatives, we had contact with, were all happy with the quality of care received and in particular praised the staff for being caring and supportive. Relatives also commented that they found all staff and management very approachable. 'overall care and support good, building clean and looked after' 'staff are friendly, caring and supportive, all bedrooms have ensuite shower which is well- maintained and cleaned daily' 'we are totally satisfied with the care and attention. Staff are really caring and we are happy with all aspects of the home' 'the level of care is very good, staff are very approachable and speak to staff or management with no problems. Is very clean and food is always nice'. Self assessment The service was not required to submit a self assessment as part of this inspection. From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership Quality of care and support page 2 of 13

3 Findings from the inspection Residents and relatives told us that they were regularly kept up to date and involved in making decisions about living in the home. We saw that action plans had been developed to address some of the issues raised through meetings and surveys. From observing interactions between residents and staff, viewing documentation and speaking with residents, relatives and staff, we found that residents' care needs were being met to a good standard. We also saw that relevant health professionals were involved where additional advice was needed to improve the outcomes for individual residents. However the evaluations of care did not reflect if the planned care had resulted in the desired outcome and how the resident had benefitted from this as a result. It was also not clear if areas identified for action at care review meetings had been progressed (see Recommendation 1). A care plan summary provided a quick reference for any new staff. This should be reviewed and updated following any changes in care and routinely following any care review meeting. Each resident was allocated a named nurse and keyworker and the service operated a 'Resident of the Day' programme which gave them an opportunity to regularly review all aspects of living within the home with the resident. However, from the keyworker, relatives' communication and resident belongings documentation viewed we could not see that this was taking place (see Recommendations 2 and 3). Residents told us that they were offered a choice of food at all mealtimes and we saw that residents were involved in food group meetings to discuss the quality and choices of food available to them. However the presentation of specialised diets needed to be improved and management told us of their plans to improve these. We also suggested that a table menu may assist residents to remember what they had ordered as well as creating some discussion amongst residents. Requirements Number of requirements: 0 Recommendations Number of recommendations: 3 1. The manager should ensure that resident care is meaningfully evaluated reflecting if the desired outcome has been achieved and the benefit to the resident. National Care Standards for Care Homes for Older people: Standard 6 - Support arrangements and Standard 12 - Lifestyle. 2. The manager review record keeping procedures regarding contact which is made with relatives/next of kin. National Care Standard for Care Homes for Older People: Standard 5 - Management and Arrangements and Standard 6 - Support arrangements. 3. The manager should review procedures regarding the documentation of clothing/belongings brought into the care home and returned to next of kin/visitors. page 3 of 13

4 National Care Standards for Care Homes for Older People: Standard 16 - Private Life. Grade: 4 - good Quality of environment Findings from the inspection People told us that 'the staff are welcoming and friendly creating a homely atmosphere for resident and relatives' as well as it being 'clean and tidy'. We found the home to have facilities which could promote small-group living and after consultation with residents, all the lounge areas in the main home were becoming lounge/dining areas with residents having chosen the new furnishings. One of the residents told us that 'their combined lounge/dining room had worked out very well as it saved a lot of time walking from one area to another'. A relative told us that their relative 'is safe and being well looked after, they know and recognise her likes and dislikes'. People had access to a beautiful enclosed garden area which relatives helped to maintain but unfortunately we did not see any doors open to it and only saw a couple of residents using this space even on a warm, sunny day. Following a residents' meeting, four weekly activity programmes, including entertainers and outings, had been developed for each unit as residents wanted to be able to choose which activities they wished to attend and plan ahead. Although we could not see that requests for a speaker and corridor rummage boxes had been progressed. We found some recorded outcomes for individuals and very personal, detailed life stories from reminiscence days but it was not clear how these informed the outcomes for the people who lived there. The manager also told us of some new planned group activities and some very thoughtful activities for specific individuals. However, the consistent use of life story or 'getting to know me' documentation could hugely enhance staff knowledge and understanding of their residents. We saw some residents enjoying different activities provided within the home lead by one of the activity staff and in particular the group events held in the afternoons in the ground floor lounge/dining room to which all residents were welcomed. However, some service users, including those in the intermediate care unit, felt that 'it can be a long day as nothing really happens' or there's 'not a lot of activities I'm interested in' and we suggested that more involvement from care staff in activity provision could improve this (see Recommendation 1). We also noted that people in the intermediate care lounge had no accessible buzzer to call for assistance when staff were not present. Requirements Number of requirements: 0 page 4 of 13

5 Recommendations Number of recommendations: 1 1. The manager should ensure that all residents have access to meaningful activity on a daily basis. National Care Standards for Care Homes for Older People: Standard 5 - Management and Arrangements, Standard 6 - Support Arrangements and Standard 17 - Daily Life. Grade: 4 - good Quality of staffing Findings from the inspection People spoke very highly of staff and described them as being 'friendly, caring and supportive' and we saw how friendly and enthusiastic staff were in their interactions with residents and relatives. Staff told us that they received appropriate support and training. Some also held a relevant qualification for their professional registration and others were working towards achieving this. To ensure standards of conduct and practice are maintained, all nursing and care staff are required to register with either the Nursing and Midwifery Council (NMC) or the Scottish Social Services Council (SSSC). The service kept a register for relevant staff and monitored this on a regular basis. We saw that all staff were registered apart from some new care staff who were still on induction. We asked management to ensure that they carried out and recorded a NMC or SSSC check where relevant and had a minimum of two interviewers as per best practice guidance 'Safer recruitment through better recruitment'. The manager had developed a 'passport to care' which was being introduced for new care staff during their probationary period. This would ensure that staff reached the required level to meet resident care needs. We discussed how this could be further developed with completion timescales and observation of practice as well as developing a similar document for nursing and ancillary staff. All staff should receive regular supervision meetings to support staff to continue to develop this level of knowledge and skill. The manager acknowledged that these meetings were not as frequent as she would like and was working on improving this. We discussed how this could be further improved by including competency assessments, observation of practice, resident and relative feedback (see Recommendation 1). We also saw that there had been occasional staff meetings and staff were encouraged to share best practice and innovative ideas to improve the service and resident care. levels were monitored by management to ensure that the necessary levels of staff were on duty to meet resident care needs. We found that the staffing levels exceeded the required level and recruitment was ongoing to maintain this. page 5 of 13

6 Requirements Number of requirements: 0 Recommendations Number of recommendations: 1 1. The manager should ensure that staff receive relevant support through supervision and the opportunity to meet to be involved in discussions with other staff regularly as well as being able to develop further in their role within the home. National Care Standards for Care Homes for Older People: Standard 5 - Management and Arrangements. Grade: 4 - good Quality of management and leadership Findings from the inspection The service continued to monitor the quality of staff practice and resident care through meetings, surveys, regular audits and any complaints received. People told us that they knew what to do or who to speak to if they had a problem or wanted to complain. Although we saw that action plans had been developed to address some issues, it was not always clear if the action had been taken or that it had resulted in improvement. We discussed with management about developing an improvement plan to demonstrate the progress made and the improved outcomes for residents (see Recommendation 1). Although there had been a recent change of manager and two new deputes appointed, all had been promoted from within the home and therefore provided a stable management team. We found the manager to be receptive to advice and direction on how to improve and committed to having a positive influence on the home to deliver a quality service. The manager had plans in place to achieve a relevant management qualification and provide supernumerary time for her deputes. We asked management to review the content of the care documentation, including activity records, for both permanent and intermediate care service users and ensure that these were evaluating any progress and reflecting the improved outcomes for service users. We also asked management to ensure that any maintenance or repair issues were being addressed till a new maintenance person was appointed. Requirements Number of requirements: 0 page 6 of 13

7 Recommendations Number of recommendations: 1 1. The manager should demonstrate the action taken and improvements made for any issues highlighted. National Care Standards for Care Homes for Older People: Standard 5 - Management and staffing arrangements. Grade: 4 - good What the service has done to meet any requirements we made at or since the last inspection Previous requirements Requirement 1 The provider should ensure that care plans give clear direction to staff in supporting residents with their needs and that all care documentation is accurate, up to date and meaningfully evaluated in relation to outcomes for residents. This requirement was made on 1 March Action taken on previous requirement We saw that relevant care plans and risk assessments were in place and supporting documentation was up to date. However the regular evaluations of care did not reflect if the planned care had resulted in the desired outcome and how the resident had benefitted from this as a result. See Recommendation 1, Quality of Care and Support. Met - within timescales Requirement 2 The provider must ensure that all care staff are appropriately registered with the Scottish Social Services Council (SSSC) and keep a register to show the date of application, registration, expiry, annual renewal and the position applied for. This requirement was made on 1 March Action taken on previous requirement We found that all staff were appropriately registered and that the manager now had an effective system in place to monitor staff registrations. Met - within timescales page 7 of 13

8 What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations Recommendation 1 The manager should ensure that residents have access to suitable facilities which are safe to use and that the systems in place as well as staff practice promotes resident safety. This recommendation was made on 1 March The assisted bathroom on each unit was seen to be well decorated although initially some storage of equipment was evident in one bathroom. Hot water temperatures were seen to be up to date and within acceptable levels. Fire doors in communal areas were wedged open however on most occasions staff were present or close by. We asked management to check with the Fire Service in relation to the intermediate care unit kitchen door being wedged open. This Recommendation has been met. Recommendation 2 2. The manager should ensure that all residents have access to meaningful activity on a daily basis. This recommendation was made on 1 March Progress reported under Quality of. This Recommendation has not been met. See Recommendation 1, Quality of. Recommendation 3 The manager should ensure that all staff receive relevant training and support in dementia care. This recommendation was made on 1 March We found that all staff had completed the informed level of Promoting Excellence in dementia care and there were plans in place with the local council and college to support staff to the next level. Progress in this will be monitored at the next inspection. This Recommendation has been met. Recommendation 4 The manager should ensure that staff receive relevant support through supervision and the opportunity to meet to be involved in discussions with other staff regularly as well as being able to develop further in their role within the home. page 8 of 13

9 This recommendation was made on 1 March Progress reported under Quality of. This Recommendation has not been met. See Recommendation 1, Quality of. Recommendation 5 The manager should demonstrate the action taken and improvements made for any issues highlighted. This recommendation was made on 1 March Progress reported under Quality of Management and Leadership. This Recommendation has not been met. See Recommendation 1, Quality of Management and Leadership Recommendation 6 The manager review record keeping procedures regarding contact which is made with relatives/next of kin. This recommendation was made on 10 February Progress reported under Quality of Care and Support. This Recommendation has not been met. See Recommendation 2, Quality of Care and Support. Recommendation 7 The manager should review procedures regarding the documentation of clothing/belongings brought into the care home and returned to next of kin/visitors. This recommendation was made on 10 February Progress reported under Quality of Care and Support. This Recommendation has not been met. See Recommendation 3, Quality of Care and Support. Recommendation 8 The manager should review communications systems to ensure all staff are familiar with service user's food choices and preferences. This recommendation was made on 10 February Residents told us that they were offered a choice of food at all mealtimes and we saw that residents were involved in food group meetings to discuss the quality and choices of food available to them. We also saw that residents food likes and dislikes were recorded. This Recommendation has been met. page 9 of 13

10 Recommendation 9 The manager should ensure all personal and confidential information regarding service users is held securely. This recommendation was made on 10 February We saw no concerns in relation to the security of personal or confidential information. This Recommendation has been met Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at Enforcement No enforcement action has been taken against this care service since the last inspection. Inspection and grading history Date Type Gradings 1 Mar 2017 Unannounced Care and support Management and leadership 26 Sep 2016 Re-grade Care and support Management and leadership 3 - Adequate 21 Jul 2016 Unannounced Care and support 3 - Adequate Management and leadership 2 - Weak page 10 of 13

11 Date Type Gradings 12 Feb 2016 Unannounced Care and support Management and leadership 7 Sep 2015 Unannounced Care and support Management and leadership 29 Sep 2014 Unannounced Care and support Management and leadership 23 Apr 2014 Unannounced Care and support 3 - Adequate Management and leadership 3 - Adequate 26 Apr 2013 Unannounced Care and support Management and leadership 7 Aug 2012 Unannounced Care and support Management and leadership 21 Feb 2012 Unannounced Care and support Management and leadership 31 Oct 2011 Unannounced Care and support Management and leadership page 11 of 13

12 Date Type Gradings 12 Jan 2011 Announced Care and support Management and leadership 14 Jul 2010 Unannounced Care and support Management and leadership 5 Mar 2010 Unannounced Care and support Management and leadership 18 Sep 2009 Unannounced Care and support 3 - Adequate 3 - Adequate Management and leadership 3 - Adequate page 12 of 13

13 To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. You can also read more about our work online at Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com Find us on Facebook Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 13 of 13