Glenfairn House Nursing Home Care Home Service

Transcription

1 Glenfairn House Nursing Home Care Home Service 28 Racecourse Road Ayr KA7 2UX Inspected by: (Care Commission Officer) Type of inspection: Lorna Clark Announced Inspection completed on: 25 June /10

2 Service Number Service name CS Glenfairn House Nursing Home Service address 28 Racecourse Road Ayr KA7 2UX Provider Number dummy Provider Name SP Glenfairn Limited Inspected By dummy Inspection Type Lorna Clark Care Commission Officer Announced dummy Inspection Completed Period since last inspection 25 June months dummy Local Office Address Suite 3 Sovereign House Academy Road Irvine KA12 8RL dummy 2/10

3 Introduction Glenfairn Nursing Home is located in Ayr and is operated by a private provider who has other care services in South Ayrshire. The home is registered to provide care for 75 older people and 10 of the available places may be used for respite. The accommodation consists of a detached stone property with a large modern extension. The home is situated within its own secure, well maintained grounds. Bedrooms are single and double, some with en-suite. There is access to the accommodation on the upper floor by means of stairs or passenger lift. The interior and exterior of the home were in a good state of repair. The overall aim of Glenfairn Nursing Home is: To ensure that all residents are given good quality care based on basic values such as privacy, dignity, independence, choice, rights and fulfilment. Basis of Report This inspection was arranged as an announced visit and was conducted on 25 June 2007, between the hours of 10am and 5pm approximately. The service submitted a completed Annual Return and Self-Evaluation form as requested by the Care Commission. Views of service users: The Care Commission Officers spoke with service users and one relative during the course of the visit. Regulation support assessment: The Regulation support assessment (RSA) helps Care Commission staff to make objective decisions about the level of regulatory support required for each service based upon a set of measurable criteria. The Care Commission Officer (CCO) responsible for regulating the service will consider information supplied on the Annual Return and self-evaluation form, plus a range of other information including: Complaints activity. Changes in the provision of the service. Notifications made to the Care Commission by the service. Action taken in respect of recommendations and requirements. Enforcement activity. New service or change of provider. Child protection/adult protection issues. Staffing and management issues. This information will then be used to undertake an RSA and will help to categorise each service as having one of three levels of regulation support: low; medium; or high. In turn, the RSA will inform the level and type of regulatory activity which takes place within a registered service. The RSA is revisited as appropriate during the inspection year given the fluid nature of providing care services. Note: Not all information supplied by the provider will be used during the inspection process. Rather, the CCO will take account of all information in determining the RSA level and base the intensity of inspection on this. The service received a MEDIUM RSA score. 3/10

4 The inspection was therefore based upon the relevant Inspection Focus Areas (IFAs): Palliative Care Child Protection in Services for Adults Protecting People Restraint Protecting People Adult Protection Scottish Social Services Council Codes of Practice and Staff Training. Two Care Commission Officers, Lorna Clark and Sue Corstorphine conducted the inspection. During the inspection, evidence was gathered from a number of sources including: Service users personal plans Policy information, including child protection, adult protection, restraint and staff training Staff training plans and records Accident and incident reports Staff rota Complaint records Discussion took place with a range of staff including: The general manager The care home manager The deputy care home manager The training coordinator Five care staff Observation were made of staff practices, the environment and equipment. All of the above information was taken into account during the inspection process and was reported on. This year s inspection focus areas (IFAs) have been developed from statutory and policy considerations and have been widely consulted upon. The IFAs are directly linked to relevant NCS. Details of the inspection focus and associated standards to be used in inspecting each type of care service in 2007/08 and supporting inspection guidance, can be found on: The Fire (Scotland) Act 2005 introduced new regulatory arrangements in respect of fire safety, on 1 October In terms of those arrangements, responsibility for enforcing the statutory provisions in relation to fire safety now lies with the Fire and Rescue service for the area in which a care service is located. Accordingly, the Care Commission will no longer report on matters of fire safety as part of its regulatory function, but, where significant fire safety issues become apparent, will alert the relevant Fire and Rescue service to their existence in order that it may act as it considers appropriate. Further advice on your responsibilities is available at Action taken on requirements in last Inspection Report No requirements were made in the previous inspection report. Comments on Self-Evaluation 4/10

5 This was completed on line as required and provided the Officers with additional information regarding the service being provided. View of Service Users Officers chatted informally to several service users. Comments were very positive regarding the care which they receive. View of Carers Officers spoke with one visitor. Comments were again positive regarding the home and included: "This is a lovely home, I am more than happy with my mum's care". 5/10

6 Regulations / Principles Regulation : Strengths Areas for Development National Care Standards National Care Standard Number 5: Care Homes for Older People - Management and Staffing Arrangements Strengths A Protection of Children policy had been devised by the home in April Staff were aware of their role in protecting children from harm and would report any concerns they may have. Staff demonstrated a good level of understanding regarding restraint. It was reported at this time, no direct physical restraining methods were used by the home. Staff were however aware mechanical methods such as cot sides and lap straps were a form of restraint, which must be risk assessed and consented to prior to being used. Care plans provided evidence of service users and their representative having been consulted with regarding any methods of mechanical restraint which were in place. Appropriate documentation and review processes were found to be in place. In house training on Non Violent Crisis Intervention was due to be cascaded to all staff. The company demonstrated a commitment to staff training and development. A new training coordinator had been employed, and spends approximately two days a week within Glenfairn Care Home. Training programmes for each staff group had been developed. These had been devised to take account of specialist training staff may require, examples being external courses with Ayr College for kitchen staff on food hygiene. The company operates a 16 week staff induction and probationary period, with new staff members being allocated a mentor who will supervise their practice and work through the staff induction workbook. The company are an accredited SVQ training organisation. At the time of this visit 34 out of the 46 care staff were either undertaking or had completed their SVQ qualification. The effectiveness of staff training is currently monitored through training questionnaires, supervision of care practices and annual appraisals. 6/10

7 Areas for Development The service had copies of the Mental Welfare Commission s guidance Risks Rights and Limits to Freedom and Safe to Wander. Although the home had previously referred to these guidelines, it was agreed staffs knowledge and awareness should be updated. This will be followed up at the next inspection. Progress regarding the Non Violent Crisis Intervention training will be followed up at the next inspection. At the time of this inspection, the company had begun to review their Adult Protection Policy to take account of forthcoming legislative changes. As a copy of the Local Authority s Adult Protection Guidelines had just been obtained, further work to complete this policy was still required prior to being implemented. This will be reviewed at the next inspection. The company have identified the need for training on adult abuse/adult protection to be cascaded to staff. Progress regarding this will be followed up at the next inspection. National Care Standard Number 19: Care Homes for Older People - Support and Care in Dying and Death Strengths The service had invested a great deal of effort prior to this inspection to ensure they were meeting this inspection focus areas. Managers had developed a range of new policy information, care documentation and staff training programmes, which were in the process of being implemented. The service provides palliative care. Copies of the document Making Good Care Better, which are the National practice Statements for Scottish Care Home, were available and had been used to inform the recent palliative care changes within the home, to ensure a palliative care approach was being delivered. The depute manager of Glenfairn Care Home had recently devised a training package called Back to Basics, which will be rolled out company wide in the coming months. This training will supplement courses already being delivered by the company s training officer regarding end of life care. Staff spoke positively regarding the training available, and the benefit this had to their role within the service. The service had recently devised a Care of the Dying care plan pathway. This had been modelled on the well recognised Liverpool Care Pathway which is currently used within specialist palliative care settings, such as hospices. Staff recognised as this was a new document; changes will be required as they become more familiar with the layout and use this in their day to day practice. 7/10

8 A sample of current care plans were reviewed and found to contain valuable information regarding individual s end of life wishes. The service had in place policy information regarding palliative care, which included utilising specialist advice where appropriate from the nearby local hospice. Staff were confident procedures were in place to communicate appropriately any symptom changes service users may present with, including pain management. Although not used frequently, pain relieving infusion pumps are used by the service, with staff receiving training and support as required from the local hospice team. The manager of this service has also many years experience working within the palliative care field. Areas for Development Officer will review the progress of the Back to Basics training programme at the next inspection. Officers will review the implementation of the Care of the Dying care plan documentation at the next inspection. It was agreed at the time of this inspection, the company s palliative care policy could be expanded to include the contact details of the local specialist palliative care providers, for staff who may be unfamiliar with the local area. National Care Standard Number 99: Other Issues Related to National Care Standards and Regulations Strengths Staffing Levels Managers confirmed staffing levels in recent months had been problematic. This was confirmed by the staff and the staff rota. Recruitment was being progress to fill vacancies. Three new care assistants were attending induction training on the day of this visit. The home manager subsequently forwarded forthcoming staff rotas which demonstrated staffing levels should improve. Maintaining the minimum staffing levels will be a requirement of this report. (See requirement 1) Regulating For Improvement Discussions took place during this inspection regarding proposed changes to the Care Commission s inspection methodology in April The Care Commission will require services to demonstrate their own quality assurance framework and consultation with those using their service. 8/10

9 Areas for Development 9/10

10 Enforcement No enforcement action has been taken since the last inspection. Other Information The following recommendation was made in the previous inspection report: Arrangements should be made to enable service users, whose finances are managed by the home, to have access to their funds outside office hours. Service users and their representatives should be made aware of this facility. National Care Standard Number 1: Office of Fair Trading - Contract Arrangements, Inspection and Complaints Information. This had been addressed. Requirements 1. The provider of the service must ensure minimum staffing levels are maintained at all times. This is to comply with SSI 114 Regulation 13 Staffing. Timescale to address: on publication of this report. Recommendations No recommendations have been made following this inspection. Lorna Clark Care Commission Officer 10/10