ࡱ> q  :]bjbjt+t+ 4AAqX]^^^^$ PF,rl eOx"8"ZZZD ,O,O,O,O,O,O$PRPOPOp^^ZZh"ppp(^RZZD ^^^^Dppt?k"DZD7o <42Dp CARE AND SOCIAL SERVICES INSPECTORATE WALES Care Standards Act 2000 INSPECTION REPORT CARE HOMES FOR OLDER PEOPLE Glascoed149 Conwy Road Colwyn Bay LL29 7NADATE OF PUBLICATION 5th July 2007Date of inspection Example. - 31/12/05 (Date inspection Started)30/06/07Time of inspection (Time started on first day: 24 Hour clock)10:00 Working Document?YESLast Visit DateVisit Number~#52163#~Version 5.0XE0015 You may reproduce this report in its entirety. You may not reproduce it in part or in any abridged form and may only quote from it with the consent in writing of the National Assembly for Wales. CARE AND SOCIAL SERVICES INSPECTORATE WALES North West Wales Regional OfficeGovernment BuildingsDinerth RoadRhos on SeaColwyn BayLL28 4UL 01492 54258001492 542569 Home:GlascoedContact telephone number:01492 533737Registered provider:Margaret M Bowe Registered manager:Margaret M BoweNumber of places:10Category:Care Home - Older AdultsDates of this inspection episode from:12 March 2007to:30 June 2007 Dates of other relevant contact since last report:Date of previous report publication:Inspected by:Linda OwenLay assessor: GUIDELINES ON INSPECTION INTRODUCTION This report has been compiled following an inspection of the home undertaken by the Care and Social Services Inspectorate Wales (CSSIW) under the provisions of the Care Standards Act 2000 and associated Regulations. The primary focus of the report is to comment on the quality of life and quality of care experienced by service users. The report contains information on the process of inspection and records its outcomes. The report is divided into eight distinct parts reflecting the broad areas of the National Minimum Standards. An overall conclusion of the homes compliance with Care Homes (Wales) Regulations 2002 is recorded. CSSIWs inspectors are authorised to enter and inspect care homes at any time. At each inspection episode or period there are visit/s to the service in addition to a range of other activities such as discussion groups, self-assessment and the use of questionnaires. CSSIW tries to find the best way of capturing service users and their relatives/representatives experiences of using the service. At any other time throughout the year visits may also be made to the service to investigate complaints and in response to changes in the home. Inspection enables CSSIW to satisfy itself that continued registration is justified. It ensures compliance with: Care Standards Act 2000 and associated Regulations whilst taking into account the National Minimum Standards The care homes own statement of purpose Readers must be aware that the report is intended to reflect the findings of the inspector at the particular inspection episode. Readers should not conclude that the circumstances of the service will be the same at all times; sometimes services improve and conversely sometimes they deteriorate. The National Minimum Standards are also very detailed and some are technical in nature and the CSSIW does not look in depth at all aspects of these standards on each visit. The report clearly indicates the requirements that have been made by CSSIW. This includes those made by CSSIW since the last inspection report which have now been met, requirements which remain outstanding and any new requirements from this recent inspection. Where requirements are made, the provider may develop an action plan to show how they plan to make the necessary changes and you may wish to discuss this with them. The reader should note that requirements made in last years report which are not listed as outstanding have been appropriately complied with. If you have concerns about anything arising from the inspector's findings, you may wish to discuss these with CSSIW or with the registered person. The Care and Social Services Inspectorate Wales is required to make reports on registered facilities available to the public. The reports are public documents and will be available on the National Assembly web site:  HYPERLINK http://www.wales.gov.uk/csiw www.CSSIW.wales.gov.uk OVERALL VIEW OF THE CARE HOME Free text approximately one side A4. The registered person was asked to complete a self-assessment document within 28 days allowing the opportunity to give an objective view reflecting the quality of the service provided areas of achievement and those for development. The document was completed in detail and returned to the CSSIW within the timescales. Following the receipt of this information, the inspector developed an inspection plan that outlined the methods and focus of the inspection. The focus being the service users perspective of the service, staff recruitment and the quality assurance measures. A combination of inspection methodology was used including: Consideration of the core policies/procedures and other information provided with the self-assessment document. Case tracking the care of two of the service users. Wider discussions with the registered persons, service users and staff during the inspection visits. Discussions with three service users relations. Questionnaires to staff. (3 out of 5 staff response ) Questionnaires to visiting professionals. (2 out of 2 responses) Direct testing of the documentation held at the home. Through observations made during one planned announced visit to the Home, 01/05/07, and one unannounced visit, which took place on 05/06/07. Discussions took place with the registered persons. Five of the service users were spoken to on the days of the inspection in private. Relatives/representatives of three service users were involved in the inspection and gave their own views about the service provided at Glascoed; this included the relatives of the two service users who were case tracked. The views of two members of staff were also sought in private. Glascoed was homely, clean and comfortable and it was noticeable that service users who have made it their home were able to live a daily life as near to their previous lifestyle as possible. The atmosphere appeared relaxed and there was evidence of a comfortable and confident relationship between staff and service users. The decoration was maintained to a high standard and the gardens and flower tubs were of their usual high standard with seating should anyone wish to make use of them. There was evidence of a high standard of care provided to those living at Glascoed. Relatives and service users who were involved in this inspection spoke in a positive manner about the service. All the relatives spoke particularly highly of the respectful and thoughtful nature of the care that they observe on a daily basis. They also stated that they have the utmost confidence in the manager, Mrs Bowe, and the staff at the home. This was confirmed by observations and findings on the days of the inspection and by the response to the questionnaires issued. In accordance with the proportionate approach to the inspection of care homes, it is not possible nor is it expected to inspect all aspects of the service in depth during inspection. It remains the responsibility of the registered person to ensure that the home operates in accordance with the relevant laws and regulations. The Inspector would like to thank the service users, staff and management for their warm welcome. CHOICE OF HOME Inspectors findings: Start free text below The registered person has produced a concise document setting out the aims of the home and essential information in an ordered manner. An up to date copy of the Statement of Purpose was provided during the inspection period. This is available in written format or in disc format. The manager assured the inspector that any other format would be made available on request. Service users and their relatives and representatives confirmed, via questionnaires and verbally, that sufficient written information had been given to them on admission to enable them to make a decision in relation to having a trial stay at the home initially and then to make a choice about remaining there. They also confirmed that they had received a copy, in writing, of the complaint procedure and given an opportunity to read previous inspection reports. The manager confirmed that the home was well supported by other professionals including the social services department and primary health care team. A copy of each persons contract is kept in the service users room and signed where possible by the service user, the family or other representative. Requirements made since the last inspection report which have been met: #ZTREQM_COH# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction requiredWhen completedRegulation number Requirements which remain outstanding: #ZTREQO_COH# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction required (previous outstanding requirements)Original timescale for completionRegulation number New requirements from this inspection: #ZTREQN_COH# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction requiredTimescale for completionRegulation number Good practice recommendations: List good practice recommendations below  PLANNING FOR INDIVIDUAL NEEDS AND PREFERENCES Inspectors findings: Start free text below Service users and their representatives confirmed that they discuss their care plans regularly with staff and management, and where appropriate sign them to confirm agreement. Each service user has a separate sheet in their file and any concerns or complaints were noted down. The care plans of the three service users being case tracked were examined in detail and found to be in order. The record keeping has been improved and the care plans now give a more accurate picture of the actual care planning. This work is currently ongoing. Again this year the service users and their representatives were very clear that the manager and staff would do their utmost to accommodate their wishes and gave many examples of excellent practice. Requirements made since the last inspection report which have been met: #ZTREQM_PINP# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction requiredWhen completedRegulation number Requirements which remain outstanding: #ZTREQO_PINP# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction required (previous outstanding requirements)Original timescale for completionRegulation number New requirements from this inspection: #ZTREQN_PINP# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction requiredTimescale for completionRegulation number Good practice recommendations: List good practice recommendations below  QUALITY OF LIFE Inspectors findings: Start free text below Visitors and relatives of service users confirmed that they are always made very welcome by all the staff of the home. Service users said that they spend the day as they choose either in their own room or in the lounge. One service user preferred to spend her time in her room and both she and her daughter said staff made sure that she was not left out of any activities or outings. There are no restrictions on movement around the home, and any restrictions that would be considered only after a full review with written records. Service users can bring their pets into the home, with the agreement of the manager and there are family pets that the service users could interact with if they chose. Staff consulted during the inspection and questionnaires confirmed an understanding of confidentiality. Staff confirmed that this is covered during their induction. Requirements made since the last inspection report which have been met: #ZTREQM_QOL# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction requiredWhen completedRegulation number Requirements which remain outstanding: #ZTREQO_QOL# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction required (previous outstanding requirements)Original timescale for completionRegulation number New requirements from this inspection: #ZTREQN_QOL# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction requiredTimescale for completionRegulation number Good practice recommendations: List good practice recommendations below  QUALITY OF CARE AND TREATMENT Inspectors findings: Start free text below Questionnaire responses and further discussion with service users and their families confirmed that they feel they are treated with respect and consideration at all times. Staff confirmed that they always try to provide personal care with awareness of the service users dignity at all times. Consultations with service users and their representatives during the inspection revealed that the registered manager, Mrs Bowe is highly effective and prompt in contacting health care professionals. It was also felt that the support of service users following medical intervention/hospital stays was excellent. The community nurse who happened to be visiting on the day of the inspection also confirmed this. Service users have a choice to take their meals either by the dining table, on a tray in the lounge or their rooms. On the day of the inspection the meal was seen to be nutritious, plentiful and alternatives were available should the service user wish. Records are kept of the menu choices. The management of medication in the home was not inspected on this occasion. The manager submitted a signed list confirming checks in fire safety, electrical safety, gas installation and lift installations have all taken place.  Requirements made since the last inspection report which have been met: #ZTREQM_QCT# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction requiredWhen completedRegulation number Requirements which remain outstanding: #ZTREQO_QCT# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction required (previous outstanding requirements)Original timescale for completionRegulation number New requirements from this inspection: #ZTREQN_QCT# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction requiredTimescale for completionRegulation number Good practice recommendations: List good practice recommendations below  STAFFING Inspectors findings: Start free text below There have been some turnover of staff during the past year but the central core of staff has stayed the same. A training programme has been put into place to update knowledge. An improved training programme forms part of the aims of the Home for the next twelve months. On the day of the inspection there were two members of care staff on duty plus Mr. Cooke and Mrs. Bowe. Three of the staff team have achieved their NVQ level 2 this means that 50% of the care staff have the required qualification. The home has a written policy for recruitment of staff. This is clearly stated in the Statement of Purpose/Service users Guide. From consultations with staff and management it was clear that high standards of care are expected. The manager has implemented formal supervision of staff. Staff questionnaires confirmed that regular recorded supervision does take place. There are no volunteers working in the home. Requirements made since the last inspection report which have been met: #ZTREQM_STAFF# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction requiredWhen completedRegulation number Requirements which remain outstanding: #ZTREQO_STAFF# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction required (previous outstanding requirements)Original timescale for completionRegulation number New requirements from this inspection: #ZTREQN_STAFF# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction requiredTimescale for completionRegulation number Good practice recommendations: List good practice recommendations below  CONDUCT AND MANAGEMENT OF THE HOME Inspectors findings: Start free text below The manager has a lot of experience and knowledge of the client group she is involved with. Mrs. Bowe does not, at present, wish to gain the Registered Manager Award qualification, although she had had training in other areas. Efforts have been made to employ a manager and advertisements have originally been placed both locally and nationally. The provider informed the inspector that, unfortunately, these have so far proved to be unsuccessful. All service users and their representatives consulted on the day of the inspection expressed their appreciation for the service. The appointee officer of Conwy Social Services handles the finances of service users that are not handled personally or by their families. The quality assurance policy is stated clearly in the Statement of Purpose and service users/relatives/friends/visitors invited to contribute feedback. There is a written and verbal system of seeking feedback from service users and their representatives. Copies of questionnaires were available as evidence that all involved are regularly asked for comments and these are fed into the homes development programme so that the service is improved accordingly. Requirements made since the last inspection report which have been met: #ZTREQM_CMH# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction requiredWhen completedRegulation number Requirements which remain outstanding: #ZTREQO_CMH# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction required (previous outstanding requirements)Original timescale for completionRegulation number New requirements from this inspection: #ZTREQN_CMH# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction requiredTimescale for completionRegulation number Good practice recommendations: List good practice recommendations below  CONCERNS, COMPLAINTS AND PROTECTION Inspectors findings: Start free text below The office manager was advised to alter the complaint procedure in line with the new amendment to Regulation 23 effective 1st January 2007. This states that complaints dealt with locally must be resolved by the registered persons within 14 days and that the complainant must be informed of their right to contact the Inspectorate or the Placing Authority. The Statement of Purpose sets out the existing complaint policy and this is given to all service users when they first arrive at Glascoed to live on a trial basis. There is a complaints book to record any complaints or concerns that may have been made. Both staff and service users confirmed that they were aware of the policy and had access to it. Service users, their representatives and the professionals consulted all said that should they have any concerns or worries they are immediately sorted out. There have been no complaints during the last inspection year and there have been no incidents of POVA. Requirements made since the last inspection report which have been met: #ZTREQM_CCP# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction requiredWhen completedRegulation number Requirements which remain outstanding: #ZTREQO_CCP# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction required (previous outstanding requirements)Original timescale for completionRegulation number New requirements from this inspection: #ZTREQN_CCP# Use Add Requirement button to insert Regulation Numbers in the Regulation Number columnAction requiredTimescale for completionRegulation number Good practice recommendations: List good practice recommendations below   THE PHYSICAL ENVIRONMENT Inspectors findings: Start free text below The home is well maintained, comfortable and homely. The standard of cleanliness is very high and everyone spoken with confirmed this. The same high standard was also observed in the dcor and furnishing of the interior. The manager advised that when a room becomes vacant it be prioritised for redecoration with the involvement of the next person to occupy it. The downstairs area consists of reception rooms combined to form a dining area and lounge area. The garden is very attractive. A professional gardener maintains the gardens with particular attention given to the smell of flowers and plants for all residents to appreciate. Toilet facilities are adequate and convenient for residents and there is an assisted bath on the ground floor. Nine bedrooms have en-suite wash basin and toilet. The manager has obtained the services of relevant professionals such as Speech Therapist, Chiropodist or a Community Psychiatric Nurse where appropriate. Pressure area risk assessments had been carried out and appropriate equipment obtained (e.g. for at least two residents at risk from damage to pressure areas. Bed rails are not used in the home. Grab rails have been fitted for assisting mobility around the home and minimising risks. A call bell system is available and accessible in all rooms. 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