Care service inspection report

Transcription

1 Care service inspection report Validation inspection Jordanhill Care Home Care Home Service 533 Anniesland Road Jordanhill Glasgow Inspection completed on 01 June 2016

2 Service provided by: Foxcare Ltd. Service provider number: SP Care service number: CS Inspection Visit Type: Unannounced Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and set out improvements that must be made. We also investigate complaints about care services and 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. Contact Us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com page 2 of 17

3 1 About the service we inspected The name of this service was changed from Morrison House to Jordanhill Care Home in Jordanhill Care Home is owned by Foxcare Ltd and is located in the Jordanhill area of Glasgow. It provides a care home service to a maximum of 38 older people within an extended traditional sandstone building. Accommodation consists of a large communal living area in the newer building and a smaller sitting room at the front of the home. There is a communal dining room and two reception areas with noticeboards and access to the gardens which have been landscaped to include a sensory area. All rooms except two have en-suite facilities. It offers service users a homely, comfortable and pleasant environment and is easily accessible by public transport. Public amenities are also close by. 2 What we did during the inspection We carried out an unannounced validation inspection on 31 May and 1 June 2016 by one Care Inspector between the hours of 9.15am pm (day 1) and 9.10am pm (day 2). We looked at the annual return, self assessment, electronic notifications submitted by the service, certificate of registration and staffing schedule in advance of the inspection. During the inspection we carried out the following activities; - - Utilising the services of an Inspection Volunteer to capture feedback from residents. An Inspection Volunteer is a member of the public who volunteers to work alongside the inspectors. Inspection Volunteers have a unique experience of either being a service user themselves or being a carer for someone who has used services. The Inspection Volunteer's role is to speak with people using the service being inspected and gathering their views. During the inspection the Inspection Volunteer spoke with 3 residents and 4 visiting carers. The Inspector also spoke with a visiting relative page 3 of 17

4 - Reviewing the content of returned Care Inspectorate questionnaires (10 from 20 issued for residents and 11 of 20 issued for relatives/ carers) - We used the Short Observational Framework for Inspection (SOFI 2) to directly observe the experience and outcomes of people who were unable to tell us their views - Interviewing the registered manager, 2 senior care workers, team leader, student on placement and visiting community nurse - Examining the content of 3 support plans and associated assessments/records - Reading minutes of meetings between management, residents, relatives and staff - Looking at surveys, analysis and action plans produced by the service - Examining how the service uses information from audits to develop the service and checking at how it handles complaints. Feedback on our findings was provided to the Manager and Senior Team Leader at the end of the inspection. 3 Conclusion Based upon our findings and feedback obtained from residents, relatives, visiting professionals and staff we concluded that there remain high levels of satisfaction with the service provided. Our findings indicated that there continues to be positive outcomes for people who use the service and conclude that the grades awarded at the previous inspection remain valid. page 4 of 17

5 4 Quality of care and support Findings from the inspection The service continues to use a range of methods to hear the views of residents, relatives/carers on key aspects of the service. A suggestion box is available for people to use. We looked at minutes of meetings with residents and found that these are being used to capture feedback on key aspects of the service including activities, catering, care plans, communications and staff development. We shared that the structure of the minutes could be better designed to reflect actions to be taken, timescales for achievement and which staff have been identified to take specific areas forward. The service continues to capture feedback from visiting professionals and from relatives. At the point of inspection we could see that the service was in the process of collating the findings from the surveys and developing action plans in response to areas that were identified as areas for improvement. The service uses a "You said...we did" board to share the views of people who use the service and how the service responded. A newsletter is produced on a quarterly basis. We found that there is a good range of information contained within the newsletter which provides details on developments within the home including changes to the environment and staff development. We looked at the content of care plans and associated assessments. These reflected good person centred information to help create a picture of the identity of each resident. Similarly there was good information detailing the best methods for communicating with residents including the use of a visual care plan. We identified a number of improvements which could be made including being fully evaluated to accurately reflect associated risks and measures put in place to minimise the same. We shared an example of a resident who had sustained a number of falls in the preceding months. page 5 of 17

6 We found that the service had used best practice material for an individual resident who had been prescribed covert medication. Care plans also reflected which residents received a fortified diet as a result of unplanned weight loss. We identified that further detail should be provided reflecting how each individual's food is fortified. However, we observed that residents were encouraged to eat and drink well between main meals. The manager has carried out work in relation to identifying the different types of dementia residents have been diagnosed with and has used this information to help staff development. We observed activities being carried out with residents which included a resident leading the activity with others. We noted that staff were responsive in changing/ adapting the activity to ensure participation from all residents. The service has also "tapped in" to using a volunteer from Alzheimer's Scotland to support residents with activities. We carried out SOFI2 observation tool to look at staff and resident interactions. We observed many positive interactions. We found that the majority of staff worked at a suitable pace with residents and communicated well. We identified examples where practices could improve and shared this at the feedback session. We received positive comments from the visiting community nurse indicating that staff make appropriate referrals, carry out any recommendations made and staff are knowledgeable in relation to the current needs of residents. Inspection Volunteer report Residents' comments about care and support: 'It's as good as you get' 'Well looked after'. Relatives' comments: 'The care is up to standard - very good' 'The staff are good at keeping us informed' 'The care is very good' page 6 of 17

7 'I have attended the reviews' 'The staff are good at informing me of anything that's happening' 'The care is excellent' 'The staff know (relatives) likes and dislikes' 'This is terrific. One of the best I have seen' 'The staff are well trained' 'I have filled in a few questionnaires online' 'I phone in regularly especially if I cannot visit'. The residents appeared to enjoy lunch. It was very settled with no music or TVs playing. The tables were set with tablecloths, napkins, cutlery and condiments. The majority of residents did not require assistance but encouragement was given to those who needed it. There was plenty of juice offered throughout the day. Residents' comments about food: 'Food is okay' 'The food is not bad at all' 'The food is very good'. Relatives' comments: 'The food is nice. *** seems to enjoy it' 'The food is very good. We were invited for lunch last Sunday as it was my relative's birthday' 'The food looks pretty good' 'Relative seems to enjoy the food'. The care home did not have an activities organiser. Staff were responsible for the activities. If it was a good day residents were encouraged to go outside. On the day of my visit, there was music playing for exercises and later in the morning residents played a ball game. Residents' comments about activities: 'I enjoy the activities' 'I am unable to take part in some of the activities due to my balance' 'I prefer sitting in my room'. Inspection report page 7 of 17

8 Relatives' comments: 'The activities are good. Outdoors if it is nice or inside on bad days' 'The trips are good' 'Encourage residents to exercise' 'Plenty of good activities going on' 'Entertainment in the evenings' 'Relative is limited to the activities but joins in some. Staff are very encouraging'. page 8 of 17

9 5 Quality of environment Findings from the inspection We found that on the days of inspection the home was appropriately secured, with visitors requiring to sign when they arrive and leave. This means that staff can monitor who is in the building at any given time. There are a checks carried out to ensure that the environment and equipment is in good safe working order. There are audits also carried out by the management team in connection with this area. We identified a need to improve records to reflect when the nurse call system and alert equipment are being checked. There are contracts in place with external contractors to ensure that equipment and systems are kept in safe working order e.g. water system and moving and assisting equipment. We identified some areas/equipment of the home that required either refurbishment or replacement. We were informed that these areas would be addressed however, we found that they had not been picked up in the environmental audits. We were informed that there have been some changes to the arrangements with handy person cover. The post was currently being advertised with temporary arrangements in place. The management team are using best practice tools to monitor key areas of health of residents including pressure ulcer safety cross and falls safety cross. However, see comments within quality theme 1 in connection with evaluations of care plans and risk assessments. We found during the inspection that overall the home was clean, welcoming and comfortable. Staff worked hard to create a relaxed and calm environment. The home has a good range of seating and destination areas offering choice for residents. Bedrooms were found to be homely and contained personal effects. Overall the signage throughout the home was useful for helping to orientate residents and visitors. We identified some bedrooms which did not contain name plates. page 9 of 17

10 We found that access to garden areas were good with residents using the area throughout the inspection. Relatives of residents have been involved with developing a small sensory garden. New garden furniture had been purchased and was in use through feedback from residents and relatives. Inspection Volunteer Report I observed the home to be clean and free from unpleasant odours. There was a large lounge for residents and there were also quiet areas where residents could sit. On the day I visited it was a hot sunny day. Residents were encouraged to sit outside. Staff offered sun protector and umbrellas were up. The gardens were well kept and some relatives assisted with the care of the plants. There were good information boards in the home. Residents' comments: 'The home is kept very clean' 'The place is clean' 'There has been a lot of decorating going on' 'I have a beautiful room' 'My room has all my family photographs'. Relatives' comments: 'The gardens are nice to sit in' 'Relatives room is personalised' 'The home is kept clean' 'We help out with the garden. My relative enjoys the outside' 'Their room is cleaned every day' 'The garden is lovely' 'It's a lovely place to sit and chat' 'There are no unpleasant odours' 'It's brilliant outside'. page 10 of 17

11 6 Quality of staffing Findings from the inspection We interviewed staff and found that there were a number of themes emerging; - staff feel that there are good supports from the management team, there is good team working and staff morale is currently good. We heard that there are good training and development opportunities. Staff have undertaken dementia training through Stirling University and that there is a blended approach taken to training i.e. face to face as well as on line training. We heard that there is regular planned supervision sessions and staff value these as an opportunity to discuss key aspects of their work. We sampled records associated with staff supervision, we found the quality of content varied and could be further developed by encouraging staff to reflect on practices and consider how training undertaken will shape day to day practices. We identified that whilst there is a staff training matrix, this needs further development to give the manager an "at a glance" record of training undertaken or due for each staff member. The management team are currently working on developing staff appraisals which is part of the management improvement plan for the service. We found that the service is committed to having a well trained and skilled staff team, this includes supporting staff to obtain SVQ qualifications. We heard that specific staff have been identified as taking on a "champion" role to ensure best practices are being adhered to. We looked at minutes of meetings with staff, it was evident that staff are encouraged to contribute their views and offer suggestions for helping to take the service forward. The format of the minutes should be amended to reflect what actions have to be taken, by whom and reflect timescales for achievement. The service should continue to involve residents and relatives with the recruitment and selection of staff. page 11 of 17

12 We received very positive feedback from residents and relatives in relation to the quality of staff. This included feedback from the completed and returned Care Inspectorate questionnaires. We discussed with the management team of capturing specific feedback and using this when staff supervision session are carried out. Inspection Volunteer Report The staff appeared to be friendly and chatted away to all of the residents. Residents' comments: 'Some are very good' 'The staff are very reasonable' 'The staff are lovely'. Relatives' comments: 'The staff are really friendly. They talk to you when you visit' 'The staff are lovely. They seem very experienced' 'The staff are great' 'You can ask them anything and talk to them' 'The staff are so caring' 'They are good with the residents'. page 12 of 17

13 7 Quality of management and leadership Findings from the inspection We found that the management team continue to be very visible, have a good level of knowledge regarding the current needs/preferences of residents and are readily accessible to residents and families. We were informed that there have been no complaints received by the service since the previous inspection. The manager has devised a number of systems to have an overview of key areas including care reviews, residents' BMIs and weights and dependency levels on a monthly basis. This is used to check if interventions and strategies are being effective for meeting residents' needs. Whilst a range of audits are carried out we identified a number of improvements that needed to be made - see comments in relation to care plans in quality theme 1 and the environment in quality theme 2. We shared at feedback that care plan audits did not always identify areas of improvement or remedial actions. We suggest that the manager should sample these audits to check that they are being comprehensively completed. We found that the completed and returned Care Inspectorate questionnaires (10 of 20 issued to residents and 11 of 20 issued to relatives/carers) either agreed or strongly agreed with the statement; - 'Overall, I am happy with the quality of care and support provided by the service.' Comments relating to the quality of management and leadership from completed questionnaires; - "I am happy with my mother's care manageress, very pleasant and always very happy to see us when we visit and has time to talk to each and everyone. Staff are great so helpful and they also have a smile from you. I am so happy my mum is there." page 13 of 17

14 "I'm confident that my mother is receiving the best possible care. The care home is well managed and the manager is always ready to meet with me to discuss my mother's health and wellbeing." "My mother has been in Jordanhill House for X (number) of years and her standard of care, cleanliness and homeliness has been of a consistently good standard. The manager and carers do a very good job. I have recommended this care home to other people." "If you have to be in a care home this is the best. We see the manager every day and she makes me feel special. Nothing is a bother." Inspection Volunteer Report The manager had an open door policy and I found them very approachable. Residents I spoke to said they would speak to the manager or the staff if they had a problem. Relatives' comments: 'I know who the manager is' 'If I had a problem I would speak to a member of staff or the manager who is very approachable' 'Always takes on board anything you say' 'We had teething problems when my relative moved in but they were soon sorted' 'I know the manager. She is very good at keeping you up to date about what is happening' 'Manager is great. She is approachable'. page 14 of 17

15 8 What the service has done to meet any requirements we made at our last inspection Previous requirements There are no outstanding requirements. 9 What the service has done to meet any recommendations we made at our last inspection Previous recommendations There are no outstanding recommendations. 10 Inspection and grading history Date Type Gradings 12 Jun 2015 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good 17 Jun 2014 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing 6 - Excellent Management and Leadership 5 - Very Good page 15 of 17

16 15 Aug 2013 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good 20 Feb 2013 Unannounced Care and support 4 - Good Environment 4 - Good Staffing 5 - Very Good Management and Leadership 5 - Very Good 10 Dec 2010 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed 10 Aug 2010 Announced Care and support 5 - Very Good Environment 5 - Very Good Staffing Not Assessed Management and Leadership Not Assessed 8 Jan 2010 Unannounced Care and support 4 - Good Environment Not Assessed Staffing 4 - Good Management and Leadership Not Assessed 12 May 2009 Announced Care and support 4 - Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good page 16 of 17

17 To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. You can also read more about our work online. Contact Us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY Other languages and formats This report is available in other languages and formats on request. Inspection report Tha am foillseachadh seo ri fhaighinn ann an cruthannan is c?nain eile ma nithear iarrtas. page 17 of 17