Inspection on 08/05/09 for Greenaways Rest Home

This is the latest available inspection report for this service, carried out on 8th May 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Greenaways Rest Home 08/06/06

Greenaways Rest Home 04/10/05

Greenaways Rest Home 04/05/05

Greenaways Rest Home 05/01/05

Greenaways Rest Home 17/08/04

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Greenaways Rest Home 56 Collington Avenue Bexhill-on-sea East Sussex TN39 3RA     The quality rating for this care home is:   two star good 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: Caroline Johnson     Date: 1 2 0 6 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 26 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 26 Information about the care home Name of care home: Address: Greenaways Rest Home 56 Collington Avenue Bexhill-on-sea East Sussex TN39 3RA 01424210899 01424732704 britheadoffice@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Jacqueline Brittain Name of registered manager (if applicable) Mrs Rosemarie Standley Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 12 The registered person may provide the following category of service only : Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Dementia (DE) Date of last inspection Brief description of the care home Greenaways is a detached property situated approximately one mile from Bexhill town centre. Resident accommodation is provided on two floors; a stair lift is fitted to assist service users to access first floor rooms. The home shares a large pleasant rear garden with another care home next door owned by the same proprietors. Greenaways is registered to accommodate up to twelve older people with dementia. The registered providers are Britannia Care Homes Ltd who also own another three homes in the area. The fees charged as of May 2009 are up to 450 pounds per week. Care Homes for Older People Page 4 of 26 care home 12 Over 65 0 12 Brief description of the care home Additional charges are made for chiropody and hairdressing. Care Homes for Older People Page 5 of 26 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: two star good 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: For the purpose of this report the people living at Greenaways will be referred to as residents. As part of the inspection process an unannounced site visit was carried out on 8th May 2009. However as there was an infection in the home it was assessed as more appropriate to return at a later date to carry out the inspection. A further visit was carried out on 12 June 2009 and this visit lasted from 10:00am until 4:40pm. During the visit there were opportunities to meet with the owner, the appointed manager, a visitor to the home and with two members of care staff. Time was spent speaking with residents in the lounge area and observing lunch and part of an activity Care Homes for Older People Page 6 of 26 in the afternoon. A wide range of documentation was examined including the preadmission documentation held in relation to one resident and two care plans. In addition records held in relation to staff recruitment and training, staff rotas, menus, complaints, quality assurance and health and safety were examined. Since the last inspection the registered manager no longer works at the home. A new manager was appointed from within the company and at the time of inspection her application for registration was being processed by the Commission. 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 Care Homes for Older People Page 8 of 26 printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 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 26 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. A detailed assessment of prospective residents needs is carried out prior to making a decision about providing accommodation. Evidence: There is a detailed statement of purpose and service user guide in place. All new residents are issued with a copy of the terms and conditions of residence. At the time of this inspection there were ten people accommodated. When a referral is received the owner and where possible the manager carries out an assessment of the needs of the prospective resident. Records were seen in relation to one resident admitted to the home. The assessment seen was detailed and clearly stated the support that the individual would require and how it should be provided. The home does not cater for intermediate care. Care Homes for Older People Page 11 of 26 Care Homes for Older People Page 12 of 26 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. Care plans provide detailed information about the needs and abilities of the residents. There are good systems in place to ensure that the healthcare needs of the residents are met. Evidence: Two care plans were examined on this occasion. In each case the needs of the residents were clearly stated along with advice to staff on the action to be taken to meet the needs identified. Where a risk is identified there is a risk assessment in place. Care plans are reviewed on a monthly basis. Since the last inspection a new form has been introduced. This is entitled client centred dementia care plan. This involves the home carrying out an assessment of the degree to which dementia affects each individual and this will assist staff in monitoring how each residents dementia progresses over time. One form seen in relation to one resident showed information about how the resident can be supported to make choices and there was also advice about how to react if someone is repeating the same information over and over. Care Homes for Older People Page 13 of 26 Evidence: In each of the care plans seen there was evidence that a care plan meeting had been held. Generally the relatives of residents are invited to these meetings and the care plan is discussed and signed by the relative on behalf of the resident. At minimum these meetings are held once a year but if a residents needs change then the meetings can be more frequent. Records seen in relation to the storage and handling of medication were in order. The home ensures that residents attend a range of health care appointments as required to meet their individual needs. These include chiropody, dentist and opticians. In addition, for some, there is regular contact with district nurses or with a community psychiatric nurse. It was noted that the home had been successful in assisting a resident to establish a good sleeping pattern and as a result the resident is much more settled and able to participate more fully in all the activities on offer in the home. Where a resident is assessed as needing bed rails at night a risk assessment is carried out and a relative is asked to sign their agreement with this. It was noted that the wording of the current format could be misconstrued and the manager agreed to reword the form to ensure it is clearer. Care Homes for Older People Page 14 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a wide range of interesting and stimulating activities available for residents. Evidence: Since the last inspection one of the care staff has been appointed as activity coordinator. Activities include karaoke, target games, icing cakes, ball games, film, client forum and table games. In addition staff stated that residents enjoy sing songs. Musical entertainment is also brought in to the home twice a month. One resident is funded to receive one to one staff support to make use of the local community once a week. A staff member stated that this resident is able to choose what they would like to do and often chooses to go bowling or play mini-golf. Activities on the day of inspection included pat dog followed by icing cakes and a discussion about recipes. The majority of residents participated in these activities and thoroughly enjoyed the process. There was one visitor in the home at the time who also participated in the cake icing. Visitors are welcomed to the home at any reasonable time. Time was spent with a visitor to the home who stated that their relative is very happy and there is a lovely Care Homes for Older People Page 15 of 26 Evidence: atmosphere in the home. They also stated that since the new manager was appointed the numbers of activities have increased and residents are always doing something. There is a four weekly set menu which is displayed in the home. Staff advised that they now have a picture of all the meals served in the home and that they have individually been laminated. The pictures are now used to inform residents about what is on the menus and to assist them in making more informed decisions about what they would like to eat. It was noted that emphasis is being placed on ensuring that residents have five fruit or vegetables a day. There is currently no choice on offer on the menu. Staff stated that the cook is aware of each residents likes and dislikes and that the menu is adjusted to cater for this. On the day of inspection one resident refused the meal served and they were offered a sandwich. Residents were offered the dessert on the menu but after much discussion many residents chose different variations of the dessert and some chose to have cheese and biscuits. Staff were observed supporting residents with their meal and it was noted that there was a very good atmosphere in the dining room, interaction skills were good and the meal time was not rushed. Care Homes for Older People Page 16 of 26 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. Systems are in place to enable anyone wishing to make a complaint to do so. Evidence: There is a detailed complaint procedure in place. Records showed that the home takes all complaints seriously and that when a complaint is received action is taken promptly to resolve the issues raised. The majority of the staff team have had training on the protection of vulnerable adults. The manager has also had deprivation of liberty training and an assessment has been carried out in relation to each resident to consider if residents are being deprived of their liberty. Care Homes for Older People Page 17 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a clean, comfortable and well maintained home. Evidence: The home is well maintained and is decorated to a good standard. Since the last inspection double glazed windows have been fitted to the front of the house and ensuite toilets have been fitted in two of the single bedrooms. New flooring has been fitted in the upstairs bathroom, and a number of automatic fire door closers have been installed to enable residents to walk freely around the home. It was also reported that a wheelchair ramp has been provided to improve access to the back garden. There are plans to replace the windows to the rear of the property next year and to replace the chairs in the lounge area. There is a lovely garden area to the rear of the property. A resident spoken with stated I really like spending time in the garden. It was noted that flowers from the garden were in a vase on the tables in the dining room. At the time of the last inspection a requirement was made in relation to ensuring that there was adequate ventilation in one of the bedrooms. The problem identified has now been resolved. In addition there was a good practice recommendation relating to Care Homes for Older People Page 18 of 26 Evidence: the need to monitor the temperature of the laundry to ensure that it was safe to work in and also to store cleaning products. The manager advised that two fans have been provided and the home has also reviewed the system for carrying out laundry. In relation to fire safety it was noted that six staff have recently received training on the subject. Some of the new staff have completed training in their previous employment and further training in fire safety will be provided. The home now carries out fire drills on a monthly basis. A small number of the staff team have had training in infection control. Care Homes for Older People Page 19 of 26 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. Staffing levels are minimal and need to be continually reviewed to ensure that residents changing needs continue to be met. Evidence: At the time of inspection there were ten residents accommodated. The manager has between eight to ten hours designated management time each week and the rest of her time is spent on shift. Two of the residents require support from two care staff in respect of their personal care. The rota provided showed that there are two care staff on duty at all times. Through the week there is a cook and three to four days a week a part-time cleaner. This means that at weekends staff have to cook, clean and care for the residents. This needs to be continually monitored particularly if residents needs change or if there is an increase in the resident numbers to ensure that residents are not at risk of harm due to minimal staff numbers. Discussion was also had with the owner regarding the low number of managment hours allocated to the manager. The owner agreed to review this. The manager advised that recruitment of new staff is carried out via the head office. The manager has no involvement in this process. This was discussed with the owner of the home during the inspection as it is the role of a registered manager to ensure that all staff employed to work in the home are suitable. The owner agreed to review this Care Homes for Older People Page 20 of 26 Evidence: practice. It should be noted that recruitment records seen showed that the company had ensured that thorough checks had been carried out in relation to new staff employed to work in the home. In relation to staff training it was noted that the majority of the staff have completed all their mandatory training. Some gaps were noted but there was evidence that training is being planned on a continuous programme. All new staff complete the common induction standards. There are twelve staff including the manager and deputy. Six of the care staff have completed a national vocational qualification (NVQ) level two or above and the deputy manager has also completed level two and has almost completed level three. Care Homes for Older People Page 21 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run in the interests of those accommodated. Evidence: Since the last inspection a new manager was appointed to manage the home. At the time of inspection her application for registration with the Commission was being processed and she was due to attend an interview in the days following the inspection. The manager has completed the Registered Managers Award (RMA) and it was noted that since taking on the role of manager she has also attended a number of short courses relevant to her current position. Staff spoken with described the manager as very supportive. One staff member stated that the manager has a good knowledge of care and the standards. Care plans are now clearer and staff know what is expected of them. Records showed that all staff receive formal supervision every other month and that all staff received an annual staff appraisal in January 2009. Care Homes for Older People Page 22 of 26 Evidence: The manager has introduced a missing persons sheet for each resident. Very good information is contained within the sheets but the photos are only computer printouts and are not very clear. The manager stated that that the home has recently purchased a new camera and the intention is to produce better photos. Staff meetings are held periodically and it was noted that meetings had been planned for the coming week one for day staff and one for night staff. The owner, or a representative on her behalf, visits the home on a monthly basis unannounced and a report is written of the findings. Records show that a wide range of issues are discussed and that a number of records are examined during these visits. In addition time is spent observing staff in the course of their duties. Comments seen showed that staff were given constructive advice following the observations made. As part of the homes quality assurance system satisfaction surveys were sent to the residents and their relatives, the findings were collated and feedback was provided to the participants. In addition a range of audits were carried out including an audit of care plans, medication, personnel files, risk assessments and catering. The home has very limited involvement in the management of residents finances. Records were seen in relation to the management of one residents finances. It was noted that the staff provide a receipt for all money spent on behalf of this resident and that the relative of the resident examines this periodically to check that all is in order. However, the system for monitoring money in and out needs to be recorded more clearly and should include signatures from the home and from the relative. The home monitors water temperatures on a regular basis. Records seen showed that in one bedroom the temperature at the sink had been in excess of safe levels for three months. It was reported that this matter had been highlighted for addressing but there was no record kept of this. The owner advised that the temperature would be adjusted. Care Homes for Older People Page 23 of 26 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 24 of 26 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 1 35 17 17 [2] 26/07/2009 The Registered Person must ensure that there is clear documentation available in the home to audit monies received and spent on behalf of residents. Residents financial interest must be safeguarded. 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 Care Homes for Older People Page 25 of 26 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. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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