Inspection on 16/04/09 for Greenmantle

This is the latest available inspection report for this service, carried out on 16th April 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Greenmantle 21/02/06

Greenmantle 21/09/05

Greenmantle 14/12/04

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Greenmantle 20 Mornington Road Woodford Green Essex IG8 0TL     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: Harina Morzeria     Date: 1 6 0 4 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 25 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 25 Information about the care home Name of care home: Address: Greenmantle 20 Mornington Road Woodford Green Essex IG8 0TL 02085062301 02085058791 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dr Thanna Abdil Hamid Kandil,Dr Mohammed Essam El-din Fahim care home 15 Number of places (if applicable): Under 65 Over 65 0 15 dementia old age, not falling within any other category Additional conditions: 15 0 The maximum number of service users who can be accommodated is: 15 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Greenmantle is a privately run residential care home in Woodford Green, registered to accommodate 15 elderly people, some of whom are suffering from dementia. The house is in a quiet residential area. The accommodation consists of one double bedroom and 13 single rooms which have en-suite facilities. Appropriate communal areas are provided as well as a well-kept garden for the residents enjoyment. A lift provides access to the first floor where most of the bedrooms are located. One of the proprietors is also the manager of the home. The proprietors are routinely involved in the day-to-day operation of the service. The Statement of Purpose informs Care Homes for Older People Page 4 of 25 Brief description of the care home residents, prospective residents and their representatives that the aim of the home is to promote a non-discriminatory service which promotes residents dignity, independence, privacy, choice, rights and provides fulfilment. There is evidence that these values are being achieved in the day-to-day operation of the home. A hairdresser visits the home fortnightly, as well as a massage therapist. Staff showed a caring and sensitive attitude towards the residents, which was confirmed by the residents spoken to on the day of the inspection. The Statement of Purpose and the Service User Guide are issued to every prospective resident and both of these documents are displayed in the entrance hall of the home. A copy of the most recent inspection report is also available. A resident or relative/representative could ask for his or her own copy, which the manager would make available. The fees for the home are £550 a week. Care Homes for Older People Page 5 of 25 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: This was an unannounced inspection which took place over six hours. The inspection was undertaken by the lead inspector, Harina Morzeria. A senior carer was present throughout the visit to aid the inspection process. We spoke to residents where possible and asked them to give their views on the service and their experience of living in the home. Care staff were asked about the care that residents receive and were also observed carrying out their duties. A tour of the premises, including all communal areas and kitchen was undertaken. The files of several residents were case tracked together with examination of other staff and home records. This included medication administration, staff training and recruitment procedures and files, maintenance records and management of complaints. Information was also taken from an Annual Quality Assurance Assessment which was Care Homes for Older People Page 6 of 25 completed and returned to us prior to the inspection. This is a self-assessment process, which all providers are required to complete once a year. Additional information was also obtained from Regulation 37, notification of events. Surveys were sent out prior to the inspection for completion by residents. We would like to thank the residents and staff for their input during the inspection. 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 printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 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 9 of 25 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. Prospective residents and their relatives have detailed information about the home to help them make an informed choice. Comprehensive pre-admission assessments are undertaken for all residents. This means that staff have detailed information to enable them to determine whether or not the home can meet prospective residents needs. The home does not offer intermediate care. Evidence: A Statement of Purpose and Service Users Guide are available. The documents are clear and up-to-date. They are specific to the resident group and outlined the facilities available to meet the needs of people who use the service. The information can be made available in different formats for example, appropriate language, pictures or braille, upon request. From the evidence seen we are satisfied that the home undertakes a comprehensive pre-admission assessment of prospective residents, from Care Homes for Older People Page 10 of 25 Evidence: which a care plan is developed. The residents are involved in this process where possible, as well as their family members where appropriate and the relevant health and social care professionals. Prospective residents and their families have the opportunity to visit the home prior to admission, talk to staff and assess the homes facilities. We spoke to two relatives who told us they visited on behalf of their relative and stated that staff were very welcoming and helpful. Care Homes for Older People Page 11 of 25 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. Residents health, social support and personal care needs are set out in individual care plans and provide staff with the information they need to satisfactorily identify and meet residents needs. There are clear medication policies and procedures for staff to follow, so as to ensure that residents are safeguarded with regard to their medication. Evidence: There was a noted improvement in the construction of care plans since the last inspection. Care plans were more comprehensive and covered health, social and personal care needs. It was evident from the care plans seen and through discussions with the residents and staff that residents health care needs are understood and met on a daily basis. Care plans were being reviewed on a monthly basis or more frequently. Staff need to ensure that these recordings are in line with the outcomes identified in the care plans, and also that the implications of the Mental Capacity Act 2005 are taken into account in both the care planning and the daily recordings. From observation and discussion with staff and residents, it was evident that the Care Homes for Older People Page 12 of 25 Evidence: privacy and dignity of residents was being respected. We spoke to several residents and asked about the care they receive in the home. One resident told us : they look after me very well, I have everything I need. The following comments were made in the surveys: the care home has been a revelation to me in terms of human kindness and care. A relative stated, every request our family has made over the years has been met. We are kept informed of everything that is connected with my aunt and her needs. Good care was evidenced when observing staff talking with residents when carrying out their duties. All staff were observed to treat residents with kindness and respect, and there was a positive level of interaction between residents and staff. Staff were seen to be very gentle when undertaking moving and handling tasks and offered explanation and reassurance throughout. Resident needs are identified as part of their care plan and record how these needs are to be met. Records indicate that health professionals such as chiropodist, dentist, opticion, GPs and community nurses have seen the residents and staff support residents to attend hospital out-patient appointments. Other written evidence includes residents being weighed monthly, as well as fluid and bowel charts are in place for those residents who require close monitoring. Appropriate risk assessments are in place and are linked to care plans. Discussions with the senior person present at the time of the inspection and observation of medication administration by staff showed that staff are following medication policies and procedures, so as to ensure that residents are safeguarded with regard to medication. Where a resident had an allergic reaction to either medication or food, this was recorded on the medication administration record (MAR) chart and in the care plan. However, it is strongly recommended that where such an allergy has been identified, it is recorded more prominently and highlighted on the front sheet of the residents file and on the MAR chart. Staff responsible for medication administration have the required accredited training. The home is able to meet the needs of people requiring end of life care. The manager has begun to draw up end of life care plans for all the residents. Care Homes for Older People Page 13 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lifestyle within the home matches the expectations and preferences of residents. The attitude and practice of the staff working in the home, promote opportunities for people living in the home to remain independent, exercise choice and express their wishes and needs. Evidence: Residents lifestyle in the home matches their expectations and preferences and the home is responsive in meeting peoples social, cultural, religious and recreational needs. Staff support and encourage residents to maintain their skills, especially their independent living skills. Residents are able to enjoy a stimulating lifestyle with a variety of options to choose from. Staff have sought the views of the residents and considered their varied interests when planning the routines of daily living and in arranging activities in the home for example, armchair exercises, massage therapist, hairdresser, reminiscence, music and movement, and a vocalist. A piano is available for two residents who enjoy playing the piano. Three residents who like knitting have individual knitting boxes for their use. All the people who assist with the activities with in the home make notes of participants, activity undertaken on that day and what the response from the residents Care Homes for Older People Page 14 of 25 Evidence: was. This is good practise in terms of future planning. The following feedback was received from relatives, my father enjoyed a social evening and plans were in hand for his approaching 100th. A marvellous Christmas event was organised. There are several events throughout the year. The routines of daily living are flexible. Throughout the visit we observed staff of allowing time for residents to express their wishes and supporting individuals to make choices in their everyday lives. Individual residents are involved in the day-to-day activities of the home dependent on their capabilities and interests. Staff know what the residents like for example, one resident likes teddies and so they know that a way to calm her when she is upset is to give her the teddy bears. It was clear from conversations with the staff that they are aware of each of residents likes, dislikes and moods and how to respond to them when they are upset. Residents are supported to participate in the religious services held at the home and other religious activities as desired. Residents birthdays are celebrated within the home, as are other festivals and special occasions. Photographs of birthday celebrations were seen in the homes quarterly newsletter. Visiting times are flexible and family/friends are encouraged to visit so that residents are able to maintain contact. A cook is employed to prepare meals. There is a daily menu and a record is maintained of what each individual chooses to eat. A good choice of meal options are available at each meal. The lunchtime meal was presented in an attractive and appealing manner and there was a relaxed atmosphere throughout the meal. Staff were on hand to offer assistance and encouragement where necessary. The following feedback was received, the meals are very good. I can not fault the meals they provide. My father compared Greenmantle to being in a hotel. There were always choices at mealtimes. One resident stated, I am a very fussy eater and they always give me what I like. Another resident stated, food is the best. Care Homes for Older People Page 15 of 25 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. The manager and staff team make every effort to sort out any problems or concerns. Residents and their relatives can be confident that their complaints and concerns will be listened to, taken seriously and acted upon. All staff working in the home have received training in safeguarding vulnerable adults to ensure that there is a proper response to any suspicion or allegation of abuse. Evidence: The home has a written policy and procedure for dealing with complaints, and staff were aware of the complaints procedure and how to deal with complaints or concerns expressed to them. Individuals and their representatives have a clear understanding of how to make a complaint and when they will get a final response. The home also makes sure that complainants are regularly updated and are kept informed of the progress of any investigation into their complaint. Residents also have access to external agencies and professionals through advocacy and details are displayed in the public areas of the home. Policies and procedures for safeguarding adults are available and give clear specific guidance to those using them. All staff have undertaken training in safeguarding vulnerable adults and this is included in the induction training for newly recruited staff. There is a policy on whistleblowing and challenging bad practice at work. Staff spoken to were able to demonstrate a good understanding of the homes policy and procedures in this area and know what to do if they had concerns about the safety and Care Homes for Older People Page 16 of 25 Evidence: welfare of residents. Care Homes for Older People Page 17 of 25 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. The atmosphere in the home is welcoming and provides a physical environment that is appropriate to the specific needs and lifestyle of the people who live there. Evidence: The standard of the decor, furnishings and fittings are generally being maintained to a good standard. The home is clean and the odour control is good. Bedrooms are generally well maintained and residents and their families are encouraged to personalise rooms so that they are reflective of the occupants culture, religious and personal interests. There are aids and equipment available around the home for those residents who need them. The environment promotes the privacy, dignity and autonomy of residents. Residents spoken to said they liked their rooms. One resident said, I am very lucky to have my own room with all my things around me. The bathrooms and toilets are fitted with appropriate aids and adaptations to meet the needs of people would use the service. The home is will lit, clean and tidy and smells fresh. The home has an infection control policy and staff work to this in order to reduce any risk of infection. Care Homes for Older People Page 18 of 25 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 satisfactory and there are sufficient staff on duty to meet the individual assessed needs of the residents. Residents benefit from a committed staff team who have the skills and training to meet their needs. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. Evidence: There is a good recruitment procedure that clearly defines the process to be followed. The procedure was followed in practice with the home recognising the importance of effective recruitment procedures in the delivery of good quality services and the protection of individuals. Staff recruited confirmed that the home was clear about what was involved at various stages and was robust in following its procedure. This was evidenced in the staff files checked. The staffing levels and skill mix of the staff team are in line with meeting the diverse and changing needs of the residents. Staff were being effectively deployed so as to ensure that residents choosing or needing to remain in their bedrooms were cared for appropriately. There is a small but stable staff team, with very little staff turnover, and no use of bank or agency staff. This means that residents get consistent care from staff they know well. Staff integrated and communicated well with all the residents and there was a positive level of interaction. Residents we spoke to were very positive about the care being provided to them. The Care Homes for Older People Page 19 of 25 Evidence: following feedback was received in the surveys, very caring and supportive staffnothing is too much trouble for them regarding residents and families. The care was outstanding. The carers were excellent. The staff are very helpful and will deal with anything I ask. There is always staff available. All staff receive training that is relevant to meeting the individual needs of the residents in a person centred way. Some training is accessed from external providers such as the London Borough of Redbridge and other training is delivered in-house. All staff receive training in central areas during their induction, with a period of shadowing more experienced staff. All staff are undertaking dementia care training and staff spoken to commented that this training has helped them understand and deliver effective care to people with dementia. Residents spoken to stated that staff were very responsive and meet their needs. The hairdresser spoken to on the day of the inspection also confirmed this. Care Homes for Older People Page 20 of 25 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 manager of the home is a well qualified and experienced person and residents benefit as the home is run in their best interests. Evidence: The registered manager is also the sole proprietor. He is supported by two deputies who both work part time. Together the management team have the required qualifications and experience and are highly competent to run the home and meet its stated aims and objectives. The manager communicates a clear sense of direction and systems are in place, particularly in relation to continuous improvements to the service provision. Staff commented positively about how well supported they felt by the manager and his team. The manager has a clear understanding of what further improvements are needed and the key areas which need development. The Annual Quality Assurance Assessment(AQAA) clearly identifies areas for improvement over the next year. The home has a range of policies and procedures which staff are expected to implement Care Homes for Older People Page 21 of 25 Evidence: when working with residents. There are clear written records of all safety checks and accident/incidents. The records were maintained in good order. The manager does not act as an appointed agent for any residents, nor does he have responsibility for any residents financial affairs. The home handle residents personal allowances. There are policies and procedures regarding this which are followed by staff. Care Homes for Older People Page 22 of 25 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 23 of 25 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 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 24 of 25 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 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!