Inspection on 07/01/08 for Greyfriars

This is the latest available inspection report for this service, carried out on 7th January 2008.

CSCI 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

Greyfriars 11/05/06

Greyfriars 15/02/06

Greyfriars 29/07/05

Greyfriars 01/03/05

Greyfriars 30/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Greyfriars 26 Clarence Gardens Shanklin Isle Of Wight PO37 6HA Lead Inspector Annie Kentfield Unannounced Inspection 7th January 2008 12:30 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greyfriars Address 26 Clarence Gardens Shanklin Isle Of Wight PO37 6HA Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01983 864361 david@greyfriarscarehome.co.uk Mr David Cable Mrs Ann Cable Mrs Ann Cable Care Home 9 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (9) of places Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th June 2007 Brief Description of the Service: Greyfriars is a home registered to provide care and accommodation for up to 9 older people with dementia. The home is a small, detached property situated in a quiet residential area of Shanklin, approximately one mile from the town centre shops. The registered owner Mrs Cable also manages the home and lives close by. All rooms are for single occupancy and a stair lift gives access to the rooms on the first floor. To the front of the building are a small lawned area with shrubs and flowers, and a patio with seating for the residents during the warmer months. There is limited parking at the front of the house or on-street parking in Clarence Gardens. Weekly fees range from £349 to £420. The purchase of toiletries, hairdressing and chiropody are additional to the stated fees. Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This report is a summary of information that we have received or requested about the service since the last inspection of 28th June 2007. We sent survey forms to residents, relatives, staff, and health and social care professionals and received completed surveys from 4 members of staff, one relative and one health and social care professional who visits the home. All comments received were positive about the service provided. We made an unannounced visit to the home on 7th January 2008; this was with one inspector (Annie Kentfield) who was in the home for four hours. During the visit we spoke to some of the residents in the communal areas of the home, and spoke to the manager, and two members of staff. We also looked at some of the home’s records and discussed the improvement plan that the home had sent us following the inspection of June 2007. What the service does well: What has improved since the last inspection? After the last inspection the home sent us an improvement plan with details of how improvements would be made in the areas of medication, care plans, staff training and health and safety checks. Regulatory requirements were made and these have been met. Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does not provide specific rehabilitative care (intermediate care) but does offer respite care if a room is available. All residents moving into the home receive an assessment of their care needs to ensure that their needs can be met by the home. EVIDENCE: The annual quality assurance assessment (AQAA) stated under ‘What we do well’ – “Complete a full assessment of the clients needs, this may be at their home or hospital or another care home. The assessment is carried out by the home’s manager or in certain circumstances suitably trained senior care staff”. This ensures that prospective residents and/or their representatives can be confident that the home can meet their care needs. The home recognises it needs to get better at obtaining information from care managers and has taken steps to discuss this with representatives of social Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 9 services and intends to develop a new full questionnaire and assessment document covering emotional, behavioural, physical and medical needs. Since the last inspection the manager has developed a new part of the assessment process to gather relevant information from residents and/or their relatives about individual personal and social histories. This information will help the care staff understand the specific needs, preferences and choices of each resident when they move into the home. The home does not offer rehabilitative care but does offer respite care if a room is available. Residents who move in temporarily for respite care receive the same assessment of their care needs. Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8. 9 and 10 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service have individual care plans that record information about their health and personal care needs. However, the care plans could contain more written detail to ensure continuity of care and to make sure that new care staff are given detailed information on how care should be provided. The people who use the service have their health care needs fully met and have their dignity and privacy upheld. The procedures for the safe storage and administration of residents’ medicines have improved. EVIDENCE: At the last inspection we made a regulatory requirement that meant the service had to improve the way that residents’ medicines were stored, dispensed and recorded. The registered manager has revised and updated all of the medication procedures and this requirement has been met. During this visit to the home and in discussion with the registered manager, we recommended as good practice that the service acquire a copy of the current Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 11 guidance for care homes: ‘The Handling of Medicines in Social Care’. This document is freely available to download from our website www.csci.org.uk and provides professional pharmaceutical advice for care providers who are involved in handling medicines. The manager confirmed that the service will regularly monitor their medication policy and procedures in line with this guidance and will also use the guidance to make sure that the storage and recording of any controlled drugs meet current regulatory requirements. Since the last inspection the service has made improvements to the way that individual care plans are recorded and kept (in a way that maintains privacy and confidentiality). The home has revised the procedures for the way that information is maintained and stored and is aware of the need for confidentiality at all times. In discussion with the registered manager we recommend that individual care plans could contain more detail about how care is to be provided. For example, where a care plan has recorded that a resident “needs some help with bathing” it would be good practice for the care plan to record in detail what help the resident requires and how they prefer the help to be given. Although it is evident that care staff are able to give a good verbal update on the individual care needs and preferences of each resident, this needs to be clearly recorded in writing. This would then ensure continuity of care and also make sure that new care staff have clear and written guidance on the care to be given, and when. We know that the health care needs of residents are being met because this is confirmed in comments we received from residents, relatives and a health and social care professional. We also saw that each care plan records every contact or visit by GP’s, District Nurses or other specialist health services. This shows us that residents’ health care needs are monitored daily and they are referred promptly to a GP or other service when required. Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service are supported to maintain contact with family and friends and take part in social activities if they want to. Residents are offered wholesome, well-balanced and varied meals. EVIDENCE: We saw that most of the residents were eating lunch in the dining room and this seemed to be a relaxed and unhurried event. The dining room is homely and cosy and made attractive for the residents with tablecloths, flowers and tablemats. The manager was shopping for food when we arrived and it is evident from comments from residents and relatives that emphasis is placed on providing a variety of fresh home-cooked meals that residents enjoy. At the previous inspection two residents told us: “There are regular activities available and a good variety, I enjoy our trips out to the garden centre” “The girls (staff) are very good, they will often spend time playing board games with me” Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 13 At the previous inspection we recommended that residents would benefit from staff updating their knowledge and awareness of good practice in dementia care, to ensure that the differing social care needs of residents are being understood and met by care staff. The manager confirmed that two of the staff have updated their training in dementia care awareness and there are plans for all of the staff to update their training as soon as further training can be arranged. The home has also developed a new system of ‘pen pictures’ of residents in liaison with residents and their relatives. This information helps staff to understand the needs and behaviour of the residents, especially those who may have difficulty communicating their needs and wishes to care staff verbally. During the inspection we observed some good examples of communication between care staff and residents who have dementia and staff worked well with residents to reduce anxiety and confusion. However, in discussion with some of the care staff they said they were also keen to regularly update their training in dementia care in order to ensure that they were aware of current good practice and increase their knowledge of best practice. Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives can be confident that the home has a procedure for addressing any concerns or complaints that may arise. The home also has a policy and procedure in place to ensure that residents are protected from abuse. EVIDENCE: The home complaints policy is clearly displayed on the resident’s information board, and each member of staff receives a copy. This information has been updated since the last inspection giving information on how to contact the Commission if ever needed. Staff are aware of what to do if a resident or their representative raises a concern or complaint. However, although no complaints have been received by the home since the last inspection, the service must make sure that any complaints and the outcomes are recorded and are available for inspection. The manager confirmed that this would be done. We have not received any concerns or complaints about the home. The manager and staff are aware of the need to protect residents and that there is a procedure to report any allegations or suspicion of abuse to Social Services, for investigation, promptly. Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a warm, comfortable and safe environment for the residents. The home maintains good hygiene and infection control procedures. EVIDENCE: We found the home environment to be clean and pleasant (there were no unpleasant odours) for the residents. The communal areas of the home are comfortably furnished, attractive and homely. During the time we were in the home, a cleaning company arrived to steam clean some of the carpets and this is arranged on a regular basis to ensure that all areas of the home are always clean and well maintained. The manager has recently updated her own professional training in good practice in infection control procedures. This training update has been relayed to the care team and new guidance written for staff and discussed individually in staff supervision. Care staff told us that they have easy access to gloves, Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 16 aprons and hand gel, as part of the home’s procedures for maintaining good hygiene and the control of infection. Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by sufficient numbers of staff that are trained and competent to do their jobs. Residents are protected by thorough recruitment procedures. EVIDENCE: From observation and information seen at the time of the inspection the home employs staff in sufficient numbers to meet residents’ needs. Staff newly recruited to work in the home have had all the required checks satisfactorily completed. This ensures the safety and welfare of the residents is protected. Records of staff training and staff supervision show us that the home has a commitment to provide ongoing training for the care team in all areas of safe working practice. Some of the staff are currently enrolled to achieve a National Vocational Qualification in Care and more staff will be enrolled as part of the home’s plan to achieve at least 50 of care staff with a national minimum qualification in care. The home has it’s own induction programme that new staff follow as an introduction to care and health and safety. In discussion with the manager, we recommended that the home use the standard induction programme that has been developed by the national training organisation for care ‘Skills for Care’. The common induction Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 18 standards provide a clear link for new care staff into the National Vocational Qualification (NVQ) in care. The manager agreed that she would do this. Since the last inspection, some of the staff have updated their training in Dementia Care Awareness, and there are plans for some of the staff to do a training day in the new Mental Capacity Act. Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is well managed and run in the best interests of the residents. The home promotes and protects the health, safety and welfare of the residents and staff in the home. EVIDENCE: The registered manager is also co-owner of the home and is a registered nurse with many years of experience working in health and social care. Although the manager is very experienced in managing a care home, it is good practice for all managers of care homes to achieve a recognised management qualification and the manager is currently enrolled to achieve the ‘Registered Manager Award’ (a National Vocational Qualification level 4). The manager is also committed to regularly updating her professional training in those areas relevant to the care of older people. Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 20 Comments that we received from residents, relatives, staff, and health and social care professionals who visit the home, confirm that the management of the home is open and positive and the home is well run in the best interests of the residents. Since the last inspection, action has been taken to make sure that the home is complying with regulatory requirements that affect the health and safety of the residents. The manager sent us an improvement plan and has confirmed that she will be undertaking regular monitoring and checks to ensure that the home continues to comply with statutory regulations and that good outcomes for residents in the home are maintained. At the last inspection we found that hot water was being delivered at high temperatures that could have been a risk to frail residents from scalding. Immediate action was taken to reduce this risk and the home are now checking and recording hot water temperatures on a regular basis. The home has also updated their policy and procedures for the control of infection and to reduce the risk of cross infection. The co-owner of the home confirmed that he was in the home that day to make sure that tests on the fire alarm system for the home were up to date and recorded. This demonstrates that the home takes seriously their responsibility to ensure that the health and safety of the residents and staff is protected at all times. It is the policy of the home and for the protection of the residents that residents manage their own financial affairs, or with the support of relatives or other independent advocates. The manager would seek advice from Social Services if any residents needed support or advice or independent advocacy with financial or legal matters. As a small home the manager and staff are in daily contact with the residents and visitors to the home and the quality assurance systems tend to be informal with issues addressed as they arise. It is recommended that the home develop a more formal system for monitoring the quality of the service that is open and transparent, and includes the regular monitoring of compliance with the Care Homes Regulations 2001 and the National Minimum Care Standards. The manager receives lots of positive feedback about the service provided and this could also be recorded or summarised as part of the quality monitoring process and be available for prospective residents and their relatives to look at. The manager should also include other stakeholders in the quality assurance process (by stakeholders we mean residents, relatives, visitors, staff and other health and social care professionals who visit the home such as GP’s, District Nurses, Care Managers). Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidston Office The Oast Hermmitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Greyfriars DS0000012495.V354432.R01.S.doc Version 5.2 Page 24 - 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!