Inspection on 13/03/06 for Alma Green Care Home

This inspection was carried out on 13th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Alma Green Care Home 27/11/07

Alma Green Care Home 23/01/07

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Alma Green Care Home Alma Green Hall Green Upholland Skelmersdale West Lancashire WN8 0PA Lead Inspector Anne Taylor Unannounced Inspection 15th March 2006 09:30 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 Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 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. Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Alma Green Care Home Address Alma Green Hall Green Upholland Skelmersdale West Lancashire WN8 0PA 01695 622504 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) Cranford Care Homes Limited Mrs Joanne Bowker Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 29 service users of the category of OP (Old age, not falling within any other category. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in Care Homes. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Rooms 8 and 9 may only be used as a bedroom for single occupancy or for shared occupancy in the case of married couples or like partnerships where both parties have expressed the wish to share. N/A 3. 4. Date of last inspection Brief Description of the Service: Alma Green is located in the small village of Upholland, which is part of the town of Skelmersdale. There is easy access to local community services such as shops, library, pharmacy, Post office and local bus route. The home is registered to provide 24 hour personal care for twenty-nine older adults of either sex, over the age of sixty-five. At the time of Inspection twenty-three people were living there. Alma Green is purpose built and privately owned by Cranford Care Homes Limited. Responsibility for the day-to-day running of the home is that of the registered manager, Joanne Bowker. The building is set over two floors accessed by a passenger lift. There are twenty-five bedrooms and two double rooms for anyone choosing to share. All have en-suite facilities. Five small communal sitting rooms are available, one of which is a designated smoking lounge. Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that started at 9.30am and lasted six hours. The inspection involved discussion with the people who lived and worked at the home and visitors, examination of records, policies and procedures and a tour of the premises. This was the first inspection since a change of ownership in August 2005. The inspection focused on outcomes for people living at the home particularly in relation to the provision of care, protection issues and staffing. As part of the inspection process the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allows the inspector to focus on a small group of people living at the home. All records relating to these people are inspected along with the rooms they occupy in the home. They are invited to discuss their experience of the home with the inspector, however this is not to the exclusion of other people living at the home. What the service does well: The staff team work well together and show a good understanding of the needs of the people living at the home. The staff team receive appropriate training and guidance that provides them with the knowledge and experience needed to care for this client group. Care is provided in surroundings and by staff that make service users feel safe and well cared for. A stable workforce and not using agency staff provides continuity and consistency of care for people living at the home. Staff put the needs of residents first and make sure they are supported to make choices about their lifestyle whenever possible. People living at the home benefit from the happy relaxed atmosphere and staff make sure that residents’ rights to privacy and dignity are upheld. The recruitment process is thorough and takes into account the need to protect people living at the home. Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 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 Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 A thorough pre admission procedure ensured that prospective residents could be involved in the process and their individual wants and needs properly assessed. EVIDENCE: Standard 6 is not applicable, as Alma Green does not provide intermediate care. Pre admission assessments carried out by the home and or social workers involved prospective residents and or their relatives. This helped residents to know what sort of care they should expect to receive when they came to live at the home. The assessments were detailed and showed the individual needs of each client. The manager said that she usually carried out pre admission assessments for prospective clients. This meant that both the home and any prospective Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 Page 9 resident could be sure that an appropriately trained person had done the assessments. Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The management of health and personal care needs was good and made sure that the needs of residents were identified and met. And their rights to privacy and dignity upheld. The systems in place for handling medication were thorough enough to ensure the continued protection of residents. EVIDENCE: Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 Page 11 Care records seen showed that each resident had a plan of care that had been agreed with him or her or a relative. This meant that residents or their relatives had some idea of what care they should expect to receive whilst living at the home. It also gave them the opportunity to discuss any concerns and identify any specific needs or preferences. A nutritional risk assessment was not done routinely for each resident when they first came to stay at the home. There was however, evidence that attention was paid to monitoring weight, dietary intake and what action was taken if a problem was identified. Risk assessments that enabled health care to be provided safely were in place so staff were confident about this part of their job and residents able to feel safe when being assisted with personal care needs. Residents were settled, appropriately dressed and well cared for. Staff were able to discuss the individual needs of the people they cared for and how they organised their workload to ensure those needs were met. They made reference to way they used the care plans and attended regular handovers when there was a change of shift, so that they were kept informed of any changes to the care residents needed. Polices and procedures describing the handling of medication were available within the home so staff had clear guidance to follow. Records of drugs administered were generally up to date. However, handwritten medication entries and amendments to the pre-printed dosage instructions were not independently checked and countersigned. Training and assessment had been provided for staff in relation to the safe handling of medication so that they were aware of the correct procedures to follow. Records showed that induction training included instruction on privacy dignity and respect so that staff had knowledge and understanding of this before they started to give care to residents. Staff spoken to were able to discuss how they put into place the home’s policies and procedures relating to maintaining the privacy and dignity of the people they cared for and how this helped to make sure that residents felt respected. Staff were observed knocking on bedroom doors before entering. They were seen to be providing care in a sensitive and caring manner, which promoted residents’ dignity. People living at the home say staff maintained their dignity and treated them respectfully. They commented, “staff are respectful and kind” and “I have a lovely room, staff always knock before they come in”. Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,15 The daily routines were flexible and residents supported to make choices about their lifestyle. The range of social activities available met the expectation of people living at the home. The importance of providing a well balanced diet was recognised by the home and residents were able to eat healthily and given a choice about what they ate. EVIDENCE: During conversations with residents and staff it was evident that residents were able to make choices about the way they lived within the home and in particular within the privacy of their own room. Rooms had been personalised and some residents had brought some of their own belongings into the home so they could have familiar items around them. Residents spoken to said that they were able to exercise choice about what time they got up and went to bed and what clothes they wore, giving them some control over their lifestyle. When asked how they helped residents to exercise choice staff said, “We always ask what they want to do, when they want to get up and what they want to wear”. Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 Page 13 Detailed records were kept of individual likes and dislikes and staff were aware of residents’ dietary needs and personal preferences, which ensured that those living at the home received a nutritional diet in accordance with their needs. The lunchtime meal was relaxed and unhurried with staff available to assist if needed. Some residents had chosen to eat in the dining room, others in their bedroom. One resident said, “I have breakfast in my room and lunch in the dining room”. Residents spoken to were generally satisfied with the range and quantity of food available to them. When asked one resident said, “The food is good, no complaints. I get a choice, the staff ask me what I want and I can have whatever I want really”. Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The home had a clear complaints procedure that ensured residents knew how and who to complain to. Management processes in relation to abuse were thorough enough to ensure the protection of any vulnerable residents. EVIDENCE: A complaints procedure was in place and residents spoken to know how and who to complain to. However, the process of recording any concerns in a book in reception should be reviewed and consideration given to recording them separately to protect and maintain confidentiality. Resident’s spoken to knew how to complain and felt that they were encouraged to raise any concerns they might have about the home and that they would be listened to and action would be taken on any issues raised. One resident said, “I would tell the manager and she would sort it out, but I don’t know why anyone would want to complain about here, its like being on holiday”. Staff were able to discuss how they would respond if a resident complained to them and realised how important it was to make sure residents felt able to raise concerns and be sure they were listened to. Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 Page 15 The home had its own adult abuse policy and whistle blowing policy, in addition to a copy of guidance issued by the department of health. Discussion with staff showed that they were aware of the above documentation and were quite clear about what they would do if an allegation or suspicion of abuse came to their attention. The manager was aware of her responsibilities in relation to protecting people living at the home and making sure staff were appropriately trained to recognise and act upon any signs of possible abuse. Induction training records for new staff included training about abuse with a multiple-choice test at the end to assess knowledge and understanding. Staff confirmed that they received updates so that they continued to be made aware of the need to protect the people they care for. Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The key environmental standards were not assessed at this inspection EVIDENCE: Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The skill mix of and number of staff on duty was sufficient to ensure the needs of residents were met. The recruitment process was thorough enough to ensure the continued protection of residents and training was provided for new and existing staff that helped make sure they were competent do their jobs and able to practice safely. EVIDENCE: Staff rotas showed the number and skill mix of staff on duty at any time and that enough staff were on duty to ensure the needs of residents could be met. The manager’s hours were not included. Comments from relatives, present at the time of inspection indicated that there was always sufficient numbers of staff on duty and residents were looked after and attended to properly. One said, “There’s always enough people to look after the residents and they always have time for you”. Staff spoken to felt that there was enough staff on duty to enable them to provide a good standard of care to residents. Training records showed that new staff received induction and ongoing training that provided them with the basic skills needed to carry out tasks allocated to Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 Page 18 them. Staff spoken to said that training opportunities were good and that they had received training in fire safety, moving and handling and other health and safety topics so that they were kept up to date about safe working practices. National vocational training (NVQ) was available to care staff and some carers had already achieved level two or three. The manager was aware of the need to have fifty per cent of staff trained to NVQ level two or above. Discussion with the manager showed that she had a positive and proactive approach to training. The development of a training and development programme would add more structure to the process and make sure all staff continue to receive the training they need to keep up to date with any changes in legislation and best practice. A recruitment checklist was in place to help with the recruitment process. Records showed that the recruitment process was thorough and took into account the need to protect people living at the home. Discussion with the manager showed that she was aware of her responsibility to appoint suitable staff that would be able to provide good care and the continuing need to protect people living at the home. Staff talked about how they had been recruited and confirmed that they had received a statement of terms and conditions of employment and a job description so that they knew what their responsibilities were and what was expected of them. Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 The arrangements for handling money on behalf of residents were thorough enough to ensure their financial interests were safeguarded. EVIDENCE: The home had a policy of not handling personal allowances for residents. Any money brought in by relatives for residents was stored in the home’s safe. Records were kept of any money handed in for safekeeping and receipts kept for any purchases made on behalf of residents. When asked about access to their money residents said, “ I have some money in the safe here and a bit of money in my room, my family looks after everything else”. Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 Page 20 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 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 3 X X X X X X X X STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? N/A 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. 1 2 3 4 5 Refer to Standard OP8 OP9 OP27 OP28 OP30 Good Practice Recommendations A nutritional risk assessment should be carried out for each resident and the assessment kept under review. Handwritten additions or alterations to the MAR should be independently checked and countersigned. The duty rota should how the hours worked by the manager. Fifty per cent of care staff should obtain a recognised qualification in care. A training and development programme should be developed. Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 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 Alma Green Care Home DS0000062739.V278978.R01.S.doc Version 5.1 Page 23 - 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. 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