Inspection on 04/01/07 for Butler Green House

This inspection was carried out on 4th January 2007.

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

Butler Green House 24/02/09

Butler Green House 23/01/06

Butler Green House 12/01/05

Butler Green House 11/08/04

Butler Green House 16/03/04

Butler Green House 05/02/04

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 Butler Green House Wallis Street Chadderton Oldham OL9 8NG Lead Inspector Carol Makin Unannounced Inspection 4th January 2007 11.30a 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 Butler Green House DS0000035532.V325698.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. Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Butler Green House Address Wallis Street Chadderton Oldham OL9 8NG 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) 0161 770 8255 0161 770 8258 sosc.butlergreen@oldham.gov.uk Oldham M.B.C. Teresa Lever Care Home 39 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (28), of places Physical disability over 65 years of age (18) Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 28 OP, up to 18 PD(E) and up to 10 DE(E). A manager, working a minimum of 30 hours each week, must be in place at all times who has the qualifications, skills and experience necessary for managing the home, and who is registered, or has an application for registration pending, with the Commission for Social Care. The ratio of care staff to service users must be determined according to the assessed needs of service users and staffing levels must be regularly reviewed to reflect service users` changing needs. 23rd January 2006 3. Date of last inspection Brief Description of the Service: Butler Green House is a purpose built establishment, commissioned and managed by Oldham Metropolitan Borough Council. Designed around a central hub, the ground floor is home to 39 people who are elderly and have physical disabilities. There are three distinct units, each one having a kitchen, lounge, dining area and bedrooms. One unit is designated for service users who require intermediate care. Applicants for the service are no longer accepted for long term care. All bedrooms are single occupancy and do not have en-suite facilities. The bedrooms are lockable, and there is a secure facility within each room. There are aids and adaptations to meet the assessed needs of the service users. The gardens are well maintained and provide seating for the service users in the better weather. The home is located in a residential area of Chadderton, with access to local and community resources. The weekly fees range from £ 100 to £ 365, which does not include hairdressing, newspapers, and magazines. A copy of the commission’s most recent inspection report is displayed in the main lounge. Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key inspection of Butler Green has been carried out which included unannounced site visits to the home on 4th & 8th January 2007. During the visit, the inspector spoke with residents, the registered manager, and care staff, had a look round the home, and examined records. What the service does well: What has improved since the last inspection? There had been many improvements to the accommodation since the last inspection. A corridor and 6 bedrooms had been redecorated, new wall lights had been installed in the lounges and they had been redecorated, one lounge had a new fire and surround, a new furniture had been provided in the main lounge, and the manager said that new carpets had been ordered for 2 of the lounges. The bathrooms had been completely refurbished, new showers and toilets had been installed, and the laundry had been refurbished. Externally there had been some landscaping and re-flagging of the garden areas. Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 6 The quality monitoring system had been improved by the introduction of meetings with residents and their carers from the community. 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. Butler Green House DS0000035532.V325698.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 Butler Green House DS0000035532.V325698.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&6 Quality in this outcome area is good. Assessments of prospective residents care needs were completed before they moved into the home, thereby ensuring that the home was able to meet residents’ needs. Facilities and care practices provided in the intermediate care unit were sufficient to help residents maximise their independence and return home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Pre admission assessments of needs, from either a care manager or health care professional in the community, were in place on the files that were seen. The manager said that it was not possible to have all applicants for short stay/respite care, assessed by staff from the home prior to admission, owing to Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 9 how quickly they sometimes come into the home. Referrals are initially taken by telephone from care managers in the community, and a manager from the home visits the prospective resident to make an assessment if the information raises any issues or doubts about whether the needs can be met at the home. The manager said she had, in fact visited a prospective resident in hospital for this purpose some weeks prior to the inspection, and a note to this effect was seen on the resident’s file. The need for more detailed information of such assessments was discussed with the manager, and she took steps to address this during the inspection. The manager said that prospective residents are invited to spend a day at the home or a least visit to have a look round prior to admission. Special facilities are provided for those service users who are admitted for intermediate care which include: Dedicated areas for equipment and therapies, e.g., adapted kitchens. Mobility aids. Professional input, e.g., Physiotherapy, Occupational Therapy, District Nurses. The residents on the intermediate care wing who spoke with the inspector felt that they had improved, and were satisfied with their care. Comments made included: “I’m feeling a bit better now”; “I’m making a lot of progress”; “ I do exercises and I’m getting physio”; “They have hand rails and things to help you here”, “It’s marvellous, they’re doing well for me, I helped to make my own breakfast today”. Butler Green House DS0000035532.V325698.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): 7,8,9,10 Quality in this outcome area is good. Care plans provide for meeting the individual needs of residents, but some recording practices need to be improved, to ensure that all their needs are consistently monitored and recorded. The control of medicines meets safe standards and promotes residents health. Staff practice supported and promoted residents rights. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of care files for intermediate, short stay, and permanent residents were seen during the inspection. Overall care plans were satisfactory, and provided information for staff regarding residents’ health and social care needs and individual preferences, (e.g. food, interests). Care plans for the residents receiving intermediate care, are done by the health authority therapists who work on the unit. Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 11 The plans focus of course, on the rehabilitation process, and they are accompanied by the therapists’ treatment/ progress reports. The carers who work on that unit also do reports relating to their input into the resident’s care. Overall, the files were reasonably well organised and maintained, but 1 of the 6 files seen was difficult to follow. There was conflicting information about the resident’s date of admission, and daily assessment reports were not consistently done, and were not always in date order. The information that was there was usually relevant and sufficiently detailed, but one comment in the daily reports referred to another resident and was clearly on the wrong file. The frequency of reviews varied depending on the care being provided, for example the care plans for the permanent residents were routinely reviewed each month, end of placement reviews were done following a period of short term care, and intermediate care residents progress was reviewed weekly. Nutritional screening had been done, and residents weight was recorded on admission and subsequently at weekly or monthly intervals depending on individual needs. Achieving independence in relation to medication is often part of the rehabilitation programme for residents on the intermediate care unit, and several residents were responsible for managing their own medication. Risk assessments in relation to this had been signed by the residents concerned, and were in place on the files that were seen. A sample number of medicine records was checked, and was found to be in order. Records showed that the management team and 27 care staff had received training in administration of medication, and that training had been arranged for a further 2 members of staff in February 2007. Residents were complimentary about the care provided, and made comments such as: “ I’m definitely well looked after”, “I’m satisfied with the care”. They also confirmed that the staff in the home respected their rights to privacy and dignity, and gave examples such as when assisting with personal care, and knocking on their bedroom doors before entering the room. Butler Green House DS0000035532.V325698.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): 12,13,14,15 Quality in this outcome area is good. Residents were able to exercise choice within the daily routine of the home thereby promoting residents autonomy in their daily lives. Activities were overall sufficient to meet resident’s needs, and provide them with stimulation. Residents were able to maintain contact with relatives and friends, providing them with links with the wider community. There was evidence that residents were offered a wholesome and varied diet, and they were able to exercise any control over their diet. This judgement has been made using available evidence including a visit to this service. Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 13 EVIDENCE: Residents who spoke with the inspector, said that the daily routine in the home was flexible and they could live as they wished, making choices about rising retiring, meals, and who to socialise with. There was overall satisfaction with the activities provided. Comments such as: “It’s pretty easy going here”; “There’s a game of bowls or bingo if you wish”; “There was a concert at Christmas it was very good, it lifted my spirits up”, “ There are things going on if you want to join in” were made by residents. Residents confirmed that visiting was able to take place at any reasonable time, and said that visitors were made welcome by the staff. Their comments included: “Visiting is any time”, “My family and people from my church come when they like”. The menus for the day were clearly displayed in the home, and showed choices at each mealtime. Residents were satisfied with the meals, and as part of the rehabilitation process those resident on the intermediate care unit were helped to make some meals themselves. Comments included: “There’s generally a choice of 2 meals”; “ The food’s good here”, “I make my own breakfast”. Butler Green House DS0000035532.V325698.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 & 18 Quality in this outcome area is good. Residents were confident that any complaints they may have would be listened to, taken seriously and acted upon. Training for staff in relation to the protection of vulnerable adults from abuse, improved measures within the home, for protecting residents from possible risk of harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents who spoke with the inspector were confident that any complaints they may have, would be dealt with appropriately by the management of the home. Comments made included: ‘ I haven’t got any complaints, but “I’d go to the person in charge if I did”; “I’ve no complaints”, “ I would speak out if I thought there was anything wrong, but I’ve no complaints”. Staff were also confident that complaints would be appropriately dealt with by ‘the managers’ of the home. A system for recording complaints was in place, and timescales for responding to the complainant were included in the home’s complaints procedure, which was in the service user guide. Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 15 There was a written procedure for dealing with allegations of abuse, which included a ‘whistle blowing’ policy. Staff who were interviewed were able to demonstrate an awareness of different forms of abuse, and knew what do if an incident of abuse was to occur in the home. Training regarding the protection of vulnerable adults was ongoing, with the most recent session having been held in December 2006. Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. The accommodation was clean and decorated to a good standard, with a programme of improvements, routine maintenance and renewal of furniture and fittings which provided a homely and comfortable environment for residents to live in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is purpose built, with level access to the property, and aids to independence in bathrooms and toilets. The accommodation is overall well maintained, and is furnished and decorated to a good standard. Standards of cleanliness continued to be maintained, and no unpleasant odours were detected. Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 17 The bedrooms that were inspected were personalised to varying degrees according to residents’ choice, and dependant on whether they were there permanent, or for short term/intermediate care. Residents were satisfied with their rooms, and made comments such as: “ My room’s very nice and it’s warm, I’m very satisfied”; “It’s very comfortable”, “ It’s always clean and I’ve got what I need in it”. Since the last inspection a corridor and 6 bedrooms had been redecorated, new wall lights had been installed in the lounges and they had been redecorated, one lounge had a new fire and surround, a new furniture had been provided in the main lounge, and the manager said that new carpets had been ordered for 2 of the lounges. Toilet and bathing facilities had greatly improved. The bathrooms had been completely refurbished to a very good standard, showers had been installed, toilets had been upgraded, and sluices had been relocated to be separate from residents’ toilet and bathing facilities. Additional storage space had been provided, and the laundry had been refurbished. Externally there had been some landscaping and re-flagging of the garden areas. Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 18 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): 27,28,29,30 Quality in this outcome area is good. Staffing levels within the home were sufficient to meet the needs of the residents. The procedures used for recruiting new staff, provided protection for residents. The training programme in place promotes a skilled staff group who are competent in meeting residents diverse needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rotas which were provided for inspection indicated that the number of staff on duty in the home, were sufficient to meet the needs of the residents who were living there. Residents were very satisfied with the care provided, and made comments such as: “The staff are very good”; “They do all they can to help you”, “They’re good little workers”. Records showed that 20 of the 33 carers had completed NVQ 2 (60 ), and training for the qualification was in progress for staff 5 care staff at level 2. Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 19 Details were provided of training that staff had received, and future training planned to the end of February 2007, which indicated that a training programme was overall good. It included, ‘Skills for Care’ induction for new staff, medication (see S9),‘abuse’ (See S18), safe working practices (See S38), and some specialist training relating to the categories of need for which the home is registered. At interview staff also gave information about the training, which they had received. It covered a range of topics and staff felt that the training provision in the home was good. There was evidence that criminal records bureau checks and 2 written references were being obtained before new staff started work in the home. Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 20 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): 31,33,35,38 Quality in this outcome area is good. Management and administration systems are in place resulting in the home being run in the best interests of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Records showed that the manager has achieved a Diploma in Social Work, and HNC in Social Care Management, the deputy manager and an assistant manager had an NVQ Level 4 another assistant manager as undertaking training for the qualification. Staff who spoke with the inspector felt supported by the management team, and staff meetings were held regularly and were considered to be beneficial. Comments included: “management listen to the staff”; “ the managers are approachable”, “they are supportive”. Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 21 A quality monitoring system was in place, which included monthly resident/carer meetings, and ongoing ‘customer satisfaction’ surveys which also included health care professionals, with regular audits of the results, and a details of the action to be taken by the home. The provider’s monthly report’s had been completed and as required in accordance with Regulation 26. Records of money held in safekeeping for 3 residents were selected at random for inspection and were found to be in order. Detailed records were kept of accidents in the home. An examination of the fire precautions records indicated that tests and checks in relation to fire precautions, and fire drills, had been done at the prescribed intervals. Staff training records and discussions with staff, indicated that staff were provided with training and up dates regarding safe working practices. Previous inspections have raised the lack of ventilation in the kitchen as an area which the providers need to address. The manager reported that some progress had been made since the last inspection, in that the work had been assessed, and passed on to the contractors to do the job. Major work is planned which will mean that the main kitchen will be out of action for several weeks, and careful planning is therefore needed because of the impact this will have on the residents. Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 22 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 3 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 Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 23 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. 1. 2 Refer to Standard OP7 OP38 Good Practice Recommendations The registered person should ensure that records relating to residents care needs are consistently completed. Ventilation should be provided to the kitchen. Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Butler Green House DS0000035532.V325698.R01.S.doc Version 5.2 Page 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. 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