Inspection on 10/10/05 for Genesis Care Home

This inspection was carried out on 10th October 2005.

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

Genesis Care Home 28/06/07

Genesis Care Home 26/10/06

Genesis Care Home 17/05/05

Genesis Care Home 17/11/04

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

CARE HOMES FOR OLDER PEOPLE Genesis Care Home 197 Peter Street Macclesfield SK11 8ES Lead Inspector Judith Morton Announced Inspection 10th October 2005 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 Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 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. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Genesis Care Home Address 197 Peter Street Macclesfield SK11 8ES 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) 01625 421623 Winnie Care (Macclesfield) Ltd Beverley Powell Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42), Physical disability (5) of places Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 42 service users to include: * Up to 42 service users in the category of OP (old age not falling within any other category) * Up to 5 service users in the category of PD (physical disability) over the age of 55 years The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 17/05/05 2. Date of last inspection Brief Description of the Service: Genesis Care Home is a purpose built home in Macclesfield that opened in February 2004. Care is provided for older service users and the home can provide respite care. The home is a three -storey building and service users are accommodated on all floors. Each floor has individual lounge and dining areas. Access between floors is via a passenger lift or one of the staircases. The 39 bedrooms all have en-suite facilities and have been furnished to a high standard. All bedrooms have a television and telephone point. The home has an adequate number of toilets and bathrooms suitable for service users. There is easy access for wheelchair users via the front entrance and throughout the home. Aids to help service users move about as independently as possible are fitted throughout the home and include bath hoists, grab rails and an emergency call bell system. The home has staff on duty twenty-four hours a day. There are garden and patio areas for service users to utilise during the warmer months. The car parking facilities are adequate. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 6 hours. The manager was on duty at the time of inspection. Five residents, three staff members and four visitors were spoken with during the inspection. Three residents’ care files and two staff files were reviewed along with other paperwork. The inspector also joined the residents at lunchtime and a meal was sampled. What the service does well: What has improved since the last inspection? What they could do better: The staff need to consider how to include the residents’ own views of the care they have received on a consistent basis. The activities that residents participate in, or in some cases, refuse to join in, need to be recorded so that future plans can reflect the resident’s likes and dislikes. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 Page 6 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. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 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 Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 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): 1&2 There is sufficient information available to enable the residents to make a choice about whether the home could meet their needs. EVIDENCE: There is a statement of purpose and service user guide available for the home. The manager had revised and produced the documents. They were in larger print, making it easier for residents with visual impairments to read. The content was good, used plain language and included sufficient information to enable the residents to make a choice about whether their needs could be met at the home. There were copies of the service user guide in those residents’ bedrooms that were visited during the inspection. One resident had clearly read the document and it acted as a reminder of what she was entitled to, such as tea or coffee 24hrs a day. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 Page 9 There were a number of small points requiring attention. These were: 1) The satisfaction questionnaire contained within the service user guide could state that people do not have to sign it if they wish to remain anonymous. (See recommendation 1) 2) The complaints procedure should state that people could complain to the Commission for Social Care Inspection in the first instance if they wish. The telephone number of Winnie Care and of The Commission for Social Care Inspection should be included in the complaints procedure. (See recommendation 2) Residents had a signed contract available on their personnel file. These were under review and new residents had a copy of the re-designed contract. There was a separate sheet in the file, which stated which room was to be occupied and the weekly charge. It would be advisable if this were attached to the contract so that the resident would know exactly what they were signing for. (See recommendation 3) Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 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, 9 & 11 Care plans are kept up to date so that residents’ needs can be met. Staff followed the correct procedures for administering medicines to residents so that they received their medicines as prescribed. EVIDENCE: The care plans were accurate and up to date and there has been some improvement in the content of the daily recordings in the care files that were viewed. There was some evidence that residents had been consulted about their care throughout the day. However, this was inconsistent and depended largely on which members of staff had made the recordings. (See recommendation 4) During the inspection there was an opportunity to observe the administration of the lunchtime medication. This was carried out in keeping with the medication policy and procedure. The medication trolley was tidy and well organised and the member of staff administering the medication re-stocked the trolley ready for the next member of staff. The medication record sheets were completed accurately and the correct coding was being used if medication could not be given. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 Page 11 In the previous month there had been an unexpected death at the home. The staff and some of the residents had been deeply affected by this. The family of the resident thanked the staff for their support, care and respect they had shown them. There was no record of the resident’s wishes in the event of terminal illness or death in the three care files inspected. (See recommendation 5) Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 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 There were plenty of activities that would occupy and stimulate the residents. The menu and food served provided the residents with a nourishing and healthy balanced diet. EVIDENCE: There was a varied programme of activities for the residents to take part in if they wished. These included, carpet bowls, hoopla, dominoes, bingo, a film night, organ player and an accordion player. There were also communitybased activities. A small number of residents chose to attend the local church hall for the good companions afternoons. Day trips are provided occasionally, the last being to the canal for a boat trip and the next will be to Buxton. The residents chose this themselves . Although a note was made on each resident’s file to say whether or not they had taken part, it did not say what the activity was. The manager was in the process of redesigning the form to include the type of activity attended, as this information would be useful in future planning. (See recommendation 6) Many of the residents said that they enjoyed the food that they were offered at Genesis. At the previous inspection one resident had commented that he did not always like the food. The manager had asked him for some suggestions as to what he did like and had added these to the menu. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 Page 13 There was a choice of two main meals offered at lunchtime. The inspector was able to share a meal with the residents. The food was well presented, hot and tasty. There were fresh vegetables with both meals. The dining room was bright and the tables had tablecloths and matching napkins. There was lively conversation between the residents and was clearly a social occasion for them. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 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 Residents, staff and visitors to the home would know how to make a complaint and feel assured that it will be dealt with appropriately. The residents would be protected from abuse by the measures being taken by the home and those working there. EVIDENCE: There had not been any complaints made in the home since its opening in February 2004. The complaints procedure is displayed throughout the home and information is included in the statement of purpose. There is also a complaints book available, which contains the appropriate columns for recording the complaint, how it was dealt with, by whom and the outcome. There were additional columns for the response from the complainant and the response from the manager. Since the last inspection 21 members of staff, including kitchen staff and the housekeeping team, had attended adult abuse awareness training. The visitors’ signing in book was also being completed, so it was clear who was in the home at any one time, as an added protection for the residents. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20,23, 24, 25 & 26. The home was warm, well lit and welcoming, providing a comfortable, safe environment for residents. All areas of the home were clean and well maintained EVIDENCE: The home continues to be well maintained, clean and comfortable for the residents. Service users live in safe comfortable bedrooms and are able to have their possessions around them. All bedroom doors are fitted with locks that could be overridden by staff in an emergency. A locked drawer is provided in each bedroom. There are a number of shared rooms such as lounges and dining rooms in which residents can choose the spend the day. They can also stay in their own rooms and some residents were seen to return to their rooms during the inspection. There were no offensive odours present in any area of the home on the day of inspection. The home was bright and airy yet warm and comfortable. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 Page 16 All of the rooms occupied by service users have windows in them that can be opened for ventilation. The home is centrally heated and thermostatic valves are fitted to the radiators to allow individual control of temperatures in the rooms. All bedrooms radiators are low surface temperature. The installation of a large ramp has now been completed but is awaiting a nonslip surface to be applied before it can be used. It will enable access to and from the building from the first floor. Security measures and a visitor’s book will be required on this floor also. (See recommendation 7) Emergency lighting is provided throughout the home. The home has an adequate laundry, which is appropriately staffed and equipped to meet the needs of the service users accommodated. Domestic and laundry staff have received training so they know how to store and handle hazardous materials, such as cleaning fluids, properly. There is a policy to deal with infection control and a copy is kept in the policy and procedures manual. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 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 staff have the knowledge and skills to meet the needs of the residents and thorough checks are carried out on new staff in order to protect residents from possible harm. EVIDENCE: The home continues to meet these standards, as found at the last inspection. There are a number of staff who have achieved their NVQ level 2 and more staff commenced their training for NVQ level 2 in September. The induction programme for new staff includes health and safety, fire safety, awareness of how to deal with hazardous substances, and Genesis’ care policies and procedures. Additional training is also provided to staff, including care of medicines and care planning workshops. The training manager supervises the progress of staff and identifies with them their future training needs. There are also regular staff meetings being held which ensure the staff are kept up to date with practices within the home. The minutes are recorded and kept in the office so that staff can have easy access to them. The two staff files checked during the inspection showed that the recruitment procedure for the home is being followed properly. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 Page 18 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): 31, 33, 35 & 38 The home is well managed and residents have a say in how it is run. Residents and the staff were comfortable with the manager’s attitude and approach to running the home. The residents spoken with all said they were happy and found all of the staff to be approachable and friendly. EVIDENCE: The manager had achieved NVQ level 2 in care of older people, people with mental health difficulties and people with learning difficulties. She was undertaking NVQ level 4 and the Registered Manager’s Award. The processes of managing and running the home are open and transparent. This was evidenced by interviews with service users, staff and relatives. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 Page 19 In addition to the needs of the residents, the manager was very mindful of the needs of the staff. She was particularly concerned for their welfare following the unexpected death of a resident, which she and they had been deeply affected by. The manager acknowledged the hard work that the staff had put in to help the home to meet minimum care standards and intended to reward this with an afternoon party for residents and staff. The staff were equally comfortable with the manager. Staff said they felt they could approach her if they had a difficulty or concern. One member of staff commented on the manager’s clear direction. She said “ you know what is expected of you and why”. The residents and relatives spoken with all praised the staff for their friendly, helpful and caring attitude. One relative spoken with visited almost every day basis and said she had never had any concerns about anything she has seen whilst visiting. Another relative said that the staff are always very happy and obliging. A further relative has two members of her family living at the home and would, therefore, be on her own at Christmas. She told of how the home had been able to accommodate her over the last Christmas period and hoped that she would be able to do the same this year. She said she is happy to pay for this service as she is able to spend time with her family at a time when she could be quite lonely. Residents’ meetings continue to be held and the notes from the meetings are kept in the staff meeting minutes folder. The manager said that a copy of the residents’ meeting notes would be made available within the home so that all residents could see them. Since the last inspection the manager has encouraged the residents to be more involved in their own meetings. One resident chairs the meeting and the only member of staff present is the activities co-ordinator, who records the minutes. This was at the request of the residents. The manager said the response from the residents has been very good. The home does not act as appointee for any of the residents with regard to the handling and management of their financial affairs. Their family or representative maintains the resident’s finances. A small amount of personal money is held in the home’s safe for some residents. One member of staff signed each time a resident was given any money from the safe. It was recommended that the resident should also sign to say they have received this or, if they are unable to do so, then two members of staff should sign. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 Page 20 (See recommendation 8) The manager had spoken with the residents about what they should and shouldn’t do in the event of a fire and a fire drill had been carried out successfully. Fire safety training and fire prevention equipment testing were taking place regularly. There is a formal quality assurance system in place. Managers from the company visit the home monthly in accordance with regulation 26 of the Care Homes Regulations 2001. The monitoring reports are available in the home. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 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 3 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 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 Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 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. 1 2 Refer to Standard 1 1 Good Practice Recommendations The satisfaction questionnaire in the service user guide should give residents the choice as to whether they wish to sign the form or not. The complaints procedure in the service user guide should state that residents could complain to the Commission for Social Care Inspection at any time. Additionally, the telephone numbers of Winnie Care and the Commission should be included. The room to be occupied and the weekly charges should be attached to the resident’s contract. A system of checking residents views about their daily care and recording them should be considered. The wishes of the residents in the event of terminal illness or death should be recorded on their file. The record of whether the residents had attended an activity or not should also include what the activity was that had been offered DS0000062417.V254274.R01.S.doc Version 5.0 Page 23 3 4 5 6 2 7 11 12 Genesis Care Home 7 8 25 34 Security measures and a visitor’s book should be provided when the ramp to the first floor comes into use. The residents should sign to confirm when they have received their money and if they are unable to do so, then two members of staff should sign. Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Genesis Care Home DS0000062417.V254274.R01.S.doc Version 5.0 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. 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!