Inspection on 28/06/07 for Genesis Care Home

This inspection was carried out on 28th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Genesis Care Home 26/10/06

Genesis Care Home 10/10/05

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 Paul Ramsden Unannounced Inspection 28th June 2007 10:00 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.V334238.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. Genesis Care Home DS0000062417.V334238.R01.S.doc Version 5.2 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 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.V334238.R01.S.doc Version 5.2 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 26th October 2006 Date of last inspection Brief Description of the Service: Genesis is a three-storey care home for people over 65 years of age. The home is owned by Winnie Care (Macclesfield) Ltd and is located in Macclesfield. It is close to the local shops and other community facilities. There are gardens and patio areas for residents to use during warmer weather. Residents accommodation consists of 42 single bedrooms all of which have ensuite facilities. The rooms have been furnished to a high standard and each of them has a television and telephone point. There are an appropriate number of communal facilities available for the numbers of residents that can be accommodated in the home. Each floor has a lounge and dining area. Access between floors is by a passenger lift or one of the staircases. The home has enough toilets and bathrooms that are suitable for the residents. Aids to help independence are in evidence throughout the home; these include bath hoists, grab rails and an emergency call bell system. The current fee range for the home is £353 - £473 per week. Newspapers, toiletries, hairdressing and private chiropody are not included in the weekly charge. Genesis Care Home DS0000062417.V334238.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 28 June 2007 and lasted 8 hours and fifteen minutes. Paul Ramsden, Inspector, undertook the visit. All of the key standards for older people were looked at. This visit was just one part of the inspection. Before the visit the home manager was also asked to complete a questionnaire in order to provide up to date information about services in the home. Questionnaires were made available for clients and families to find out their views and other information received since the last key inspection was reviewed. Four client and two relative survey forms have been returned. During the visit various records and the premises were looked at. A number of clients, relatives, staff members and other visitors to the home, including a visiting nurse assessor were spoken with; they gave their views about the home and the service provided. The new manager was on holiday at the time of the inspection visit, she is currently undergoing registration with the Commission. A number of positive comments from residents and staff members were made about the impact she has had since being in the home. Prior to her appointment Genesis had had two other managers in the previous 12 months and whilst the good quality of care provided to the residents had been maintained these changes had impacted upon staff moral and some of the documentation, for example, the care plans. References to these matters have been made within the main body of the report. What the service does well: The staff members at Genesis provide a good standard of care to the residents that live at the home, they were seen to be treating clients with respect and dignity and were able to demonstrate an awareness of their diverse needs. Good relationships were seen to exist between residents and staff and those people that commented all said that the staff members were good. Comments from residents and relatives included; “The home is very good, the staff get on really well with my relative and he is very happy and settled”. A resident said. “If I have to be in a home, this is the best, I please myself”. A good variety of activities/social events are organised, these include both external trips and in–house events. Genesis Care Home DS0000062417.V334238.R01.S.doc Version 5.2 Page 6 Catering within the home was well managed and the majority of the residents spoken with said the food was good. A wide selection of training courses is available for the staff members working in the home. 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. The summary of this inspection report can be made available in other formats on request. Genesis Care Home DS0000062417.V334238.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 Genesis Care Home DS0000062417.V334238.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): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The pre-admission assessment gives prospective clients confidence that the home will be able to meet their needs. EVIDENCE: There is a statement of purpose and service user guide available for the home. They are in larger print, making it easier for residents with visual impairments to read. The content is good, using plain language and includes enough information to enable the residents to make a choice about whether their needs could be met at the home. All of the information required under the Care Homes Regulations 2001 and Standard 1 of the National Minimum Standards for Older People is contained within these. One of the relatives has written on a survey form; “We still can’t believe our luck in finding such a lovely caring home”. A relative of a prospective resident arrived at the home unannounced during the visit; she was made to feel welcome, given information about the home and various practical matters and given a tour of the building. Genesis Care Home DS0000062417.V334238.R01.S.doc Version 5.2 Page 9 Pre-admission assessments are carried out to ensure the home can meet an individuals needs. Four residents’ care files were checked. There was a good, detailed pre-admission assessment document on each of the files seen and these covered all aspects of the prospective resident’s life. The front sheet of the care file contained identifying information about the resident, their contacts, date of birth etc. The area manager was undertaking a preadmission assessment on the day of the inspection. Residents’ health needs were assessed before they moved into the home and this continued to be assessed once they were living there. Any medication they were on and a detailed medical history were recorded. There was also a residents’ choice form which described the residents’ preferences, such as, what time to get up, where to have breakfast, what drink they preferred, what time they liked to go to bed. Genesis does not provide intermediate care. Genesis Care Home DS0000062417.V334238.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 care plans seen generally provided sufficient information for staff members to be able to take appropriate action to meet an individuals needs. EVIDENCE: The two previous managers have both changed the care planning; including assessment and risk assessment documentation. This has led to a confusing system that does not help the staff members who are providing the care to the residents. The new manager and area manager have undertaken an audit of the whole system of care planning and have identified a number of shortfalls within the quality of the documentation that is in use. They are now implementing new paperwork/procedures in order to bring everything up to a higher standard and to make it user friendly. They intend to have this fully operational within four months. Although there are some problems with the current care plans the four seen as part of the case tracking process provided sufficient information to look after a person’s needs. Appropriate risk assessments had also been completed. Genesis Care Home DS0000062417.V334238.R01.S.doc Version 5.2 Page 11 The health and well being of residents was being monitored and an appropriate record of development and actions taken was being kept. There was written evidence to confirm that care plans were being reviewed monthly and where necessary re-written. Residents or their families/advocates are involved in the care planning process. Staff members spoken with had a good understanding of the people they were supporting and were able to meet their diverse needs; they continually monitor the residents’ health needs and there was evidence to show that they were receiving appropriate support from health care professionals. This included GPs, community nurses, optician, dentist and chiropodist. The changing needs of individuals are discussed as and when required; the inspector was able to see this in practice during the visit. A visiting nurse assessor spoke very positively about the home; “The quality of care is very good, staff are professional and very caring”. All personal care is carried out in the privacy of a resident’s bedroom or one of the bathrooms. The residents spoken with during the inspection all said that the standards of care provided were very good and that they had been able to express their opinions and wishes about their daily routines. It was also seen throughout the visit that residents were being treated with courtesy, respect and good humour by staff. Genesis has a written policy on the receipt, administration [including selfadministration] safekeeping, handling, recording and disposal of medication within the home. The home uses a blister pack system dispensed by a local pharmacist. No obvious issues were seen during the inspection visit. The preinspection questionnaire gives the names of those staff members who administer medication. Genesis Care Home DS0000062417.V334238.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. People spoken with were positive about the home and the support they received so they could maintain contact with friends and family and make choices about their daily lives. EVIDENCE: Residents were able to move around freely within the home and a choice of sitting areas was available. They confirmed that routines within the home were flexible and that they were able to make choices in many areas of daily living, for example times of rising and retiring, where to spend their time and with whom and participation in planned activities. Staff members were seen to knock on the door and to await permission before entering a resident’s bedroom. One of the residents said, “I would not like to be anywhere else”. The home employs an activities co-ordinator whose role is to work with people both individually and in groups. A good variety of social and other activities are organised and information about these was displayed on the notice board and throughout the home. The residents who commented made a number of positive comments about the activities available. Genesis Care Home DS0000062417.V334238.R01.S.doc Version 5.2 Page 13 Links with the local community are maintained and people are able to come and go from the building. Visitors are free to visit the home at any reasonable time. Personal mail was delivered unopened, or given to relatives if appropriate. Meals can be taken in the dining areas or in the privacy of a person’s own room. There are new menus that have the flexibility to meet individual needs and choices. The majority of the people that commented said the food was good and that choices were available. Special diets are prepared where necessary. Drinks and biscuits/fruit were readily available whenever people wanted them. The few negative comments about the food provided were passed on to the deputy manager during the feedback session that took place at the end of the inspection visit. Genesis Care Home DS0000062417.V334238.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 are able to complain and action is taken to respond to their concerns. Adult protection training for staff is available to ensure the continued safety of people staying in the home. EVIDENCE: There is a clear complaints procedure for the home and information on how to raise any concerns or complaints are readily available throughout the home. Information on how to complain is included in the statement of purpose and service user guide. There is also a complaints book for recording any complaint and how it was dealt. The people spoken with during the visit confirmed that they knew what to do if they were unhappy or wanted to make a complaint. The survey forms received also confirmed this. The preinspection questionnaire indicates that no complaints have been received during the previous 12 months. Genesis provides policies and procedures for the protection of vulnerable adults, which complies with the Public Disclosure Act 1998 and the Department of Health Guidance ‘No Secrets’. Staff members working in the home have received training in this area. Genesis Care Home DS0000062417.V334238.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, 20, 23, 24 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The clients’ stay in a safe, homely, clean and comfortable home. EVIDENCE: A tour of the premises was undertaken; this included the lounges, communal areas and a number of bedrooms. The home continues to be well maintained, clean and comfortable for the residents. Furnishings, fittings and lighting in the lounges and communal areas are of a good quality and are domestic in character. Due to the location of the home the entrance is actually located on the first floor. A large ramp going from ground level up to the first floor was installed when the home first opened in 2004. Unfortunately due to errors in its construction it has not been used due to safety reasons during the previous two years and requirements for this to be addressed are still outstanding. Genesis Care Home DS0000062417.V334238.R01.S.doc Version 5.2 Page 16 Winnie Care does not own the building so it is therefore the landlord’s responsibility to repair the ramp. The area manager of the company who was present during the inspection explained that the issue was almost resolved and quotes were currently being obtained. The area manager also explained that a grant to improve the garden facilities had been obtained from Cheshire County Council and work was due to start in the near future. Bedrooms seen during the inspection were personalised, comfortable, wellfurnished and contained items of furniture belonging to residents’. All bedroom doors have locks that can be overridden by staff in an emergency. A lockable drawer is provided in each bedroom. A resident has written on a survey form, “very clean”. The home provides adaptations for use by residents with mobility problems: these include bath and toilet aids, hoists, grab rails and wheelchairs. The home was found to be clean and tidy on the day of the visit. The laundry is appropriately equipped and good systems are in place for the care of peoples’ clothes. 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.V334238.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. Staff members work positively with residents and families to improve the quality of life of people living in the home and a robust staff recruitment process is in place in order to protect people from possible harm. EVIDENCE: Staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff is adequate to meet the needs of the residents within the home. Staff members were cheerful and friendly. Residents and relatives spoken with were complimentary about staff attitude and competence. One of the residents said; “On the whole staff are wonderful, helpful and caring”. The staff members working at the home are able to undertake NVQ training, a recognised qualification for staff involved in delivering care. It was explained that four staff members had just completed NVQ level 2. The staff members spoken with also said that they are able to access a wide range of training courses and that in their opinion this was really positive aspect about working at the home. The pre-inspection questionnaire states that staff have been able to attend the following courses during the previous 12 months; NVQ, continence care, moving and handling, including use of the hoist, fire training, first aid, care plan training, nutrition, medication, health and safety, food hygiene, COSHH, customer care, falls prevention, care of the dying and dementia care. Genesis Care Home DS0000062417.V334238.R01.S.doc Version 5.2 Page 18 The files for three recently appointed members of staff seen contained all of the required information and a robust recruitment procedure was in place for the protection of residents. Prospective staff members are checked against the POVA list before employment commences and CRB disclosures are obtained. 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. The training manager supervises the progress of staff and identifies their future training needs with them. There were also regular staff meetings being held which ensures that the staff members 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 home’s induction procedure is based upon the Skills for Care, Common Induction Standards. Genesis Care Home DS0000062417.V334238.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. The home is being well run and managed on a day-to-day basis and there are appropriate procedures in place to make sure that clients are safe. EVIDENCE: There has been a change of manager at Genesis since the last inspection. She is currently undergoing registration with the Commission for Social Care Inspection. Although the manager was new to Genesis the residents were fully aware of who she was and made a number of positive comments about her during the visit. Genesis Care Home DS0000062417.V334238.R01.S.doc Version 5.2 Page 20 The staff members also spoke positively about her and the changes she had implemented since being in post. They went on to say that they were looking forward to a period of stability after having two other managers within the previous 12 months; this had affected staff moral and some staff members had actually left. A deputy manager, senior staff and an administrator support the manager to run the home. A quality assurance survey to ascertain whether residents and families are happy with the standards of care being provided is in place. Residents’ personal allowances are being handled appropriately. Personal monies were being kept securely and those inspected had correct balances and accurate records. There is a comprehensive health and safety manual as well as policies and procedures in relation to safe working practices in place and there was evidence to confirm that staff were receiving training in areas such as moving and handling, first aid and adult protection. The fire precautions record book was up to date and demonstrated that checks of the alarm system, emergency lighting, fire drills and staff training were taking place. Monthly visits to comply with regulation 26 of the Care Homes Regulations are being carried out. Genesis Care Home DS0000062417.V334238.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 3 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 3 X X 3 3 3 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.V334238.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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. 1 Standard OP19 Regulation 13(4)(a) & (c) Requirement Timescale for action The access ramp must be 01/10/07 repaired so that the residents can use it safely. [Timescale of 01/03/07 not met] 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 Genesis Care Home DS0000062417.V334238.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Genesis Care Home DS0000062417.V334238.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. 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