Inspection on 21/11/06 for Greatwood House

This inspection was carried out on 21st November 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

Greatwood House 24/10/05

Greatwood House 16/05/05

Greatwood House 05/10/04

Greatwood House 14/04/04

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

CARE HOMES FOR OLDER PEOPLE Greatwood House Mancunian Road Denton Tameside M34 1GX Lead Inspector Janet Ranson Unannounced Inspection 21st November 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 Greatwood House DS0000005569.V319895.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. Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greatwood House Address Mancunian Road Denton Tameside M34 1GX 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 336 5324 0161 320 3896 greatwood@tamesidecg.co.uk Tameside Care Limited Mrs Deborah Thompson Care Home 60 Category(ies) of Dementia - over 65 years of age (60), Old age, registration, with number not falling within any other category (60), of places Physical disability over 65 years of age (60) Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 60 service users to include: *up to 60 service users in the category of OP (Old age not falling into any other category); *up to 60 service users in the category of PD(E) (Physical disability over 65 years of age); *up to 60 service users in the category of DE(E) (Dementia over 65 years of age). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 24th October 2005 2. Date of last inspection Brief Description of the Service: Greatwood House is a purpose built, adapted and extended single storey building. The home is registered with the Commission for Social Care Inspection to provide personal care for 60 older people, some of whom may have a physical disability or dementia. All the accommodation is provided in single rooms, 37 of which have been extended to include en-suite facilities. The home is divided into small units each one having its own small kitchen, dining area and lounge. There is a separate day care centre within the building that is not subject to regulation. There are aids and adaptations throughout the home, to meet the assessed needs of the service users. A landscaped garden is situated in the centre of the building. It is secure and fully accessible from the home. Originally commissioned by the local authority, Greatwood House is now owned and managed by Tameside Care Limited, a not for profit organisation. The home is located within a large estate, close to community resources and transport networks. Fees for accommodation and care at the home are £356.66. Additional charges are also made for hairdressing and chiropody services, newspapers and personal toiletries. There is also a voluntary weekly charge for social activities. The statement of purpose and service user guide are available in the main hallway. Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the key inspection, which included an unannounced site visit by one inspector and an ‘expert by experience’. The site visit took place on 21st November 2006 and covered a period of eight hours from 9:30am until 5:30pm. The Commission for Social Care Inspection are trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are currently testing a method of working where ‘experts by experience’ are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term ‘experts by experience’ used in this report describes people who have been appointed by Help the Aged, under the direction of the Commission for Social Care Inspection, to take part in the inspection of services for older people. During the inspection time was spent talking to residents, relatives and staff and observing the home’s routine and staff interaction with residents. The expert by experience also had lunch with the residents. A total of six residents’ identified needs were looked in detail. Individual details of their experiences and care were examined from the point of admission to their current care. The inspector looked around the building and a selection of staff and residents’ records was examined, including records of care, medication records, employment and training records. The inspector checked what the Commission had asked the home to do at the last inspection (Oct 2005) had been done. Questionnaires were left at the home for use by residents, their relatives and the staff to comment on the service. Some of the responses have been incorporated in this report. Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 6 What the service does well: Greatwood House provides a good standard of care from a well-trained and committed staff team. The environment is very well presented and the standard of accommodation meets fully with the residents’ expectations. The activities programme remains imaginative and stimulating. A resident commented, “The home has an excellent activities co-ordinator. (The activities) are well supported by the residents, there are musicians, singers, outings for those who are capable, evening social with invitations to relatives and friends, bingo, arts and crafts, afternoon teas and flower arranging plus other things on most afternoons. No need to be bored here.” Responses contained within the relatives comment cards include: • “The care at Greatwood is excellent. Everyone is genuinely kind, caring and friendly. We could not wish for a better environment.” (for my relative). “I am very pleased with the overall care my relative receives, I think the staff at Greatwood House take good care and are thoughtful in their approach to the residents.” “My relative has been in care for seven years and is always treated with love and respect.” • • The expert by experience noted in her report “I found the home warm and welcoming, the interaction between the staff and residents was very good.” What has improved since the last inspection? The organisation has improved the recruitment and selection process. This now means that any gaps in employment history are investigated and documented, and the references are appropriate to the proposed designation. The residents have been consulted about changes to the daily menus. The menus were drawn up in draft and a further consultation carried out before they were finalised. Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 7 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. Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 8 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 Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 9 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 (Standard 6 intermediate care is not provided at Greatwood House) Quality in this outcome area is good. The home’s system of assessment reflected individual preferences and social requirements. This meant that the home could be certain they could meet the prospective resident’s diverse needs. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Individual care needs assessments were contained within the six care files examined as part of the inspection. The home also has a process of assessing potential residents’ needs carried out by a senior member of staff. Prospective residents and their relatives are also invited to visit the home so that they can meet other people and see the accommodation for themselves. By completing such an assessment, the home can be sure that individual needs can be met. A relative commented, “I think consideration was given not only to care requirements, but to location, which meets our needs (as visitors) perfectly.” Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 10 Another relative commented (on behalf of her relative) in response to: “did you have enough information about the home before you moved in so that you could decide if it was the right place for you?” that she: • • • • Viewed the website Received the brochures Was shown around by the assistant manager Was shown around generally Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 11 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. The care planning process clearly identifies the residents’ individual health and social requirements. They provide the carers with action to be taken to provide appropriate care on a day-to-day basis, enabling the residents to benefit from the individual care. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Six care plans were examined as part of the inspection process. They clearly set out the residents’ individual personal care needs. The care plans document the action to be taken by the carers to ensure all aspects of health, personal and social care are met and reviewed. A resident wrote in the comment card, “ I think on the whole the attention and care I get is very good.” Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 12 Where identified, the resident’s health is monitored and addressed by the appropriate health care professionals. The district nurses are involved on a regular basis, as are the chiropodist, audiologist and dietician. A relative wrote in the comment card, “The doctor is always requested when necessary, medication is discussed with us and adjusted to meet changing needs.” The senior staff are responsible for the administration of medication. There was evidence to show they had received training to correctly administer medications. Records are retained to show changes to medications and medical interventions. There is a policy and procedure in place to ensure all medications are administered in the correct manner. The medication storage was satisfactory. Based on observation, it was apparent that the staff respected the residents’ privacy by knocking and waiting before entering rooms. A visitor said to the expert by experience “the staff treat my relative with great respect and cannot do enough for him. I am always made welcome and offered a drink when I come to visit.” Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 13 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. The choices offered to the residents meet with their requirements and needs and enable them to exercise elements of control over their lives. The programme of activities provided suits the residents’ requirements for stimulation. Visitors are made to feel welcome and remain in contact with their relatives’ care. The contents of the menu appeared nutritious and meals were nicely presented. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: There is a planned programme of activities. A part-time worker is responsible for the content and application. During the inspection a quiz was enjoyed by some of the residents, along with some of the people from the day care unit. Carers were on hand to provide assistance and the whole session was obviously enjoyed. Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 14 Photographs around the home showed other social activities, including a party to celebrate the building’s 40 years, afternoon tea parties and Halloween. Before the quiz a resident made a short speech and presentation to the activities organiser in recognition of her silver wedding anniversary. Entertainers also visit the home on a regular basis. Based on direct observation, the residents benefit from relaxed informal contact with the staff. A visitor said “The management and staff are always alert to our changing needs, both of our relative and our needs as a family visiting her. It is like being part of one big family who all support each other.” The main meal of the day at Greatwood House is served at midday; breakfast is flexible, as and when the residents get up. The choice for the day was displayed on each table in the dining areas. The expert by experience took her lunch with the residents in the dining room. She noted that a resident said “the food is very good.” The expert by experience also said there was a good choice of meals but anyone wanting an alternative to what was on the menu had to request it the night before. It is understood that the menus had recently been changed, taking into account residents’ ideas and preferences. They had been sent out in “draft” form for the residents’ approval before being put into operation. A resident who had not lived at the home for long, said the food was “excellent” and not what they expected. A resident responded in the comment card, “The home has a very competent cook she is very good with special diets.” Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 15 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. The home has a satisfactory complaints system with evidence that residents feel that their views are listened to and acted upon. Staff knowledge and understanding of adult protection issues provides a safe environment to protect residents from abuse. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The home has a policy and procedure concerning reporting and investigation of complaints. This is available to the residents in the service user guide. Those residents who spoke with the inspector were not aware of the process but did say they would either tell their relative of any concerns or speak with a member of staff. They said their expectations would be that the concern would be looked into and made better for them. Residents wrote in the comment cards: “I have never needed to make a complaint. explained to me.” But the procedure has been “Everyone from management to staff is willing to discuss problems or worries of any kind.” Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 16 The expert by experience reported that one resident said, “if I had a complaint to make I would speak to the manager of the home.” But another resident also said he “had no idea how to make a complaint.” The home has a policy and procedure to respond to allegations of abuse. The senior carers have received formal training in the Protection of Vulnerable Adults (POVA) as required. The carers who spoke with the inspector confirmed they had also received the POVA training and demonstrated their understanding of their responsibilities. Responses contained in the care workers surveys also confirmed they had received this form of training. Two internal disciplinary actions confirm that the organisation takes the protection of vulnerable adults seriously. Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 17 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. Improvements to the home now provide the residents and their visitors with a pleasant warm and welcoming environment. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: In the course of the inspection a tour of the communal areas of the home was undertaken and a selection of the bedrooms were looked at. In general, the bedrooms were nicely personalised. Two residents and one visitor who spoke with the inspector confirmed their satisfaction with the accommodation. A visitor wrote, “The décor is lovely and there is usually someone busy tidying and cleaning. Every room is pleasant.” Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 18 All areas of the home were clean, although a smell of stale urine was most noticeable in a communal area. This created an unpleasant environment for the residents and their visitors. It was evident that those residents who are independently mobile were able to move around all areas of the home at will. Visitors could be seen in the home throughout the inspection. There is a room specially equipped for hairdressing. Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 19 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. The residents receive care from welltrained staff who respond to the residents and visitors in a respectful manner. The home’s recruitment policy and procedure provides protection to the residents from potential abuse. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: From observation during the inspection the numbers of staff on duty met with the residents’ assessed needs. The majority of comments from the residents and their visitors confirmed this to be the case. One person said, “There is always someone on hand to answer questions, or to give help where needed.” Two residents wrote in response to the question, (Are the staff available when you need them?): “Not always available when wanting to go to the bathroom.” Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 20 “The carers are very dutiful. (But) So many residents need two persons to help them to the toilet also to get them to the dining table three times daily.” The staff also had similar comments regarding staffing levels. “The home runs fine but not always enough staff to help.” The carers were seen to be attentive and responded to the residents and their visitors in a respectful manner. A carer responded to the question, is there anything that the home does really well that you want to tell us about? “Basically it’s a well run home, which I am proud to say I work in. Everyone pulls well together and everything we do is teamwork and that makes all the difference. Its nice to know if we have a problem, the office door is always open for us to talk the problem over. It is dealt with in a confidential and appropriate manner.” The organisation continues to be a committed to the National Vocational Qualification training scheme with a total 76 of carers achieving level 2 in care practices. The carers who spoke with the inspector and the expert by experience confirmed they had attended an induction programme and had completed all the health and safety (mandatory) training. A small number of staff files were examined. They contained the required documentation and there was evidence of references including satisfactory checks with the Criminal Record Bureau. Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 21 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. The manager of the home has the skills, experience and qualifications to run the establishment. The residents’ financial interests are safeguarded. Systems are in place to protect the residents, their visitors and the staff’s health and safety. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The manager is supported through the organisation by the operations director and in the home by senior carers. She has the skills, experience and qualifications to manage the home. Those carers who spoke with the inspector said they felt supported by the management and they were proud to work at Greatwood House. Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 22 Reports of Regulation 26 visits made to the home by the registered provider or their representative are supplied to the Commission for Social Care Inspection as required. The operations manager undertakes the visits and the manager stated that all visits were unannounced. Other unannounced visits were carried out to check on the health and safety aspects in the home. A system of annual satisfaction questionnaires is being used by the organisation to enable the residents and their relatives to improve or comment on their care. The results are made public and recommendations acted upon. One resident continues to manage their own finances. For those residents who are no longer able to deal with their money the home has a system to protect their financial interests. Small amounts of personal allowances are retained for safekeeping. Satisfactory records with receipts covering all expenses are retained for auditing and inspection purposes. The home has a system of residents meetings that enable the residents to have their say about how the home is organised. A resident takes the minutes during the meeting and also makes sure the residents understand what the meetings are all about. No hazards to health were noted during the inspection. The health, safety and welfare are further ensured by the systems in place to report accidents and incidents. Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 24 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 Refer to Standard OP27 Good Practice Recommendations The registered person should ensure that all areas of the home are maintained free from offensive odours. Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 25 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 Greatwood House DS0000005569.V319895.R01.S.doc Version 5.2 Page 26 - 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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