Inspection on 09/08/05 for Green Close

This inspection was carried out on 9th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Green Close 16/10/08

Green Close 19/10/07

Green Close 20/11/06

Green Close 30/01/06

Green Close 25/01/05

Green Close 24/05/04

Green Close 22/10/03

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

CARE HOMES FOR OLDER PEOPLE Green Close Drakes Avenue Sidford Sidmouth Devon EX10 9JU Lead Inspector Caroline Rowland-Lapwood Unannounced 9 August 2005 th 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 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. Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Green Close Address Drakes Avenue, Sidford, Sidmouth, Devon, EX10 9JU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01395 515050 01395 512815 Mr Ian Rice, Devon County Council Mrs Frances Lee Care Home 23 Category(ies) of OP - Old Age (23) registration, with number PD - Physical Disability (23) of places PD - Physical Disability over 65 (23) Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 11/07/2003 Service Users in the category PD (Physical Disability) must be over the age of 50 years There is a variation in place allows admission of one named person, in the category PH, for a period of up to twelve weeks from the date of their admission ( june 2005) The maximum number of persons accommodated at the home will remain at 23. On termination of this placement the particulars and conditions of this registration will revert to those held on the 13th June 2005. Date of last inspection 25/01/2005 Brief Description of the Service: Green Close is a Care home providing accommodation and personal care people over the age of 50. There is currently only one long stay service user and the home does not intend admitting any further persons on a long stay basis. The home has three short stay beds, 3 recuperative care beds, and sixteen rehabilitation beds. The home is dedicated to helping people who may be ready to leave hospital but are unable to return home without further rehabilitation. The home can also care for those people who are struggling to remain at home.The rehabilitation service offers service users a stay of up to eight weeks, during which intensive therapy is provided by health and social care professionals. The service user is assessed throughout their stay and their needs are addressed so as to ensure a safe and appropriate discharge, tailored to meet their needs.The accommodation is on three floors, with a passenger lift between each floor. The access throughout the home is level, and the home has a good level of equipment to assist mobility including handrails, grab rails, and assisted bathrooms. There is a lounge and dining room on each floor. Outside there are lawns and flowerbeds and a pleasant courtyard with plenty of seating. Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and arranged with the manager as part of the normal programme of inspection. It took place over five hours, between 0930 am and 2.30pm. The inspector met many of the residents and spoke with the home manager, and several other members of staff. She looked around the entire inside of the home and looked at paperwork in relation to care planning and other documentation relating to the home. The manager of the home had completed a pre-inspection questionnaire and four comment cards from residents and relatives were received by the CSCI prior to the inspection. What the service does well: What has improved since the last inspection? Improvements within the home have been undertaken. This includes the installation of a sluice on the top floor of the home, which has improved Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 6 infection control procedures, and funding has now been approved for the laundry to be refurbished. This work will begin within the next few weeks. Staffing levels have been improved as several new staff have been recruited. 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. Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 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 standard(s) 1,3,6 Service users benefit from good admission and assessment practice, which ensures that the home is able to meet their needs. EVIDENCE: Green Close has a very high rate of admissions and discharges. All service users admitted have a care plan generated from assessments. Those service users admitted for rehabilitation have care plans that are goal and problem solving oriented. Those admitted for respite or recuperative care have care plans, which are necessarily far less comprehensive. Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 9 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 standard(s) 7,8,9,10 Resident’s health care needs are met and promoted by good planning arrangements. Resident’s privacy and dignity are met and promoted by the staff and management team at Green Close. Residents are being properly protected by a comprehensive and robust medication procedure. EVIDENCE: Privacy and dignity are given a high priority and residents are treated with respect. Residents said that all their personal care needs are dealt with in private and that staff behave as (welcome) visitors in their home. Staff were observed knocking on bedroom doors and treating residents with discretion and respect. Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 10 The medicines for each person are stored in individual baskets in the medicine trolley. The supply of medicines to service users looked after is recorded and risk assessments have been carried for those people who self medicate. Medicines requiring refrigeration are stored in a dedicated medicines fridge. The inspector sampled three care plans. Each one contained information of how to meet resident’s needs. However not all set out details of the action which needs to be taken by care staff to ensure that all aspects of health care of the service users are met, (ie.diabetics blood sugar testing). As most of the service users are admitted for short periods their care plans are reviewed on a daily and weekly basis. Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 11 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 standard(s) 12,13,15 Residents receive a wholesome and varied diet. Residents are encouraged to maintain contact with their families or friends as they wish. Residents are free to follow their religious beliefs. EVIDENCE: A variable, nutritious diet is provided at the home. This was confirmed by residents and from the meal on the day of the visit. The residents are asked individually on a daily basis what they would like for their lunch and supper that day. Choices are available and special diets catered for. Some comments made by the residents on the day included “ the food is very good”, “lovely food” and “the food is very tasty”. Residents confirmed that they were able to have visitors at any time and that they were always made welcome. Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 12 A limited choice of activities is provided at Green Close. There are books, knitting, some board games and daily exercise sessions provided by the staff. The Pets as Therapy dogs visit on a weekly basis Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 13 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 standard(s) 16,18 Residents are confidant that they are listened to and their requests actioned. Arrangements for protecting service from abuse users are inadequate. EVIDENCE: Residents confirmed that their views are taken seriously, that their concerns are fully taken on board and that action is taken where needed. Not all staff has had up to date training in the protection of vulnerable adults. Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 14 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 standard(s) 19,20,24,25,26 Residents live in a safe, comfortable and clean environment that is well maintained. EVIDENCE: Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 15 The home is well maintained and decorated. The home is well located in a residential area, close to shops and bus services. There is limited car parking on site, and also car parking on the road outside. There is a large courtyard entrance ideal for sitting outside in warmer weather, also flower beds and lawned areas. There is level access into and around the home. The home is arranged over three floors, with a passenger lift between each floor. On each floor there is a lounge and dining room, toilets and bathrooms. Bedrooms have been enlarged in recent years by knocking two rooms into one to create bed sitting rooms. The home has been well maintained and decorated throughout and appeared bright, airy and comfortable. There are no CCTV cameras in the home. Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The numbers and skill mix of competent staff are sufficient to meet residents’ needs. EVIDENCE: On the day of the inspection the manager, assistant manager, six care staff, the cook, kitchen assistant, laundry assistant and two domestic staff were on duty. Residents spoken to said that the staff were kind and caring and were always there to help. During the visit staff were observed spending time with residents and responding to their needs promptly. Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The inspector found that in general the health, safety and welfare of service users and staff are well provided for. EVIDENCE: This standard was not fully inspected. All the radiators are guarded to prevent harm from burns. Water temperatures are regulated to prevent harm from scalding. Mandatory checks and tests are carried out with regard to fire safety and all were satisfactory. The staff undertake regular training in fire safety. However, it was identified during the inspection that some members of staff had not attended this training for some time. Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 x x x 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x x x x x 2 Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 19 no Are there any outstanding requirements from the last inspection? 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 38 Regulation 23(4)(d) Timescale for action The registered person shall make 09/11/05 arrangements for persons working at the care home to receive suitable training in fire prevention. The Registered person shall 09/11/05 make arrangements by training staff to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. Requirement 2. 18 13(6) 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 7 Good Practice Recommendations Care plans should be expanded to to include detail as to how specific medical conditions should be mananged (ie. diabetes, epilepsy). Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Exeter Office, Suites 1 & 7 Renslade House Bonhay Road EXETER, EX4 3AY 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 Green Close D54-D06 39212 Green Close 235719 090805 Stage 4.doc Version 1.30 Page 21 - 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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