Inspection on 02/03/06 for Green Lane House

This inspection was carried out on 2nd March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Lane House 01/12/08

Green Lane House 27/11/07

Green Lane House 04/10/06

Green Lane House 04/10/05

Green Lane House 14/03/05

Green Lane House 08/09/04

Green Lane House 12/03/04

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

CARE HOMES FOR OLDER PEOPLE Green Lane House Green Hill Brampton Cumbria CA8 1SU Lead Inspector Liz Kelley Unannounced Inspection 2nd March 2006 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 Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 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. Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Green Lane House Address Green Hill Brampton Cumbria CA8 1SU 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) 01697 72345 claire@greenlanehouse.com Greenlane Care Homes Ltd Mrs Claire Pratt Care Home 28 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (28) of places Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two service users may share a bedroom of at least 16 sqm usable floor space only if they have made a positive choice to do so and when a shares space becomes vacant the remaining service user has the opportunity to choose not to share, by moving to a different room if necessary. When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. The home is registered for a maximum of 28 service users to include: up to 28 service users in the category of OP (old age not falling within any other category) up to 5 service users in the category DE(E) (Dementia over 65 years of age) The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered from time to time to admit persons between the ages of 60 and 65 years of age. 4th October 2005 2. 3. 4. 5. Date of last inspection Brief Description of the Service: Greenlane House is a period home, on the outskirts of Brampton, set in extensive well-maintained gardens with ample car parking. There are 25 bedrooms, 7 of which were en-suite, with an additional three assisted baths and four separate wcs. There are three communal lounge areas, which open onto patios, and an additional smaller room, which was designated as a smoking area. The Home has a passenger lift, ramps and rails and has suitable furniture and equipment to met the needs of older service-users. The services provided included meals, personal care, and administration of medications, personal laundry, organised activities and trips out. Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out over the late morning and afternoon period. Time was spent talking to service users. Documents examined included care plans, daily notes and safety and maintenance records. The manager, care staff and cook on duty were all interviewed. Two visiting relatives and a volunteer were asked about their experiences of care in the home. What the service does well: 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 Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 Page 6 contacting your local CSCI office. Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 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 Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 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): The key standards were assessed and met at the last inspection. EVIDENCE: Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 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 the following standard(s): 9 and 11 The medication at this home is well managed promoting good health. The care of terminally ill people is very well managed allowing people to remain within the home. EVIDENCE: Medications in the home were well managed, with an orderly medicine cabinet and very well ordered and accurate medication charts. Staff had received training in the care and dispensing of medications and this was an area well managed by the home. Health care plans were identified as an example of good practice in enabling the individual service user to be involved. Recording in these plans was in good detail making it easy to identify contacts and outcomes from health care professionals and to ensure that regular appointments and checks were carried out in all health areas, such as dentist appointments drugs reviews, chiropody. The home is good at identifying service users that maybe at risk and intervening. For example, by carefully monitoring weight loss and referring to dieticians for specialist advice. The home was recording calorific intake in a number of people susceptible to weight loss. When interviewed the cook was knowledgeably of the individual needs of service users and those requiring Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 Page 10 special diets. The home was using a recognised good practice tool for nutritional assessment. Other areas of healthcare being monitored were Waterlow scores and interventions to promote good skin care and prevent pressure sores. Service users were confident that their healthcare needs were being well met by the home and were pleased to be able to have regular contact with their own GP’s. Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 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 the following standard(s): 14 and 15 Dietary needs of service users are well catered for with a balanced and varied selection of good quality food available that meets service users tastes and choices. Service users choice and control over their lives has a high profile in the home and staff are skilled at enabling service users to make informed decisions. EVIDENCE: Discussion with the cook and examination of menus demonstrated that meals were of a good nutritional quality, varied and home cooked. Service users stated that the meals were very good and they had plenty of choice. A menu board is displayed in each of the three lounges with the weekly menu. A recent consultation on meals had highlighted that some people preferred gravy and sauces to be served separately and other would like more potatoes. These have all been put in place. The Home had a strong emphasis on respecting individual’s rights and this has been demonstrated in a recent consultations on not only meals but also activities. Service users are also to encouraged to manage their own financial affairs and to retain interests and contacts that they had prior to living at the home. Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 Page 12 Decision-making has a high profile in the home and staff have a good understanding of service users support needs. Risk assessments are in place to support decision-making and to assist in activities to take place rather than preventing them. Emphasis is on what service users can do rather than cannot. Service users are enabled to make informed choices through and many examples were found and identified as good practice in this field. For example supporting a service users with dementia to take regular walks alone by careful planning, regular review of risk assessment and by involving the family. Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 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 the following standard(s): 16 and 18 Staff have a good knowledge and understanding of Adult Protection issues which protects service users from abuse. The home has a satisfactory complaints system with evidence of service users able to express their views on the home, and these being acted upon. The home regularly reviews aspects of its performance through a good programme of self-review and consultations, and service users, and relatives are central to these processes. EVIDENCE: The home had the latest guidance on the local multi-disciplinary procedures for reporting abuse. Adult protection is an area covered in all staff induction programmes, and when spoken to staff had a good awareness in this area. Service users were observed freely expressing opinions to staff and other ways of expressing views more formally via the complainants procedure were seen. The open atmosphere created within the home ensures that service users feel free to express their opinions and are confident that they will be listened to and concerns acted upon. All service users spoken to felt that they could speak up if they had any concerns or worries. Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 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 the following standard(s): 19 A continuous programme of improvements and maintenance has ensured that the accommodation is of a high standard and is comfortable and homely. EVIDENCE: The Home is maintained to a high standard and service users benefits from an on-going programme of improvements and maintenance. Recent improvements have been the re-decoration of the lounges and individual bedrooms. Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 Page 15 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): 29 and 30 The recruitment practices of the home ensure that service users are safeguarded and that staff have the qualities and aptitudes to work in social care. EVIDENCE: The selection procedure includes obtaining two written references, a formal interview and an informal interview involving service users, wherever possible. All staff had enhanced CRB disclosure checks. Upon appointment staff are issued with a handbook, which includes job descriptions and terms and conditions. Appointments are subject to a six-month probationary period. Staff are also issued with the General Social Skills Council’s code of conduct handbook. These are all good practices and ensure that service users are supported by a carefully selected and vetted staff team. The home continues to demonstrate a commitment to providing staff with a thorough training programme. Since the last inspection staff have also had training in Dementia care, stoma care, and care of the terminally ill. Training is arranged in response to the changing needs of service users. The manager is good at seeking out the latest guidance and training, for example the home adopts a person centred approach to looking after people with dementia. The evidence examined demonstrated that this standard was exceeded. Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 Page 16 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): 33 and 35 The financial interests of service users living at the home are safeguarded by the systems in place. Effective quality monitoring systems are in place to ensure a high standard of service is delivered to service users. EVIDENCE: The manager ensures that service users control their own money wherever possible, and if not then relatives assist with these tasks. The home does not act as appointee for anyone living in the home. Secure facilities are provided for the safe-keeping of money and valuables both in service users own rooms and on behalf of service users. The manager has developed a Quality Assurance system that is effective in ensuring that the quality of the service is high across all areas. This includes seeking the views of service users and relatives there were a number of examples were these had been acted upon. A number of ways had been explored to seek these views and the most effective had been to sit down and spend individual time with each person. Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 Page 17 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 4 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 Page 18 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. Refer to Standard Good Practice Recommendations Green Lane House DS0000043390.V281350.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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. 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