Inspection on 04/10/06 for Green Lane House

This inspection was carried out on 4th October 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

Green Lane House 01/12/08

Green Lane House 27/11/07

Green Lane House 02/03/06

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 D Jinks Unannounced Inspection 10:00 4 October 2006 th 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.V306141.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. Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 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.V306141.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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. 2nd March 2006 2. 3. Date of last inspection Brief Description of the Service: Green Lane 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 bathrooms and four separate toilets. There are three communal lounge areas, which open onto patios, and an additional smaller room, which is designated as a smoking area. The home has a passenger lift, ramps, handrails and has suitable furniture and equipment to met the needs of older service-users. The home produces a guide to the services and facilities provided by the home and this is available on request from the manager. The scale of charges range from £363.00 - £422.00 per week (October 2006), subject to the assessment. There are extra charges for hairdressing, magazines, chiropodists and other personal items that service users may wish to have. Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The assessment of this service included an unannounced visit to the home, discussions with the manager and staff at the home as well as meeting and talking to some of the people living at the home. During this visit all the key standards of the National Minimum Standards were assessed. Questionnaires were sent out to people living at the home, their relatives or representatives and visiting health care professionals. These helped to obtain personal views of the services provided by the home from people with varied backgrounds and experiences. The registered manager had completed a pre-inspection questionnaire prior to this visit, which assisted in verifying information throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: People living at the home said that there are ‘sometimes’ activities available that they can join in if they wish. The activities programme at the home would benefit from a review, to include the views of people living at the home. This would help to ensure that leisure and social interests of everyone living at the home are considered and included in the activities programme. Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 Page 6 Service users should also be consulted about the meals and menus that are provided at the home. Menus should be available in suitable formats to enable residents to make choices regarding their meals. Risk assessments are undertaken but do not always contain sufficient detail and information. This matter was discussed with the manager during the visit, as it requires some attention. 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 Lane House DS0000043390.V306141.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 Green Lane House DS0000043390.V306141.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 does not apply). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments are obtained prior to service users moving into the home. This helps to ensure that the home is suitable and will be able to meet their needs appropriately. EVIDENCE: Samples of service user care files were looked at during this visit. The manager at the home carries out care needs assessments. Additional assessments are also obtained from social services or the hospital if this is appropriate. Service users spoken to during the visit indicated that they had been given sufficient information about the home prior to moving in. In many cases the resident’s family had been more involved with this and had acted on their behalf. People living at this home had been given contracts (terms and conditions of residence) and copies are kept on their personal files. Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 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): 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 health and personal care needs of residents are recorded in a plan of care, which is kept under regular review. This helps to ensure that residents receive appropriate support and assistance. EVIDENCE: Residents care plans are detailed and individualised. They include aims and goals to help maintain and promote the independence and dignity of people living at this home and the actions that staff need to follow in order to ensure that residents needs are met, are clearly recorded. The care plans are reviewed and updated every two months. This helps to identify any change in resident’s needs. Nutritional screening of residents is undertaken on admission and is monitored periodically, unless there are indications that more frequent monitoring or action is needed. People living at this home have access to health and social care professionals, for example chiropodists, opticians, district nurses, physiotherapists and hospital appointments. The home has designated staff who are responsible for the administration of medication and who have received training to help ensure that they carry out this duty competently and safely. Medication is securely stored at the home Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 Page 10 and accurate medication records are kept. The manager indicated that the home is able to consult their pharmacy for advice and information when needed. People living at the home were seen to be treated with respect and dignity. Staff knocked on doors prior to entering rooms, assisted service users with mobility problems in a dignified and sensitive manner and addressed them in a friendly but polite manner. Service users indicated that they could see their visitors in private if they wished and had access to a telephone (in a private room) or had their own telephones. Health care professionals indicated that they are able to see service users in private. Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 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): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides some social and leisure activities for people living at the home. EVIDENCE: Residents at the home say that there are sometimes social and leisure activities available. There is a minibus at the home and occasional trips out are organised for residents. Entertainers sometimes visit the home, for example musicians and singers. Games are also sometimes played residents mentioned bingo, dominoes and craft sessions. On the day of this visit there were no activities seen to be taking place. Some of the staff were spoken to during the visit. They said that usually in the afternoons there is time for individual sessions with the residents. Some of the ladies at the home had their nails manicured during these times, games were played or residents liked to chat. One resident was seen to go out for a short walk. This is usually a daily activity for this person. There are some residents who attend church each Sunday and a priest visits the home each month. Residents are able to choose whether they join in activities or not. Some residents prefer to stay in their own rooms for much of the time. They had their own TV and some had a newspaper delivered each day. The interests and hobbies of people living at the home had been recorded in their assessment. Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 Page 12 Residents are able to receive visitors either in their own rooms or in one of the communal areas as they wish. They are also able to go out with their families. Personal possessions have been brought into the home by residents in order to personalise their rooms and there are facilities available at the home for the safe keeping of valuables should service users wish to use these. The menus at the home gave brief details of the meals available and copies of the menus were available in the lounge areas. The residents knew that they were there. However, comments were received to indicate that not everyone could read them because of the small print. Comments were also received to indicate that residents did not really have a choice at mealtimes. Three residents said that they had a set meal but if they didn’t like something then an alternative would be provided. The serving of the lunchtime meal was observed during the visit. All the residents seen had the same meal. The cook is aware of people requiring special diets and indicated that advice from dieticians is sought and acted upon. Where possible, residents are encouraged by staff to be independent at the dinner table. Where a resident required some assistance from care staff, it was provided sensitively. Soft diets were not seen to be served but, the cook confirmed that pureed meals were served in an appealing manner and that each food item would be pureed separately and not all mixed together. Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident that their concerns would be listened to and acted upon. EVIDENCE: The home has policies and procedures in place to help them deal with complaints, comments and the protection of vulnerable adults. This includes the local authority’s multi-disciplinary procedures, staff training and ensuring that residents are aware of the complaints process. The complaint process is available in the home and people participating in this inspection indicated that they are aware of the process. Residents said that they would talk to the manager if they had any concerns ‘she is very approachable and would listen’. The residents spoken to during the visit had no complaints, they were very happy. The manager has undertaken training provided by Action for Elder Abuse. This training enables her to ensure that staff working at the home are aware of the protection of vulnerable adults, which helps to make the home a safe environment for residents. Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is maintained to a high standard. It is warm, clean, fresh and comfortable. EVIDENCE: There is a dedicated team of domestic assistants at the home. They ensure that the home is kept clean, fresh and tidy. The grounds of the home are well maintained and are accessible to residents. Several areas of the home have been redecorated and upgraded including lounge areas and some of the resident’s bedrooms. There is a programme of routine maintenance, which is currently under review, to help ensure that the home remains comfortable. There are several bedrooms with en-suite facilities. Additionally there are several communal bathrooms and toilets situated throughout the home. The communal bathrooms contained various toiletries. These items should not be in communal bathrooms, it either means that they are in communal use or are personal belongings, which should be held within the resident’s own room. This was discussed with the manager as requiring attention. Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 Page 15 The bathrooms and toilets are equipped with mobility aids and adaptations, which help residents to maintain their independence in a safe way. There is a passenger lift at the home and hand rails are in place on the stairways and the ramped areas, which also help to maintain the safety of people living at the home. Emergency call bells are carried by residents so that they can summon assistance from staff if they need to, in any area of the home. Cleaning fluids and materials were generally stored safely but on the day of the visit a bottle of disinfectant was left on one of the corridors – this was discussed with relevant staff and the manager. The laundry at the home is a rather compact area that would benefit from a general tidy up. Laundry is kept separately and special laundry bags are available to help prevent the spread of any infection. It was discussed with the manager that protective clothing should also be available in the laundry. This would provide staff with some protection and help to reduce any potential risk to the spread of infection. Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that staff are recruited and trained appropriately. This helps staff to understand and meet the needs of residents safely and adequately. EVIDENCE: Samples of staff files were looked at during this visit. The manager ensures that all the necessary checks and information is obtained prior to the employment of new staff. Staff training records show that staff receive appropriate training such as induction training, first aid, manual handling, medication and health and safety training. Other training is also provided to help staff understand any special needs or conditions of people living at the home. Most of the staff at the home have gained National Vocational Qualifications (NVQ) at levels 2 and 3. Some of the staff working at the home were spoken to during this visit. They confirmed that they are encouraged to participate in the training offered. Staff commented on the usefulness of their NVQ training. A number of staff are about to undertake training to help them when working with residents who may have dementia. Information received from both residents and staff, indicates that there are sufficient staff on duty at the home at all times. The home employs domestic assistants to help ensure that care staff are available to meet the needs of residents. Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 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 run in the best interests of the people living at the home. EVIDENCE: The manager is experienced, qualified and competent. The management of the home is open and positive. Staff and residents commented positively on the attitude and leadership of the manager, some had noticed improvements made to the home since she had taken over. One relative described an example of where the manager had helped his relative he commented that ‘the manager of this home is exceptional’. Other comments received clearly showed that people were very satisfied with the care provided at the home. The manager is not responsible for service user finances, although there are facilities available for the safekeeping of service users valuables if required. Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 Page 18 There are auditing systems in place to help ensure that the home is run safely. This includes, for example the monitoring of food temperatures, staff fire training, fire equipment checks and cleaning of the home. The kitchen area and food storage areas were kept in a clean and tidy condition. Food was stored appropriately, covered and labelled. The registered manager ensures that regular checks and maintenance of central heating systems, electrical systems, moving and handling equipment, appliances and water systems/temperatures are made. Risk assessments are carried out and are kept under regular review. Risk assessments would benefit from further review to ensure that full details of risks are recorded for example, the use of bed rails, falls and use of hoists. Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 Page 19 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 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 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 2 Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 Page 20 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. 1 Standard OP26 Regulation 13 Requirement The registered person must ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. Cleaning fluids must be stored securely and in line with the Control of Substances Hazardous to Health Regulations (COSHH) 1998. The registered person must ensure that risk assessments are carried out for all safe working practice topics and that significant findings of the risk assessment are recorded. This must include the use of equipment such as hoists and bed rails. Timescale for action 10/11/06 2 OP38 13 10/11/06 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 Good Practice Recommendations DS0000043390.V306141.R01.S.doc Version 5.2 Page 21 Green Lane House 1 Standard OP12 2 OP15 3 OP26 It is recommended that service users are consulted about the programme of activities arranged by the care home to help ensure that they are given sufficient opportunities for stimulation through leisure and recreational activities in and outside the home. It is recommended that the registered person ensure that there is a menu, offering a choice of meals in written or other suitable formats to suit the needs of all service users. It is recommended that the registered person ensure that the laundry area is given a general tidy up. Protective clothing should also be available to staff working in this area in order to reduce the risk of the spread of any infection. Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 Page 22 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. Extracts may not be used or reproduced without the express permission of CSCI Green Lane House DS0000043390.V306141.R01.S.doc Version 5.2 Page 23 - 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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