Inspection on 18/08/06 for Green View House

This inspection was carried out on 18th August 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Green View House 13/08/07

Green View House 24/11/05

Green View House 09/08/05

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

CARE HOMES FOR OLDER PEOPLE Green View House 34 Greenhead Road Huddersfield West Yorkshire HD1 4EZ Lead Inspector Tracey South Unannounced Inspection 18th August 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 Green View House DS0000064138.V295022.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 View House DS0000064138.V295022.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Green View House Address 34 Greenhead Road Huddersfield West Yorkshire HD1 4EZ 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) 01484 306633 01484 300066 Green View House Limited Care Home 33 Category(ies) of Dementia - over 65 years of age (33), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (33) Green View House DS0000064138.V295022.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Can accommodate one service user under 65 years of age - category DE 24th November 2005 Date of last inspection Brief Description of the Service: Green View House is a care home with nursing. The home has the provision to accommodate 33 older people with mental health care needs. It is a large Victorian building, which stands within its own grounds, with a driveway and car park to the front. There is a frequent bus route to Huddersfield town centre. There are two lounges and a very spacious dining room on the ground floor. The home has 6 bedrooms on the ground floor all of which have ensuite facilities. There are 10 bedrooms on the first floor, three of which are double rooms all have ensuite facilities. Twelve bedrooms are located on the second floor, 4 of which have ensuite facilities. There is a passenger lift, which serves the ground, first and second floor. The current charges at the home range from £337.28 to £493.84 per week. Additional charges are made for hairdressing and chiropody. Green View House DS0000064138.V295022.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of this key inspection the Commission for Social Care Inspection undertook a site visit to the home. Alongside this, the staff at the home also completed a pre-inspection questionnaire, which was returned to the Commission before the inspection as requested. Information from this questionnaire was also used for this report. One inspector carried out this inspection over 1½ days and spent approximately 10 hours in the home. Surveys were sent to service users, their relatives, visiting professionals and GPs. Nine surveys were sent out to residents, none were returned. However the residents at Green View House are unable to comment directly about their care and support because of their level of dementia. Nine surveys were sent out to relatives, five responses were received. Four surveys were sent to GP’s two responses were received. This inspection was carried out to assess the home against a pre-determined selection of the National Minimum Standards for Older People and to check was progress had been made on meeting the requirements from previous inspection visits. In writing this report, information and evidence was not only obtained by way of visiting the home, but information and evidence was obtained from notifications sent to and information obtained by Commission for Social Care Inspection. The last inspection report was also consulted. Care practice was observed throughout the day. Inspectors spoke to one relative as well as the management, care staff and ancillary staff. Records were examined and a tour of the home was also undertaken. What the service does well: Prospective residents are thoroughly assessed prior to them moving into the home. The care plans in place are good and clearly state the needs of the resident as well as the level of support they require. Relatives are welcome to visit the home at any reasonable time. One relative spoken to on the day of the inspection confirmed this. She explained she is always offered a drink and she is able to stay for a meal with her husband when she wishes. Green View House DS0000064138.V295022.R01.S.doc Version 5.2 Page 6 Staff spoke positively about the home. They said the manager is an approachable and supportive person who has the resident’s best interest at heart. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Green View House DS0000064138.V295022.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 View House DS0000064138.V295022.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): 2 & 3. 6 does not apply. Residents only move into the home once assurances have been given that their assessed needs can be appropriately met. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Three resident’s case files were examined during this inspection. Each file contained a contract of residence supplied by the funding authority. The acting manager explained that privately funded residents receive a contract on behalf of Green View House Ltd. Prospective residents are thoroughly assessed by the funding authority and/or by the staff at the home. The manager explained how she is usually the person to carry out the pre-admission assessment although some of the nursing staff have expressed an interest in becoming involved in this process. It was clear from reading the information in the pre-admission assessments that this is then used to form the basis of the initial care plan. Green View House DS0000064138.V295022.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 Each resident has a care plan in place which sets out their health, personal and social care needs. Resident’s health care needs are fully met. Medication systems are good but mistakes are being made. Residents are treated with respect. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Information gained as part of the pre-admission assessment is used to form the basis of the initial care plan. Each of the three care plans examined gave a good account of the residents’ needs including the level of support they required. All three care plans had been reviewed monthly although one review was not as thorough as it could have been. The staff must ensure that completed assessments such as Waterlow assessments (used to identify those people who are prone to developing pressure sores) nutritional assessments and risk assessments link in with the care plan. For example, one resident had been identified as being at risk of malnutrition. The resident had been weighed Green View House DS0000064138.V295022.R01.S.doc Version 5.2 Page 10 regularly and a weight loss had been recorded although there was nothing within the care plan evaluation to suggest any action had been taken. Manual handling assessments were seen in place but the information contained is very brief. These assessments must include more specific details such as the level of support required and any specialist equipment that may be needed. There was good evidence that residents have access to health care services. Visits by health care professionals are recorded in each resident’s case file. Two GP surveys were returned to the Commission, both of which indicated that staff demonstrate a clear understanding of the care needs of residents. And that when they visit patients at the home they are able to see them in private. The nursing staff are responsible for administering medication. Three discrepancies were noted in the medication records and supplies of medication did not tally. These were discussed with the acting manager on the day of the inspection. Green View House DS0000064138.V295022.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 & 15 There is no structured programme of activities taking place. Relatives and friends are able to visit the home at any time. Mealtimes are poorly organised. Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: There is no structured programme of activities taking place. This is an area of development for the home. The acting manager explained that a member of the care staff has expressed an interest in becoming the activities co-ordinator for the home. Research is underway as to suitable activities for people with dementia. Outside entertainers occasionally visit the home; this is usually at Christmas time. A Harvest festival is planned for September. There are no arrangements in place in order for residents to satisfy their religious needs. Relatives are welcome to visit the home at any reasonable time. One relative spoken with on the day of the inspection said she is made to feel welcome at the home and is always offered refreshments. Relatives/visitors surveys indicated that staff welcome them into the home and that they are allowed to visit they relative/friend in private. Returned surveys Green View House DS0000064138.V295022.R01.S.doc Version 5.2 Page 12 also indicated that relatives/friends are kept up to date with important matters affecting their relative/friend. Residents are able to bring their personal belongings with them when they move into the home. Evidence of this was seen whilst carrying out a tour of the home. A mealtime was observed and the quality of food on offer was poor. The mealtime was generally badly organised. There are a number of residents who require a soft diet and the cook had liquidised the meal, which was fish steak, potatoes and mushy peas. The presentation of the liquidised meal was unappealing. The items of food had not been liquidised separately which resulted in a green coloured substance. One resident was observed moving the contents of her plate onto a fellow resident’s plate without any intervention from staff. The acting manager should re-think the dining arrangements to ensure that all residents receive a wholesome appealing balanced diet in pleasant surroundings. During the second day of the inspection the meal on offer was of a much better standard. Green View House DS0000064138.V295022.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 & 18 The home has an appropriate complaints procedure in place. Residents are protected from abuse. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The home has not received any complaints in the last 12 months. Relative’s surveys indicated that some people were not aware of the home’s complaints procedure. However, the complaints procedure is displayed in the home, a copy of which is contained within the statement of purpose for the home. The acting manager was advised to make a record of any informal complaints or concerns received. The information recorded should also include any action taken to resolve the matter. The majority of staff have received adult protection training. Adult protection policies are in place. Green View House DS0000064138.V295022.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 Improvements to the décor of the home needs to take place. Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: A number of the fixtures and fittings need replacing and the décor requires upgrading. The damaged area on the dining room ceiling needs redecorating. The carpet in the dining room is uneven and is a potential tripping hazard. This needs to be addressed. Curtains pulled down by residents need rehanging. Radiator covers are dirty and need redecorating or replacing. Bedroom furniture in a number of bedrooms needs replacing, as drawer fronts and handles were missing or broken off. The extractor fan in bedroom 3 needs servicing, as it was noisy when in use. The acting manager explained that she undertake a full audit in respect of the redecoration and replacement of furniture required in the home. Priority is being given to the top floor accommodation, as it is very “shabby”. Green View House DS0000064138.V295022.R01.S.doc Version 5.2 Page 15 A requirement was made in the last inspection report to ensure that any outstanding fire safety work in accordance with the fire safety officer’s report was completed. Not all work has been completed and therefore the requirement has been repeated. The home is generally clean and tidy. The laundry facilities are sited outside the main building. Designated laundry staff are employed at the home. The laundry area was found to be well organised and the staff spoken with said they enjoyed their job. Green View House DS0000064138.V295022.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 & 30 There are sufficient numbers of staff to meet the resident’s needs. Residents are potentially at risk as the home’s recruitment procedure is not always thorough as it should be. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: There are currently 33 residents living at the home. The staffing levels are 1 trained nurse and 4 care staff on the morning shift. The afternoon shift consists of 1 trained nurse and 3 care staff. Nights are staffed by 1 trained nurse and 2 care staff. The acting manager works normal office hours and is supernumerary. Care staff are supported by domestic, kitchen and laundry staff. Five relative’s surveys were returned to the Commission, 3 of which felt there were enough staff on duty. One relative said they didn’t feel there were enough staff. One relative did not respond to the question. There are 18 care staff employed at the home, 5 of which have a NVQ qualification in care. Five staff are currently working towards their NVQ level 2 award. The personnel records of two newly recruited staff were examined. Employment checks had been carried out in respect of both. The acting Green View House DS0000064138.V295022.R01.S.doc Version 5.2 Page 17 manager needs to ensure any gaps in employment are thoroughly explored as part of the recruitment process. When references are provided by people, different to that on the application form, this should also be explored with the prospective employee. Training records were not available on the day of the inspection and it was therefore difficult to establish the level of training the staff have received. The acting manager did confirm that 26 staff have received moving and handling training, 28 staff have received dementia training and 11 staff have received fire training. The acting manager must ensure that training records are available for the purpose of inspection. There was no evidence in the files examined of any induction training taking place. This needs to be addressed. Green View House DS0000064138.V295022.R01.S.doc Version 5.2 Page 18 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 Improvements have been made with the health and safety systems in the home. Quality assurance systems are being introduced. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The acting manager is also the owner of Green View House Ltd. She has over 20 years experience of working in a care setting and has a qualification in management. The acting manager is an NVQ assessor and is due to register on the Registered Manager’s Award in the very near future. The acting manager has made a start in implementing quality assurance systems. Questionnaires were sent out to relatives on 21.8.06 asking for comments about the service and facilities provided at the home. The acting manager explained that she plans to evaluate the findings of any returned Green View House DS0000064138.V295022.R01.S.doc Version 5.2 Page 19 questionnaires and will produce a report, which she will make available to all interest parties. Further work in this area needs to continue. Relative surveys returned to the Commission for Social Care Inspection indicates that relatives are happy with the overall care provided by the home. The acting manager must make arrangements for management visits to take place by an independent person who is not directly concerned with the conduct of the home. The purpose of the visit is to seek the views of the people living there as well as inspecting the home’s records of events and complaints. A written report must be prepared on the conduct of the home, a copy of which must be sent to the Commission for Social Care Inspection local office. Monies are held on behalf of residents. Records are maintained in respect of each resident, which detail any transactions made. The personal monies of 3 residents were examined, all of which were correct. There is no lockable storage space available in resident’s bedrooms. The acting manager has made good progress implementing health and safety systems in the home. One item that remains outstanding is the implementation of risk assessments in respect of safe working practices. Green View House DS0000064138.V295022.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 X X 2 Green View House DS0000064138.V295022.R01.S.doc Version 5.2 Page 21 Yes Are there any outstanding requirements from the last inspection? Green View House DS0000064138.V295022.R01.S.doc Version 5.2 Page 22 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 OP12 Regulation 16 Requirement A programme of stimulating activities must be provided to residents within groups or on an individual basis. Residents must receive a wholesome appealing balanced diet in pleasant surroundings. Mealtimes must be organised to ensure individual residents’ needs are met. The outstanding work in accordance with the fire safety officer’s report must be completed. A redecoration programme needs to be implemented. An action plan must be submitted to the CSCI outlining the timescales for completion. All new staff must receive induction training within the 12 weeks of employment. A record of all training undertaken, including induction training must be kept in the home. Management visits must take place on a regular basis. A copy of the report must be sent to the CSCI local office. Risk assessments must be in place referring to safe working practices. Timescale for action 30/10/06 2. OP15 16 30/09/06 3 OP38 OP19 13 30/10/06 4. OP19 23 30/10/06 5 6 OP30 OP30 18 17 30/10/06 30/10/06 7 OP33 26 30/10/06 8 OP38 23 30/10/06 Green View House DS0000064138.V295022.R01.S.doc Version 5.2 Page 23 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. 2. Refer to Standard OP7 OP8 Good Practice Recommendations Thorough reviews of care plans need to take place. Moving and handling assessments need to include detailed information about the level of support required including any equipment, which is needed to assist with transfers. Any issues arising from the completion of health care assessments should be recorded in the care plan and monitored as part of the monthly review. Staff should take greater care when administering medication to avoid mistakes being made. All gaps in employment should be explored when recruiting new staff. An application to register the manager should be submitted to the CSCI local office. Work should continue in developing quality assurance systems. Lockable storage space should be made available to those residents who would benefit from its use. 3. 4 5 6 7 8 OP8 OP9 OP29 OP31 OP33 OP35 Green View House DS0000064138.V295022.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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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