Inspection on 09/08/05 for Green View House

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 View House 13/08/07

Green View House 18/08/06

Green View House 24/11/05

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 9 August 2005 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 View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Green View House Address 34 Greenhead Road Huddersfield West Yorkshire HD1 4EZ 01484 306633 01484 300066 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) Green View House Limited Mr Matthew Scott Care home with nursing 33 Category(ies) of 33 x Dementia over 65 years, 33 x Mental registration, with number Disorder over 65 years of places Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Conditions of this registration are listed on the registration certificate displayed at the service. Date of last inspection 15 March 2005 Brief Description of the Service: Green View House is a care home with nursing. The home has the provision to accommdate 33 older people with mental health 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 longes and a very spacious dining room on the ground floor. The home has 6 bedrooms on the ground floor all of which have ensuite factilites. 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. Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report refers to an unannounced inspection carried out on 9th August 2005. The inspection took place over 5 hours. There were 31 residents living at the home on the day of the inspection. One new resident was due to be admitted the following week. A tour of the home was undertaken and a small number of bedrooms were seen. Care plans, case files, staff files were examined. One service user and four members of staff were spoken to. What the service does well: The home provides good information about the care and facilities prospective residents and their relatives can expect to receive. Each resident has a care plan in place that clearly states the needs of the resident and the support they require to ensure those needs will be met. Care plans are reviewed regularly and amended as the needs of the resident’s change. Staff are quick to involve other health care professionals for advice and support. The medication is well managed. Records are well maintained, neat, tidy and easy to follow. Residents look well cared for. The staff and residents appear to share good relationships with each other. The atmosphere at the home is relaxed and friendly. Visitors are made to feel welcome. Residents enjoy the freedom of being able to walk around the home. The home is spacious with a number of comfortable seating areas for residents to enjoy the company of others or to sit in private. Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 6 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 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 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 View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 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) 1,2,3,4,5 The home’s admission procedures are good. Prospective resident’s are fully assessed before they move into the home to make sure staff can give them the care and support they need. Relatives of prospective resident’s are able to visit the home to look at the facilities on offer and speak to the staff so they can make an informed decision about whether the home is suitable. EVIDENCE: The statement of purpose is a detailed document and is made available to all prospective residents and their relatives. The contract/statement of terms and conditions currently being used needs amending to include the name of the current manager. The manager carries out pre-admission assessments prior to new residents being admitted to the home. The manager is reminded to date and sign the assessment once completed. A community care assessment (CCA) completed by a social worker, is received prior to the new resident being admitted to the home. There was evidence that the information outlined in the CCA is used to form the basis of the initial care plan. Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 9 It was clear from reading care records and observing care practices that the needs of people living at the home are being met. The manager spoke of how they have received positive feedback from relatives, who are said to be more than happy with the care provided at Green View House. It is not always appropriate for residents to visit the home prior to their admission, as the majority would find the experience unsettling. However the manager explained that relatives are encouraged to visit the home. This gives them the opportunity to look at the facilities on offer as well as being able to speak with the staff on duty. Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 10 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) 7,8,9,10,11 Care plans are detailed and give staff the information they require to meet resident’s needs. Resident’s medication is well managed. EVIDENCE: Each resident has a care plan in place. Three care plans were examined. All three care plans contained detailed information about the health, welfare, personal and social care needs of each individual. Each care plan is written in a format that is easy to follow and staff are fully aware of what is expected of them when caring for each resident. Care plans are reviewed each month. There was no evidence in place to suggest that care plans have been signed by either the resident or their representative. At the point of admission a number of health assessments are completed. These are then kept under regular review. It was noted that one particular resident had lost a significant amount of weight from one month to the next. There was no evidence that this had been addressed. Staff must be vigilant when monitoring weight loss/gain and act accordingly. One resident had been referred to the tissue viability nurse after developing a pressure sore. The nurse had recommended that the wound be measured Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 11 weekly to monitor healing. There was no evidence of this taking place. Details of treatment provided to residents who are suffering from pressure sores are recorded. However, the records do not detail the condition of the pressure sore. It is recommended that a “wound chart” be implemented which includes any progress or deterioration relating to the pressure sore. Risk assessments are implemented as and when appropriate and evidence of this was noted in two of the three case files examined. It was noted that one resident, who was prone to falling out of bed, did not have an appropriate risk assessment in place. This needs to be addressed. Accident/incident reports are completed, however, staff should ensure that they complete the section about preventative measures. It is understood that not all accidents can be prevented however, the staff must be able to demonstrate that every effort is being made to at least minimise the chance of such accidents recurring. Medication records were examined. As required in the last inspection report PRN medication is now being checked regularly. A controlled drugs register is in place and this medication is stored and administered appropriately. The temperature of the medication fridge is checked regularly. Arrangements have not yet been made to dispose of surplus medication, as the health authority is no longer disposing of medication in nursing homes. The manager agreed to speak to the owners about this. Staff were observed spending time with residents. Treating people with respect and dignity is of high regard and this was demonstrated through documentation and the approach staff have towards residents. Residents looked well cared for. Although there is a section within the case file about arrangements following death, there was no evidence that this has been addressed. Whilst it is appreciated that this is a difficult subject to raise with some residents and their families, it is, nevertheless, important. The manager should ensure that this information is recorded and suggestions were given as to the best way to approach this sensitive subject. Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 12 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) 12,13,14,15 Relatives are welcome to visit at any reasonable time. The meals at the home are good, offering choice and variety. The rights of residents are respected. EVIDENCE: There is no planned programme of activities that take place. The home has not yet been successful in recruiting an activities co-ordinator. The manager explained that occasional outside entertainers do visit the home. More informal activities take place such as watching videos, listening to music, reading the local paper. Some residents enjoy a walk around the home, escorted by a member of staff. The hairdresser visits the home each week. Visitors are welcome at any reasonable time. The manager explained that good relationships have been formed with relatives and friends. Positive feedback, about the care provided, has been received since the new owners took over the home over ten months ago. The residents at Green View House suffer from some form of mental illness but this does not affect their rights. Residents are able to get up and go to bed as they choose. A number of residents were seen walking around the home freely and one resident was seen dancing along to the music playing on the CD. Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 13 Residents are able to bring their own possessions with them. The home now provides information about how advocacy services can be accessed. Kitchen staff explained how they have got to know the likes and dislikes of residents. This information is also recorded in the resident’s case file. The majority of residents eat their meals in the main dining room. Support is given to those people who have difficulty with feeding. The meal on offer was corned beef hash, with gooseberry crumble and custard for dessert. The teas on offer are usually a “lite bite”, which is served in the main lounges rather than the dining room. Supper is also available. The cook mentioned that the menus are to be changed to include a new two weekly menu. The kitchen staff are reminded to ensure that all food given to residents, is recorded in writing. Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 14 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) These standards were not assessed on this inspection. EVIDENCE: Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 15 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) 19,26 Major improvements to the fabric of the building have been made over the past ten months. Communal areas are tastefully decorated creating a comfortable and homely environment. EVIDENCE: The redecoration of a number of individual bedrooms and communal lounges has taken place over the last ten months. The communal lounges are now bright and airy offering a comfortable environment for residents. The dining area has been tastefully decorated and new furniture has been purchased. Individual bedrooms are being decorated as they become vacant. Carpets have been replaced in communal areas and part of the staircase. It was noted that on the top floor landing the carpet was frayed and is a potential tripping hazard. The manager was requested to ensure this was made safe on the day of inspection. Surplus items of furniture are being stored on the top floor, near to the lift. These items should be removed as a matter of urgency. The owner explained that the majority of the fire safety work has now been completed or is due to be completed. It is requested that an action plan, Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 16 detailing the work still outstanding, be forwarded to the CSCI office. The home has recently received a visit from the environmental health officer who made some minor recommendations. The CSCI should be notified when the recommendations have been addressed. The home was clean and there were no unpleasant odours. The laundry person has a good effective system in place. All items of laundry had been washed, dried, ironed and delivered back to residents by early afternoon. There were good stocks of linen and towels in place. Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 17 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) 27,28,29,30 There are enough staff on duty to meet the needs of the residents. Good progress is being made with NVQ qualifications. The procedures for recruiting staff are not thorough enough and do not provide the necessary protection to people living at the home. EVIDENCE: The current staffing levels are set at: AM – 1 trained nurse and 4 care staff PM – 1 trained nurse and 4 care staff NIGHTS – 1 trained nurse and 2 care staff The manager’s hours are supernumerary and the two owners are regularly in attendance at the home. The nursing and care staff are supported by kitchen staff, domestic and laundry staff. There are 58 of the staff in the home who have achieved NVQ level 2. Five staff are working towards NVQ level 3. Three staff files were examined. CRB checks had been requested and received in respect of two staff prior to them starting work. The third member of staff had a POVA first check in place but there was no evidence that the CRB had been received. The manager was confident that it had been received but could not locate it during the inspection. Only one staff file contained two written references. One file had no references in place and the second had only one. Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 18 By not carrying out thorough recruitment procedures the people at the home are potentially being put at risk. Two written references must be obtained prior to the person starting work, to ensure their suitability of working in such a setting. The staff at the home have undertaken a number of training courses within the last ten months. For example; manual handling, first aid, fire training, food hygiene, basic breakaway techniques, dementia training and health and safety. Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 19 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) 31,35 The home is well managed. EVIDENCE: The home is managed by Matthew Scott. He is a Registered Mental Nurse with over 25 years experience in the NHS and private sector. He has undertaken a number of training courses since working at the home and is to enrol for NVQ level 4 by the end of this year. Monies are held on behalf of some residents. Each resident has an individual account held at the home. All transactions are recorded and receipts are kept. The money is securely stored but there are concerns about the amount of money being held in respect of certain individuals. The manager was advised to seek other arrangements for this. Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 2 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 1 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 x x x 3 x x x Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 21 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 OP8 Regulation 12 Requirement Monitoring of residents health care needs must take place and include any action/support required. When risks to residents have been identified, a risk assessment must be completed. The risk assessment must clearly indicate any measures that have been put into place to minimise the risk. Accident/incident forms must be completed in full. A CRB including a POVA check and two written preferences must be received prior to new staff starting work. Timescale for action 9th August 2005 and thereafter. 9th August 2005 and thereafter. 2. OP8 13 3. 4. OP8 OP29 13 19 9th August 2005 and thereafter. 9th August 2005 and thereafter. 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 OP2 OP8 Good Practice Recommendations The contract should include the details of the current manager. Wound charts should be implemented to monitor progress 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 22 Green View House 3. 4. 5. 6. 7. 8. 9. OP11 OP12 OP15 OP19 OP19 OP19 OP19 when treating residents who are suffering from pressure sores. Every effort should be made to ensure that the arrangements following death section is completed within each residents case file. The home should seek to employ an activities co-ordinator. The kitchen staff are reminded to record all food provided to residents. Confirmation that the frayed carpet has been repaired should be sent to the CSCI. The surplus items of furniture should be removed from the top landing. An action plan should be sent to the CSCI outlining any outstanding fire safety work. The recommendations made by the environmental health officer should be addressed. Notification of this should be sent to the CSCI. Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 23 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Green View House 20050809 Green View Hs IR X00015 J51 v229059 s64138.doc Version 1.40 Page 24 - 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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