Inspection on 03/05/07 for Greenacre

This inspection was carried out on 3rd May 2007.

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

Greenacre 02/08/06

Greenacre 13/12/05

Greenacre 20/01/05

Greenacre 20/05/04

Greenacre 14/07/03

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOMES FOR OLDER PEOPLE Greenacre Brewers Hill Road Dunstable Bedfordshire LU6 1UU Lead Inspector Leonorah Milton Unannounced Inspection 3rd May 2007 11:00 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 Greenacre DS0000014904.V334821.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. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenacre Address Brewers Hill Road Dunstable Bedfordshire LU6 1UU 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) 01582 603029 BUPA Care Homes (Bedfordshire) Ltd Mrs Nicola Jane Berry Care Home 42 Category(ies) of Dementia - over 65 years of age (33), Learning registration, with number disability (2), Learning disability over 65 years of places of age (7), Old age, not falling within any other category (33), Physical disability over 65 years of age (40) Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may provide care for 2 service users less than 65 years and have a learning disability. This condition applies only to the 2 service users who have been identified to the Commission for Social Care Inspection. The home may not admit any other person under this category. The Commission must be informed when either service user ceases to live in the home. Date of last inspection Brief Description of the Service: Greenacre is a large purpose-built home for older people, situated in a residential area on the outskirts of Dunstable. It is close to local amenities such as schools local shops and places of worship, but too far from the town centre for service users to be able to walk there. The home is on a bus route. The registered provider is BUPA Care Homes (Bedfordshire) Ltd. The post of registered manager was vacant. The home is organised around a central quadrangle that has an enclosed garden area that is well maintained and contains a bird aviary and a fishpond. The building is laid out to provide into five separate living units. The home is registered to provide services to forty-one service users over the age of sixty-five who may have dementia and/or physical disabilities or learning difficulties and one temporary arrangement for a service user with learning difficulties under this age range. The fee for accommodation at this inspection for those of private means was a standard £561 per week. The fee for those funded by the local authority was £417-41. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report sets out the significant evidence that has been collated by the Commission for Social Care (CSCI) since the last visit to and public report on, the home’s service provision in August 2006. Reports from the home, other statutory agencies, and information gathered at the site visit to the home, which was carried out on 3rd May 2007 between 11.00 and 17.55, were taken into account. The visit to the home included a review of the case files for three people living in the home, conversations with seven people, two visitors, and six members of staff. Much of the time was spent with people in communal areas of the home, where the daily lifestyle was observed. A partial tour of the building was carried out and other records were reviewed. The Commission had received thirteen responses from people living in the home to a questionnaire circulated prior to this inspection. These have been taken into account and reflected in this report. The manager was absent on the day of the inspection visit but the deputy and members of the senior team were on site to assist with the inspection process. The last inspection of the home identified significant shortfalls to the service that may have been in part due to a period without a manger in post. This inspection showed that action had been taken to restore the standard of the operation to its previous good standard. What the service does well: Despite the size of the home, the arrangement of small living areas had enabled the service to create a homely environment and atmosphere. The building was well decorated and comfortably furnished. Arrangements to maintain a safe place to live and work in were good. People living in the home who contributed to the inspection were mostly positive about their experiences in the home. “Its nice here, I have no complaints”. “The home is wonderful, the staff are lovely, really kind.” “ I am happy with the care and support.” It was evident that visitors had welcomed into the home. A person living in the home stated how important it was to them to be able to see their visitors without any restrictions. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 6 People living in the home had been able to voice their opinions about the standard of care through formal individual review and an annual quality audit. Meetings were also held for those living in each “unit” of the home so that they could influence the day-to-day activities of the service. What has improved since the last inspection? What they could do better: Two written references must be obtained for new members of staff before they commence duties in the home. The home must obtain sufficient information about people’s needs before they move into the home to ensure that the home has the capability to care for them properly. The home should consult with people who having increasing frailties to ensure the level of support they receive is sufficient for their changing needs. This should include emotional care for those who need support to accept the changes in their life that have resulted from admission to the home. People living in the home must be served with beverages when they want them. Assessments of need and resulting plans of care should record specific detail about food preferences to ensure that people are served food to their liking. Clothing mislaid during laundering must be found and returned to its owner. Where there has been a repeated loss of items and the resident is dissatisfied, the home must record and investigate their concerns using the home’s complaints procedures. People living in the home must be able to move around the home and go out without restriction. This means they must be given the numbers of the key pads for the doors to enter the building and on the staircases, unless a risk assessment has established this would not be in their best interests. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 8 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 Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3, 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home had not obtained sufficient information about people’s needs before they moved into the home. This had resulted in the failure to properly meet at least one person’s needs. EVIDENCE: At this inspection the case file seen for the most recent admission to the home showed that an assessment of need had been obtained from the placing authority before the person was admitted to the home. The home had also carried out an assessment using a format that included the details outlined in the National Minimum Standard. Entries on this assessment were rather brief. The sections for sight, skin integrity, medication usage, mental state and cognition were blank. The section for diet and weight recorded “no allergies”. There were no references to any other dietary needs or the person’s Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 10 preferences. The assessment obtained from the placing authority indicated that this person had neglected themselves. The Commission had received a copy of a complaint made to the home in January 2006. The home’s response dated February 2006, which was also forwarded to the Commission by the complainant, showed that the home acknowledged a failure to obtain any pre-admission documentation from the placing authority prior to admission. The home also acknowledged that it had only carried out an assessment by telephone, having assumed that it knew enough about the person’s needs because they attended the home’s day centre. This was not the case, as subsequent problems identified the home was not aware of this person’s needs over the 24 hour period. The home did not provide an intermediate care service. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning arrangements had improved significantly and in most instances provided staff with sufficient guidance to individual need. However there were some instances when people felt that the level of support had not kept up with their diminishing abilities. EVIDENCE: Three case files were assessed. Two contained care plans that were based on thorough assessments of need. The other was in relation to a recent admission and was a work in progress. Plans covered people’s personal, physical, health, recreational, social and emotional needs. A document listing the peoples’ preferences for their daily lifestyle had been completed. This listed preferred times for getting up and going to bed, preferred beverages, frequency for bathing, hairdressing and similar. It was disappointing that preferences for food were not recorded. This included those for the most recent admission to the home, whose care plan detailed the person had been taking a poor diet and that monitoring of food intake and weekly weighing was to take place. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 12 Case files indicated that risks incurred during daily living for each individual had been taken into account. Records indicated that care plans had been reviewed on a monthly basis and updated when needs had changed. The inspector was unsure whether these reviews had involved the person living in the home. One person who spoke to the inspector was dissatisfied with the level of support they received from staff. They explained that they found it difficult nowadays to wash and dress them selves and felt they required more assistance. On enquiry they said they had not asked for further assistance. Consultation at monthly reviews would provide opportunities for this person to explain their increasing difficulties. Other people living in the home were satisfied about the level and standard of care they received, “ I am very happy to live here. I was quite ill when I first came to Greenacres but got better soon, mainly due to the care I received here”. “The care here is excellent”. Records on case files indicated that people living in the home had been supported to access healthcare specialists for routine treatment such as chiropody and optical check ups. Referrals had been made to doctors, district nurses, for continence services, physiotherapy and in relation to mental health needs. Conversations with people living in the home and the responses to the questionnaires showed that they were mostly satisfied with the arrangements for their health care needs. “I am happy with the medical support”. “I always receive the best medical support”. One person said, “Feels like I don’t get my cream enough. If I could buy it myself, I would”. Another said that they needed to have ointment applied 3 times daily but mostly did this their self because members of staff were too busy. Another wrote, “My doctor is no good. He talks down to me and his attitude to my health is rubbish”. It was unclear whether the home had any way of checking that people living in the home were satisfied with their general practitioner. Arrangements seen in relation to the storage, administration and recording of medicines followed safe guidelines. Medicines were stored securely in locked cupboards and a lockable mobile trolley. Records were maintained of individual prescriptions of medicines for reference purposes. Records for the administration of medicines had been properly kept and tallied with stocks of medicines held in the monthly monitored dosage systems. It was explained that only trained senior members of staff were authorised to administer medicines. A senior was observed to administer medicines. They demonstrated knowledge of the responsibility of their role and followed safe practice when administering medicines. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 13 People confirmed they had been treated with respect, “They are very kind to me”. “ I get on well with the staff. They are nice and kind”. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The majority of people living in the home had been supported to achieve a lifestyle that met their expectations. There were however instances when staff needed to be more aware of people’s emotional well being in order to support them properly. Peoples’ choices had been compromised by restrictions to enter and move around the building. EVIDENCE: There was evidence to show that activities for recreation and stimulation were available. A large notice was posted to advertise forthcoming events. The responses to the survey circulated on behalf of the Commission showed that the majority were satisfied with the arrangements for their daily lifestyle. Of the 13 responses, 7 said there were “always “activities they could take part in, 4 people responded “usually” to this question and 1 responded “sometimes”. One person commented that they “would like to go out more”, another that they “would like more carers to sit with us when we smoke but they have other Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 15 jobs to do”, and another, “I would like to go out more if there were enough staff to take me”. Other comments were, “I like all the activities” and another commented on the flower arranging activity. People living in the home who spoke to the inspector confirmed that they were able, within the constraints of risks to their safety, to do what they pleased, “Its easy to live here, staff are friendly, I can do what I like but not make a cup of tea because its dangerous”. “I can go to bed and get up when I like”. One person who had lived in the home for sometime and, whose spirits were evidently low, said they had not wanted to live in the home but had accepted they had been struggling to care for themselves in their own home. They said they didn’t wish to join in activities and said that some staff would sit and talk to them but others were too busy. When asked if they would like to talk to staff more often they responded, “ not really, I don’t know the staff, I am waiting to die”. Access to the home and to the upper floor was restricted by keypad entry systems. Minutes of a recent meeting indicated relatives visiting the home were to be given the access codes for these keypads. It was also noted that few people living in the home had been given these access codes. The manager subsequently explained people could leave the upper floor via the lift, there being no restriction on its use. It was also explained that a few people who were able to leave the building without escort had been given the access code to the main entry door. It was concerning that there were no assessments of risk in place to qualify the withholding of these access codes from people living in the home were in their best interests. There was no evidence to show that people who had the capacity to make a decision in this matter, had been consulted about their wishes. Two visitors to the home confirmed that they had been welcomed into the home. One stated that they visited every week and that they felt their friend “was very well cared for”. Service users had been enabled to bring private possessions into the home. Many of the bedrooms contained a plethora of personal items and memorabilia. Menus seen showed a nutritious and varied choice. Case files seen contained nutritional needs assessments and a strategy in one to monitor food intake. While preferences for beverages were recorded there was insufficient evidence to show that people or where appropriate their representatives had been consulted about their likes and dislikes for meals. The results of the survey showed that 3 people “always” liked the meals in the home, 7 “usually” liked the meals and 3 “sometimes. Comments included, “a great improvement in meals” and “I like all meals”. Comments during the inspection included, “Plenty to eat and drink”, “ I would like a cup of tea early in the morning. I get up at 07.00 but don’t get tea until 08.00…it depends who’s on (staff)” This Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 16 person also said that they didn’t always get a mid-morning drink, it depends who is on but we get a drink at night”. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had implemented its procedures to investigate concerns and to protect people living in the home from abuse. There had been however some delay to complete the investigation of a recent complaint within the home’s guidelines. This may have delayed required action to prevent a re-occurrence. EVIDENCE: Previous inspections had identified the home had robust complaints and protection procedures. Since the last inspection the Commission had been notified by a relative about concerns about admission procedures and the personal care of a person living in the home on a temporary basis. Records indicated this complaint had been investigated and responded to in part. As noted previously in this report, the home had acknowledged a failure to carry out thorough admission procedures. More senior managers from the organisation were investigating other aspects of the complaint. There was no record in the central complaints log to show this part of the investigation had been concluded. The inspector was informed that this part of the investigation was still unresolved. Given that the date of the complaint was 22nd January 2007, this delay to complete the investigation was concerning. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 18 A person living in the home said several items of their clothing had been lost in the laundry. They stated they had informed laundry personnel but no explanation had been given for the failure to locate their property. This person also indicated that although they were dissatisfied with the response they had not made a formal complaint about this issue. Responses to the questionnaire showed that 9 people knew how to make a complaint, 1 usually and 1 sometimes. Records and conversations with members of staff showed they had been briefed and were aware of procedures to protect people living in the home from abuse. Training for personnel in protection procedures was taking place. Records indicated that recruitment procedures had been sufficient to ensure the background of candidates for employment had been checked to ensure that staff working in the home were of the right calibre to work with vulnerable people. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People had been provided with a clean and comfortable environment that was suitably adapted to meet their needs. EVIDENCE: A tour of the building showed it had been designed to promote the ethos of small group living. The home therefore had been able to accommodate people with diverse needs. The building had been purpose built to meet safety requirements for the provision of a residential care service to frail people. Suitable equipment and aids were in place to assist those with physical disabilities. The home provided an attractive and homely environment. The standard of décor and furnishings was predominantly good throughout. Information Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 20 supplied by the provider prior to this inspection showed equipment had been regularly services and maintained by qualified contractors. Visual checks on equipment during the inspection showed that regular checks/maintenance had been carried out. Infection control issues had been well managed there being procedures and staff training in place about these matters. Protective clothing and disposable gloves had been provided for staff. The systems for the separation of linen for laundering to prevent cross infection were good. It was noted that carpeting in some lounges and dining areas was stained and in need of a thorough clean. People living in the home were positive about cleanliness of the building. All 13 of the responses to the survey commented “always” to the question, “ Is the home fresh and clean?” Comments made by people living in the home during the inspection included, “Its homelike, lovely and clean”, “I find the accommodation impressive”, “Its comfortable to live here, my bed is comfy”. Two comments received commented that the call system did not always work. This had been resolved at the visit to the home. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home had been supported with their needs by a competent and knowledgeable team. EVIDENCE: People living in the home were predominantly satisfied with the service they had received from staff. One person described the staff as “Wonderful, really kind” and another remarked that, “ They are very attentive”. Written comments received included, “Staff do their best”, “Very satisfied with support”. Conversations with members of staff showed that they were aware of people’s care needs as detailed in their care plans and how these were to be met. Training records and conversations with staff showed that the home had provided sufficient basic training to enable staff to care for people. One recent employee described their induction process as helpful and stated they had received briefing in the routines of the home, peoples’ basic care needs, fire safety, infection control, an overview of health and safety, protection procedures and had undertaken training in safe moving and handling techniques. Information provided before this inspection showed that the home had planned future training to update previous training and to continue the Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 22 development of the team. Information provided indicated 48 of the care team had achieved a National Vocational Qualification in care. Other members of staff were working towards this qualification. Rotas seen showed that sufficient care and ancillary staff had been scheduled to meet peoples’ needs. The home had an established senior team to support and guide the staff. Members of this team who were spoken to were knowledgeable about the operation of the home and showed confidence in their roles and empathy for those in their care. Records seen showed that recruitment procedures had been mostly of a good standard. It was noted that one personnel file contained a telephone reference and another contained a “to whom it may concern” reference that predated the date of the application for employment. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35,37. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home had improved. Strategies were in place to consult with people living in the home and to provide guidance and support for staff. EVIDENCE: The manager had been appointed to her position shortly before the previous inspection. She had previously worked as member of the senior team, also operated by BUPA and had recently been registered by the Commission as the manager at Greenacres. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 24 Records and conversations with both the people loving in the home and members of staff showed that arrangements were in place to consult with those living and working in the home. It was reported that senior staff meetings were held monthly and there were frequent general staff meetings. Minutes of meetings confirmed these arrangements. Meetings were also held most months with people living in the home. These were organised into unit meetings so that people living in the various areas of the home could comment on the daily lifestyle in the vicinity where they lived. An annual review of the service had taken place. The report of this audit recorded an increase in the ratio of satisfied customers by 3 at an overall rating of 75 . The ratio of people who were satisfied with the staffing arrangements was shown at 100 . Monies held on behalf of people were in accordance with BUPA’s corporate systems. These system paid monies received on behalf of people living in the home into private savings accounts and billed people or their representatives for purchases not included in costs for the accommodation, such as hairdressing and chiropody treatment. Small amounts of cash were held on site for those who wished to pay for these items directly. Records seen showed that proper accounts had been maintained of purchases made on behalf of service users. Health and safety arrangements had been well managed. Information provided showed routine servicing and maintenance of equipment had been carried out by qualified contractors. Members of staff had received training in safe working practices and were seen to use safe practice when moving and handling people, administering medication and handling food. Access to areas of the building in which there were risks to the safety of those living in the home such as the main kitchen, laundry, lift room and storage areas were restricted. Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 25 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 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 26 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 OP3 Regulation 14 Requirement The registered person must arrange for the home to obtain sufficient information about people’s needs before they move into the home to ensure that the home has the capability to care for them properly. The registered person must ensure that people are consulted regularly about their care needs so that the level of support is increased as individual’s ability to care for themselves decreases. The registered person must ensure that two written references are obtained for candidates for employment before the work in the home to ensure people living in the home are cared for by members of staff of the right calibre. Timescale for action 31/05/07 2. OP7 12(2)(3) 31/05/07 3. OP29 19(1)(c) 31/05/07 Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations The home should consult with people who having increasing frailties to ensure that the level of support they receive is sufficient for their changing needs. This should emotional care for those who need support to accept the changes in their life that have resulted from admission to the home. Care plans should record more detail about people’s likes and dislikes for food. The home should ensure that people living in the home are satisfied with the service they receive from their doctor and support people who are not, to transfer to another doctor. People living in the home must be able to move around the home and go out without restriction. This means they must be given the numbers of the key pads for the doors to enter the building and on the staircases, unless a risk assessment has established this would not be in their best interests. Investigations of complaints should be carried out within the home’s procedural timescales. 2. 3. OP7 OP8 4. OP14 5. OP16 Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Greenacre DS0000014904.V334821.R01.S.doc Version 5.2 Page 29 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!