Inspection on 01/03/07 for Greenacres

This inspection was carried out on 1st March 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

Greenacres 06/11/07

Greenacres 17/05/06

Greenacres 12/09/05

Greenacres 10/05/05

Greenacres 22/11/04

Greenacres 26/07/04

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

CARE HOMES FOR OLDER PEOPLE Greenacres Greenacres The Horseshoe Banstead Surrey SM7 2BQ Lead Inspector Mary Williamson Unannounced Inspection 1st March 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Greenacres DS0000059315.V330008.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. Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenacres Address Greenacres The Horseshoe Banstead Surrey SM7 2BQ 0207 759 9100 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) sharon.blackwell@anchor.org Anchor Trust Mrs Jean Louisa Williamson Care Home 60 Category(ies) of Dementia - over 65 years of age (20), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (5), Old age, not falling within any other category (60), Physical disability over 65 years of age (20) Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. From time to time the home may admit persons for respite care from 60 years of age. 17th May 2006 Date of last inspection Brief Description of the Service: Greenacres is an Anchor Trust care home for older people. The home is purpose built and offers well-equipped accommodation for sixty (60) service users. The accommodation is divided into five units and all service users have single rooms with en-suite facilities. Communal facilities are arranged on each floor, these include dining rooms, lounges and small-equipped kitchens. Each floor also has suitable toilets, assisted bathrooms and walk in shower rooms. The home is located in a residential area of Banstead, with easy access to community amenities. The home has a car park at the front of the building, and is surrounded by an enclosed garden. The fees charged at this service range from £480 to 690 per week. Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first site visit of a key inspection and was unannounced. The inspection took place over five hours. Mary Williamson, Regulation Inspector, carried out the inspection. The Registered Manager, Mrs Jean Williamson represented the establishment. A tour of the premises was undertaken and a number of records relating to the care of the service users and the management of the home were examined. Discussions were held with several of the service users both individually and in small groups. They were very complimentary about the home and the care provided, stating that the staff are “kind” and “caring” There were various activities taking place in the home. For example a group activity taking place in Bluebell Unit, and there was a volunteer playing classical music in the lounge on the ground floor. The kitchen was visited and the cook was spoken to. The catering arrangements are well organised and the food offered is fresh, varied and wholesome. Home scones were served with morning coffee and homemade cakes were served with afternoon tea. Several service users commented on the food, stating, “The food is very good”, and “we are very lucky to have such a good chef”. There was opportunity to talk with staff both individually and in groups. They were able to confirm some of the training they had undertaken, and were very aware of the safeguarding adult procedures. They were also aware of the assessed need of service users in their care. Recruitment procedures were sampled and three staff employment files were seen. These contained all the required documentation to comply with employment legislation. The CSCI would like to thank the service users, manager and the staff team for their help and hospitality during the inspection. What the service does well: The home offers a good standard of accommodation in single en-suite rooms. The communal areas of the home are spacious and well decorated, including fresh flowers on all the dining tables and in the reception area. The standard of care is good and all the service users looked well cared for. Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 6 The arrangements in place to meet the health care needs of the service users are good and reflect the individual needs assessments, and care plans in place. There is a wide and varied leisure activities programme in place to meet the individual and collective needs of the service users. This is planned over seven days to include evenings and weekends. The catering arrangements in the home are excellent and the food was observed to be wholesome, fresh, and varied. All dietary needs can be met. Several service users commented that the “food is good here”, and “the chef will cook me something different if I have lost my appetite”. The recruitment and training of staff is ongoing, and the staff employment files sampled appeared to be in order. The training files seen evidenced that all the appropriate induction and mandatory training was in place and personal development is ongoing. What has improved since the last inspection? What they could do better: There are no requirements as an outcome of this inspection. Greenacres DS0000059315.V330008.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. Greenacres DS0000059315.V330008.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 Greenacres DS0000059315.V330008.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): 1, 2, 3, and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their families have the appropriate information available to them to help make an informed decision about the home. All service users have a needs assessment and contract of occupancy in place. EVIDENCE: The home has a statement of purpose and service user guide in place, which is available to all service users and their relatives on admission to the home. This has been updated and now includes all the new details including the mew management structure. Contracts of occupancy are in place. Three of these were sampled and include the accommodation offered, the amount of fees payable and the method of payment. Contracts are signed by the service user or their designated representative and dated. Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 10 All prospective service users have a needs assessment undertaken prior to admission to the home. The manager explained that whenever possible the prospective service user will be invited to spend a day in the home for assessment purposes. It was possible to observe an assessment in progress and to talk with the service user and gain some feedback on how she felt. Three needs assessments were randomly samples. These were detailed and gave a good outline of individual needs and if the home has the expertise to meet these needs. The home does not provide intermediate care. Greenacres DS0000059315.V330008.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): 7, 8, 9, and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual care plans outline the specific care to be provided. The health, and medication needs of service users are met, with dignity and respect. EVIDENCE: Individual care plans are in place. These are based on the pre admission needs assessment, and have been written with the input of service users, relatives, and any other health care professional information. Three care plans were seen and are informative, outline the care to be provided and by whom. Regular reviews of care take place and the care plans updated to reflect changing needs. The home has a medication policy in place. At the last inspection four requirements were made around medication issues and since then procedures around the administration of medication have greatly improved. The deputy manager has the responsibility for ensuring good practice prevails and the inspector observed the deputy manager and a senior carer checking all the medication for the forthcoming month into the home, which was delivered during the inspection. This procedure took several hours. Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 12 The medication practice was sampled on one unit. Boots the Chemist in blister pack format supplies these. All medication is stored correctly. The medication recording charts were seen and these are well maintained. They include a photograph of the service user, and any known allergies. Only staff members who have undertaken the appropriate training and are competent administer medication. The deputy manager stated that daily medication checks are carried out on each unit. Throughout the inspection staff were observed to be polite and respectful to service users. They addressed service users by their preferred name and knocked on bedroom doors prior to entering. Several service users made positive comments regarding the “caring” and “kind” staff. Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14, and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The activities programme in place meets the collective and individual needs of service users. Family links are maintained and the nutritional needs of service users are met. EVIDENCE: There is an activities programme in place, which is overseen by an activities coordinator and includes games, exercise, music, aromatherapy, reflexology, art and craft, and team games for example skittles. Social evenings are arranges each Saturday night and bingo is also arranged on Sunday evenings. During the inspection there was a volunteer playing classical music in the ground floor sitting room and there was group activity taking place on Bluebell un it. Several service users stated that “it is very happy here” and “there is always plenty to do”. The manager stated that she organises family support meetings once a month in the form of cheese and wine evenings. Visitors are encouraged into the home at any reasonable time and relatives are included in care planning process and also invited to reviews of care. Relatives are also invited to participate in all of the home’s social functions. Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 14 The catering arrangements in the home are well organised by the catering manager who is also the head chef. The menus are planned four weekly with input from the service users. These are well balanced, nutritious, and include fresh vegetables and fruit. Special diets are catered for and include diabetic, vegetarian, and cultural needs. Several service users stated that the food was very good and that they could order what they wished, if they did not like the choice of menu. The chef evidenced this. During morning coffee home- made scones were served and the inspector observed cakes being made in the kitchen for afternoon tea. One service user stated that this is an every day occurrence. The kitchen is well managed and is clean and hygienic. Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 15 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): 16,and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure and abuse awareness procedures in place protect the service users living in the home. EVIDENCE: There is a complaints procedure in place, which forms part of the service user guide. This is available to all service users and their relatives on admission to the home. During discussion with service users they were aware of this procedure but felt that they would not have to use this as “everything was fine” and “things get sorted out immediately”. The home has an abuse awareness policy in place and all staff have training in this policy during induction training. During discussion with staff in various units of the home they were all aware of this procedure and would feel confident implementing this if the need arose. The home has a copy of Surreys Multi Agency Policies and Procedures in Safeguarding Vulnerable Adults in place and the manager and senior staff have attended training in these procedures. The manager also attended training in “Managing Safely in Adult Protection” on 10th October 2006. There have been no referrals under these procedures since the last inspection. Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 16 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): 19, 20, 22, 24, and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users live in a safe well maintained home which meet their, individual communal and mobility needs. EVIDENCE: Service users live in a well -maintained, comfortable and safe environment. The accommodation is arranged over three floors in five individual units. Each unit has it’s own lounge and dining room, which are all well decorated and comfortably furnished to a high standard. All bedrooms are single occupancy, en-suite rooms, which are all comfortably furnished and personalised to reflect individual personalities. Service users are encouraged to bring personal items of furniture and possessions into the home. Some service users have their own telephone, which is a private arrangement with the telephone company. The home has been adapted to meet individual mobility needs of service users. Some en-suite toilets have raised toilet seats, grab rails have been fitted in appropriate places, there are assisted bathrooms and shower rooms in each Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 17 unit, there is a call bell in every room, and a lift to access each floor. There is a ramp access to the large rear garden with raised flower- beds and sensory garden. The standard of cleanliness is good and well maintained by the housekeeping staff. There is an infection control policy in place and all the staff are aware of this. They were observed washing their hands frequently and changing their aprons when serving food. . Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 18 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): 27, 28, 29, and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number and skill mix of staff meet the service users needs. The recruitment procedures in place protect the service users in the home. EVIDENCE: The staff duty rota was seen and the number and skill mix of staff on duty was satisfactory to meet the assessed needs of the service users. The manager stated that she has the flexibility to increase the number of staff on duty according to need and circumstances. The home also employs a large ancillary staff team. During discussion with various staff members they all confirmed they had a job description and contract of employment. The home operates the organisations recruitment procedures. These are robust, and protect the service users in the home. Three staff employment files were seen. These are well maintained and contained all the required employment documentation including two written references, an employment history and a CRB (Criminal Records Bureau) disclosure reference number. Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 19 Staff training files were sampled. All staff undertake induction training, which takes place over a week. This is followed by shadow working for a further week. Other training undertaken includes health and safety, first aid, manual handling, fire safety, food hygiene, wound care, back care dementia awareness, deaf awareness, tissue viability, medication administration, and protecting vulnerable adults. NVQ training is in place with 28 of staff having an NVQ level 2, and 12 of staff with an NVQ level 3. The manager stated that a further 40 of staff have been registered to undertake NVQ level 2 in the next year. During various discussions with staff they were able to confirm the training they had undertaken. Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 20 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): 31, 33, 35, and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users live in a well manager home, which is run in their best interest and promotes their health, safety, and welfare. EVIDENCE: The registered manager has been registered with the Commission for Social Care Inspection since the last inspection. She has several years experience in the provision of care for older people and has been a Registered Manager with Anchor Trust for many years. She holds an RMA (Registered Managers Award) and an NVQ level 4 in Management. She is also an NVQ assessor and verifier. She has a competent deputy manager and a team of senior care staff to support her. Several service users stated that they were happy with the management structure within the home and said that they could talk to the manager and management team whenever they needed to. Several staff stated that there was an open and inclusive atmosphere in the home and they could approach a senior staff with any problems. Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 21 Quality assurance is monitored and the manager stated that service user, and relative questionnaires are sent yearly. Surveys are sent to outside agencies for example, GP’s, and other health care professionals for feedback. Service users meetings take place monthly and relative support meetings also take place. Unit meetings and regulation 26 visits are also used to measure quality assurance. The home will hold small amounts of personal monies for service users if required to so. There is a policy in place for cash withdrawals, which safeguards service users financial interests. The home has a wide range of health and safety policies and procedures in place and a variety of these were sampled during the inspection. Risk assessments are in place for all identified risks and safe working practice. The fire safety records were seen and are well maintained. Fire alarms are tested weekly, and there is a contract in place for the maintenance of fire fighting equipment and emergency lighting. Accidents are recorded and reported according to procedure. Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 22 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 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 X 3 X 4 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Area Office Burgner House, 4630 Kingsgate Oxford Business Park, South Cowley Oxford OX4 2SU 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 Greenacres DS0000059315.V330008.R01.S.doc Version 5.2 Page 25 - 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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