Inspection on 10/05/05 for Greenacres

This inspection was carried out on 10th May 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

Greenacres 06/11/07

Greenacres 01/03/07

Greenacres 17/05/06

Greenacres 12/09/05

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 The Horseshoe Banstead Surrey SM7 2BQ Lead Inspector Mrs Sue McBriarty Unannounced 10th May 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. Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Greenacres Address The Horseshoe Banstead Surrey SM7 2BQ 0207 759 9100 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) Anchor Trust Mrs Mary Painter Care Home 60 Category(ies) of DE(E) - Dementia over 65 (20) registration, with number of places MD(E) - Mental Dissorder over 65 (5) OP - Old Age (60) PD(E) - Physical Dissorder over 65 (20) Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Dementia - over 65 years of age (20), Mental Disorder, excluding learning disability or dementia - over 65 years of age (5), Old age, not falling into any category (60), Physical disability over 65 years of age (20). Date of last inspection 6th October 2004 Brief Description of the Service: Greenacres is an Anchor Trust care home for older people. The home is purpose built and offers well equipped accomodation for sixty (60) service users. The accomodation is divided into five units and all service users have single bedrooms 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. Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first for 2005 – 2006. During the inspection seven service users and six staff were seen excluding the manager. Five of the staff were spoken to in depth, including the manager. A tour of the building took place and documents including care plans, risk assessments and personnel files were sampled. What the service does well: What has improved since the last inspection? What they could do better: The home needs to ensure that care plans and risk assessments are updated on a regular basis and that they are easily accessible to staff. As stated above the home had a problem with the boiler and this had left parts of the home colder than usual. Residents said they had not been advised of the problem, it was recommended that residents be kept up to date with such problems and Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 6 what action was being taken to resolve it. Residents said that if they knew what was happening they would feel less anxious. 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. Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 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 Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 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) 1,3,4,5 Information about the home was available for prospective service users and they would be able to visit the home before making a choice about living there. There was evidence of assessments being undertaken prior to a new service users moving into the home. EVIDENCE: The home had a statement of purpose and service user guide, both required updating showing the changes in management structure within the home. The new manager had been in place since January 2005 and had been working with the staff team to reconsider their roles and responsibilities. Service users and their families were able to visit the home before deciding whether they wished to move in. The service users were able to spend time at the home as part of their decision making, staying for a meal, a weekend and where possible for a weeks respite care. The manager visits the persons own home to undertake a written assessment before the service user moves in. Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10, The home provides detailed care plans and risk assessments that required some updating. Service users are treated with dignity and respect. EVIDENCE: The senior care staff undertook a detailed assessment of each person within the first few weeks of their moving in. The assessments covered all aspects of their lives including personal care needs and cultural needs. Risk assessments were seen and evidenced that they were put in place as soon as staff became aware that there was a concern. A number of service users smoke and they are able to do so in their own bedrooms, as with all the risk assessments these also need updating on a regular basis. None of these documents had been updated. Records were held in several different locations and this was not seen to be helpful to staff who needed the information about service users to be easily accessible. The home was part of a short-term project that provided a practice nurse who visited the home on a regular basis. This was said by both the nurse and the manager of the home to have reduced the number of times a doctor had to be called into the home. The nurse was able to see a number of service users during her visits and decide whether a doctor needed to be called. Both Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 10 expressed the view that they wished the project to become long term. The nurse was able to talk to staff about good practice and to help with some aspects of training. The manager informed the inspectors that complaints from staff had reduced since the nurse began the project with the home. The project was seen as good practice. The residents views on this project were not gained during this inspection. All the service users spoken with during the inspection were very positive of the help and support they received from staff. One service user said of a member of staff “ I was impressed by how respectful they were”. Each of the service users had their own bedroom and family members and friends were able to visit throughout the day and to see each other privately. Throughout the inspection staff were heard talking to service users in a calm and respectful manner. Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 Service users are able to exercise choice including maintaining contact with friends and relatives. The menus seen were varied and nutritious. EVIDENCE: The home employs an activities co-ordinator and service users choose whether to join the activities provided within the home. Others attended a nearby day centre or were able to make their own way into town if they wished to see friends or go shopping. Family and friends were seen to be visiting their relatives throughout the day. Those service users spoken to talked about who had visited them or what they had been doing during the week. The inspector spent some time with the chef and menus were seen and evidenced a varied and nutritious diet. Fresh fruit and vegetables were used wherever possible. The chef had been working at the home since September 2004 and had built a good relationship with service users. On occasion she had visited particular service users to discuss their preferred options in order to try and improve their diet. The service users confirmed that they could order what they wished including a cooked breakfast if they wanted one. Service users could choose to eat in the dining area or in their own rooms. The chef was in the process of revising the menus. Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 12 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) 16, 18 The complaints procedure in place was adequate to meet the needs of service users. Some progress is required to ensure that staff have been trained in the protection of vulnerable adults. EVIDENCE: No complaints had been received by the home since March 2005 and those received had been dealt with appropriately. The new manager is updating the staff training records and was not able to evidence during this inspection whether staff had or had not been trained in the Local Authority Multi-agency Protection of Vulnerable Adults procedure. The manager was putting a central training record together at the time of this inspection that would assist with the gathering of such information. A recommendation has been made that the manager informs the CSCI of the outcome of the training record to ensure that the appropriate training had taken place. Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 13 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, 20, 21, 22, 23, 24, 25, 26 The home provided adequate communal and individual space for the service users. Sufficient bathing and toilet facilities were available. EVIDENCE: The home is close to the local shops and community facilities and those service users with mobility scooters or were reasonable mobile on foot were able to access the facilities on offer. Where assistance was needed this was provided by staff and or friends and family when they were visiting. The home was clean and comfortable furnishings were provided throughout. Each of the rooms had en-suite facilities available, assisted baths were also available for use where required. Adequate bathing and toileting facilities were provided. A number of the service users rooms were seen, each had been personalised and were spacious, light and airy. Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 14 Some progress was required in relation to keeping chemicals safely locked away. During this inspection both the boiler room door and the door to the hairdressers had been left unlocked. Both rooms could place service users at risk from chemicals, electrical shock or trip hazards. The manager ensured that both doors were locked immediately the matter was brought to her attention. Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 15 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, 29, 30 Staffing levels meet the needs of the service users. Some progress is needed to ensure that training records are accurate and up to date, recruitment information is held at the home. EVIDENCE: The home ensures that eight (8) staff were on duty each morning and afternoon and four (4) each night. On the day of this inspection the staffing levels met the needs of service users. The service users spoken to stated that staff members attend to their needs when the call bell is used and they were advised if they had to wait for any period of time. The activities co-ordinator worked four (4) days per week and was willing to work flexibly over evenings and weekends if needed. The co-ordinator helped to raise money to take the service users out on day trips or fund a fish and chip supper if they wished. A receptionist was available during weekday mornings and an administrator was available Monday to Friday each week. At the time of this inspection the home did not have the original Criminal Record Bureau (CRB) checks on site. The Human Resources Department held the records and the home were sent an email confirming they had been received. A requirement has been made that the original document is held at the home for inspection by the CSCI. As noted previously the manager was updating the staff training that had taken place and it was therefore difficult to show exactly which courses the staff had been on. However there was evidence of a variety of courses being Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 16 supplied. The record being updated by the manager will make it easier to check the training needs of each member of staff. Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, 32, 36, 37, 38 On the evidence gathered shortcomings were identified under The national Minimum Standards 7, 36 and 38. These will need to be addressed to ensure that residents health, personal and social care needs are met. Further work is required in a number of areas. Records for both staff and service users were held appropriately. EVIDENCE: The acting manager had completed the NVQ Level 4 and was working toward the Registered Managers Award. An application for registration has been received by the CSCI in order that the acting manager can be considered for registration as the manager of the home by the CSCI. The staff spoken to during the inspection spoke highly of the new manager and her open and inclusive style of management. Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 18 At the time of this inspection the senior staff were reviewing the risk assessments for the home and had been taken off other duties in order to ensure they had to time to complete the task. Some progress was required to ensure that documented staff supervision is provided on a regular basis. Some health and safety issues were found during the course of this inspection. No records of temperature checks were being kept for the fridges in the separate units within the home although food was being stored. Records were being kept consistently in the main kitchen. However some foodstuffs in the fridge and freezer that had been opened or placed in the fridge fresh had no dates on them. The manager had reviewed the fire safety and evacuation procedures with the local Fire Safety Officer. The new procedure offers clear instructions to all staff and details how each area is to be evacuated. As noted previously the care plans and risk assessment required updating on a regular basis. The unit kitchens are to be provided with liquid soap and paper towels to reduce the risk of infection. Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x 2 2 2 Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 20 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 OP1 Regulation 4,5 Requirement The registered person must update the Staement of Purpose and Service User Guide to ensure that the information regarding the staffing changes is clear. The registered person must ensure that the service user care plans and risk assessments are updated regularly and wherever possible signed by the service user. The registered person must ensure that all original CRB checks are held at the home and open to inspection by CSCI. The registered person must ensure that those areas that present a risk to service users remain locked or fully supervised when not in use. The registered person must ensure that temperature records of all fridges within the home are recorded regularly and th erecords kept for inspection. The registered person must ensure that liquid soap and paper towles are provided in each of the unit kitchen in the home. Version 1.30 Timescale for action 31st July 2005 2. OP7 14)2)(a) (b) 31st July 2005 3. OP29 (17)(2) Schedule 4(6)(f) 13(4)(a) 30th June 2005 10th May 2005 (immediate ) 30th May 2005 4. OP38 5. OP38 13(4) (c ) 6. OP38 13(4) (c ) 30th June 2005 Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Page 21 7. OP38 13(4)(C ) The registered person must ensure that any open foodstuffs stored in the fridge/s or freezer is dated. 30th May 2005 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 30 Good Practice Recommendations It is recommended that the manager provide CSCI with the outcome of the centralised training record to ensure that all training required has been provided. Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 22 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Greenacres H58_s59315_Greenacres_v213865_100505_stage4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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