Inspection on 11/07/05 for Greenacres

This inspection was carried out on 11th July 2005.

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

Other inspections for this house

Greenacres 26/07/07

Greenacres 03/10/06

Greenacres 12/12/05

Greenacres 15/12/04

Greenacres 02/07/04

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

CARE HOMES FOR OLDER PEOPLE Greenacres Pighue Lane Wavertree Liverpool L13 1DG Lead Inspector Inger Moynihan Announced 11 July 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 F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Greenacres Address Pighue Lane Wavertree Liverpool L13 1DG 0151 259 7899 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) Mr Ilam Chaudry Mrs Lynn Williams is currently acting manager CRH PC 42 Category(ies) of OP - 42 places registration, with number of places Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: There are no conditions attached to the registration of this service. Date of last inspection 15 December 2004 Brief Description of the Service: Greenacres is a residential care home providing 24-hour personal care and accommodation for 42 older people. There is currently no registered manager at this home. Mrs Lynn Williams is currently acting as manager of the home and her application to become registered is currently being processed by the CSCI. The home is located in the Wavertree district of Liverpool and is within easy access to bus routes, churches, shops and local amenities. The home is a purpose built single storey building, which was opened in 1996. There is car parking to the front and side of the home and a central courtyard provides a safe garden area for service users to sit. Bedroom accommodation comprises of 40 single bedrooms and one double bedroom all with en-suite facilities. Communal space within the home consists of two lounge areas, a dining room and a small smoking area. Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over seven hours and was the statutory announced inspection for 2005/2006. A tour of the premises took place and service users records were inspected. Six staff, eight service users and two relatives were spoken to during this inspection. What the service does well: Service users’ care needs are assessed before they move into the home to ensure the acting manager and staff team can provide the required care. Details of service users care needs had been compiled into a documented plan of care which gave staff information on how to look after the service users properly and attend to their care needs. Thorough medication procedures were in place. The daily routines within the home are flexible and service users can come and go as they choose. A range of social activities are provided and contribute to creating a lively and interesting environment for the service users to live. These social activities also provide a forum for service users to mix as a group and maintain mental stimulation. A varied and nutritious diet is provided which ensures service users good health. A complaint procedure is in place to ensure service users views are taken into account with regard to the care provided. An adult protection procedure was in place to ensure service users safety and welfare. The standard of decoration throughout the home is good and provides a comfortable and pleasant environment for the service users to live. There are sufficient trained and competent staff to meet the service users needs and thorough recruitment and selection procedures have been put into place to ensure service users safety and welfare. The acting manager offers clear leadership to staff to ensures service users receive a high standard of care. Efficient systems are in place to ensure the home is run for the best interests of the service users. The health, safety and welfare of the service users is well promoted. The relative of one service user commented I am very happy with the care my mother receives. The acting manager always contact me when any issues arise in relation to my mothers care. Another relative commented I cannot fault the staff they are very kind and go out of their way to look after my mother. Another service user commented the staff are very kind and caring and I could not fault them at all. The acting manager is lovely. Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.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 F52_F02_s25108_Greenacres_v243133_110705_stage_4.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 and 3 Service users’ care needs are assessed before they move into the home to ensure the acting manager and staff team can provide the required care. EVIDENCE: An assessment of service users individual care needs is carried out prior to any service user being admitted into the home. This ensures the registered manager and staff team are able to meet the service users’ specific care needs as they require. New service users are only admitted to the home following a pre-admission assessment which is undertaken by the acting manager. The assessment process includes meeting the prospective service user and their relatives/representatives. The process also includes discussion with social/health care professionals and a copy of the social services care management assessment document if appropriate. After the last inspection it was recommended that the homes banking arrangements for aservice users money is included in the home Statement of Purpose. This issue has not been addressed and it is further recommended that for the purpose of improvement, the registered person includes this information in the Statement of Purpose. Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.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 medAndication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 11 Details of service users care needs had been compiled into a documented plan of care which gives staff information on how to look after the service users properly and attend to their care needs. Thorough medication procedures were in place. EVIDENCE: Service users health, personal and social care needs are set out in an individual plan of care. This is in line with good practice and ensures staff know how to care for the service users in accordance with their particular needs. This also demonstrated how service users health, personal and social care needs would be met. This information covered a range of relevant issues and included the use of various assessment tools which were used to monitor service users health care needs as required. All of this information was regularly reviewed although the acting manager did acknowledge that the care plans needed to be streamlined as they held a lot of surplus information. The inspector noted that some documents made reference to nursing staff being employed in the home when this is not the case. The care plans also need to include the history of falls and any issues around service users mental health. The registered person is required to ensure all documentation reflects the correct staffing structure and care plans reflect all aspects of the service users care needs. Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 10 Service users have access to their GP, chiropodist and district nurse to ensure their physical and mental well being; documentation was in place to confirm this. A record of service users well-being is also kept to enable staff to monitor service users general welfare. This is further supported by a system whereby staff spend time each day discussing any issues or concerns that may have arisen over the past 24 hours. All of these factors contribute to providing a safe environment for service users to live and ensures service users welfare is monitored daily. Efficieose monitoring of this medication, only trained senior staff are allowed to administer medication. Documentation was in place to demonstrate staff have undertaken appropriate training in this area. Staff spoken to demonstrated an understanding of how to ensure service users privacy and dignity. This is particularly important when carrying out personal care. The relative of one service user commented I am very happy with the care my mother receives. The acting manager always contact me when any issues arise in relation to my mothers care. Another relative commented I cannot fault the staff they are very kind and go out of their way to look after my mother. Another service user commented the staff are very kind and caring and I could not fault them at all. The acting manager is lovely. At the last inspection it was recommended that that cultural and ethnic death rites be included in the homes policy for this standard. This issue has not been addressed and it is further recommended that the registered person include this information in the homes policy for this standard. Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.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) 13 and 15 The daily routines within the home are flexible and service users can come and go as they choose. A range of social activities are provided and contribute to creating a lively and interesting environment for the service users to live. These social activities also provide a forum for service users to mix as a group and maintain mental stimulation. A varied and nutritious diet is provided which ensures service users good health. EVIDENCE: A range of social activities are provided which the service users confirmed they were free to participate in if they wish. The acting manager places a great emphasis on social activities and demonstrated an understanding of the need for a varied and stimulating environment to be provided. During discussion, service users confirmed their friends and relatives could visit at any time and they were free to go about their routines as they wished. The menus demonstrated a varied and balanced diet is provided with service users’ medical needs being catered for. All of the service users commented on how much they enjoyed the food with one service user stating I always enjoy the meals and i always have enough to eat and drink, I always find mealtimes leisurely. Another service user however commented she felt that mealtimes were rather rushed. This issue was discussed with the acting manager during inspection who agreed to address the matter straightaway. Is it important that service users are given sufficient time to eat their meals as this could lead to Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 12 malnutrition and poor health. In light of this the registered person is required to address this issue as a matter of urgency. Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 A complaint procedure is in place to ensure service users views are taken into account with regard to the care provided. An adult protection procedure was in place to ensure service users safety and welfare. EVIDENCE: The CSCI has received one complaint about the standards of care provided at Greenacres; the investigation of this complaint is ongoing. The acting manager confirmed she had also received a complaint about the standards of care which had been investigated and responded to. The registered manager informed the inspector that all staff have undertaken training in relation to the protection of vulnerable adults from abuse. The staff spoken to demonstrated they were clear on the action they would take in the event of them receiving a complaint or suspecting or knowing an incidents of abuse had taken place. They were also clear on who to contact in the event of this situation occuring. The acting manager agreed that training around the protection of vulnerable adults from abuse needed to be updated although some staff had completed this training more recently when undertaking National Vocational Qualification level two. Last year the organisation Action on Elder Abuse set up a telephone line whereby service users and staff could report incidents of abuse anonymously. It is recommended that for the further protection of service users, this telephone number is made available to both staff and service users in order that they can raise any concerns. This telephone number be found on the Action on Elder abuse website. Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 14 One of the service users commented I have no complaints to make about the standards of carer I receive. Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The standard of decoration throughout the home is good and provides a comfortable and pleasant environment for the service users to live. EVIDENCE: The location and layout of the home is suitable for its purpose and overall is well maintained. There is a programme of routine maintenance and renewal of the fabric and decoration of the premises. The inspector noticed some of the carpets in the corridors were badly stained and required cleaning or replacing. Also the dining-room was rather stark in appearance and would benefit from redecoration and refurbishment as would one of the shower rooms identified during the inspection. These issues were discussed with the acting manager during the inspection who agreed with the inspectors comments but did state the carpets in the corridors were cleaned on a regular basis however this made no improvement to their appearance. She agreed with the inspectors comments that these carpets therefore required replacing. The home was clean and free from offensive odours, and systems were in place to prevent the spread of infection. Appropriate laundry facilities were provided. It is clear the staff are working hard to ensure a clean and tidy environment is provided for Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 16 the service users to live. Greenacres is built around an inner courtyard where there is a pleasant garden and seating area. This area had been made safe for all service users to wander into as they wish. All bedrooms within the home are single occupancy with ensuite facilities. To ensure service users feel most comfortable within the home, they are encouraged to personalise their rooms with their own belongings which many have done. Various items of equipment have been provided to assist service users with their mobility and bathing. Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 17 Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 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 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 and 29 There are sufficient trained and competent staff to meet the service users needs and thorough recruitment and selection procedures have been put into place to ensure service users safety and welfare. EVIDENCE: The staff rota indicated the staff were evenly deployed across the week to ensure service users’ care needs are met at all times and to ensure their safety and well-being. The staff spoken to during the inspection confirmed that a range of relevant training was available and the acting manager encouraged them to become involved in all training. This is a positive aspect of the home and ensures service users are being cared for properly and their needs are being met in accordance with good practice. Through discussion it was evident that staff had completed training relevant to the care of elderly people and the running of the home. The staff spoken to confirmed procedures were in place to ensure their continual development within their role. The acting manager is currently drawing up a training plan to the in the forthcoming year. Thorough recruitment and selection procedures are in place which include carrying out the necessary Criminal Record Bureau disclosure checks. This ensures suitably qualified and competent staff are employed in the home and that service users’ safety is promoted. Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 19 The inspector was informed there is a low staff turnover which is a positive aspect of the home and ensures consistency in the care provided to service users. Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 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 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) 33, 35 and 38 The acting manager offers clear leadership to staff to ensures service users receive a high standard of care. Efficient systems are in place to ensure the home is run for the best interests of the service users. The health, safety and welfare of the service users is well promoted. EVIDENCE: Through discussion, the acting manager demonstrated she was aware of her responsibilities with regard to the management of the home, supervision of staff and the care of service users. The staff spoken to during the inspection spoke highly of the acting manager and senior staff and said they were supportive and approachable. Efficient communication systems within the staff team have been established for the smooth running of the home; staff confirmed the systems are effective for the purpose of their role. The staff spoken to commented they worked well as a team and enjoyed their work. Discussion with staff and examination of documentation confirmed that safe working practices were promoted within the home and staff were provided with Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 21 appropriate training for this purpose. All of these issues demonstrate a good quality of care continues to be provided at Greenacres and that service users health and safety is well promoted throughout the home. Staff have undertaken training in relation to health and safety issues. The temperature of the water was tested at various points around the building and was within recommended safe temperature limits. The acting manager has implemented quality assurance systems by way of service user and family meetings and questionnaires on the standard of care provided. This is a positive aspect of the home and ensures the standard of care provided is maintained at a satisfactory level. Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 23 yes 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 7 Regulation 15 Requirement The registered person is required to ensure that all documentation accurately reflects the staffing structure within the home. In this instance that documents do not make reference to nursing staff. The registered person is required to ensure the care plans include all aspects of service users care needs including any history of falls and their mental health. The registered person is required to ensure service users are not rushed during mealtimes The registered person is required to ensure the carpets that are sustained in the corridors are are cleaned or replaced. The registered person is required to ensure the dining-room is redecorated or enhanced to make this area a more pleasant places to eat. Timescale for action 2 September 2005 2. 7 15 2 September 2005 11 July 2005 2 December 2005 2 December 2005 3. 4. 15 19 16 23 5. 18 23 Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 24 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 18 Good Practice Recommendations It is recommended that the telephone number of the organisation Action on Elder Abuse is made available to all service users, staff and carers in order that they may report any incident of abuse anonymously. It is recommended that the homes banking arrangements for aservice users money is included in the home Statement Of Purpose. It is recommended that cultural and ethnic death rites be included in the home policy for this standard. 2. 3. 1 11 Greenacres F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 25 Commission for Social Care Inspection Liverpool Area Office 3rd Floor 10 Duke Street Liverpool, L1 5AS 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 F52_F02_s25108_Greenacres_v243133_110705_stage_4.doc Version 1.30 Page 26 - 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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