Inspection on 17/11/05 for Greenacres

This inspection was carried out on 17th November 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 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 20/06/07

Greenacres 04/07/06

Greenacres 04/05/05

Greenacres 06/01/05

Greenacres 19/07/04

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

CARE HOMES FOR OLDER PEOPLE Greenacres Wellfield Close Hatfield Hertfordshire AL10 OBU Lead Inspector Mrs Alison Butler Unannounced Inspection 17th November 2005 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 DS0000019413.V265940.R01.S.doc Version 5.0 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 DS0000019413.V265940.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Greenacres Address Wellfield Close Hatfield Hertfordshire AL10 OBU 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) 01707 280 500 01707 280 561 Quantum Care Limited Toni Patricia Greenhill Care Home 60 Category(ies) of Dementia - over 65 years of age (60), Old age, registration, with number not falling within any other category (60), of places Physical disability over 65 years of age (60) Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th May 2005 Brief Description of the Service: Hertfordshire County Council first registered the home on 1st July 1992. Greenacres is a modern purpose built two-storey building. The accommodation is offered on four units. It provides a home to elderly people requiring long stay residential care. Each bedroom has en-suite toilet and wash hand basin. Each wing has two lounge/dining areas, a kitchenette and night/medication storage station. Each wing has an assisted bathroom and assisted shower room. Other facilities include a reception area and an activities/day area. A fully equipped kitchen is located on the ground floor, as is the administrator’s office and reception desk. On the first floor are the hairdresser’s salon and fully equipped laundry. Facilities for staff include a smoking room, staff room and changing room with shower on the first floor. The home has an enclosed garden in the centre of the building with patio areas. Greenacres is situated close to the centre of Hatfield with all its community facilities, health centres, and clinics. There is a day centre for the elderly in close proximity. Greenacres is able to offer respite care to enable families to take a break and offer day care to those who live in the community. Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out with the duty care team manager as the manager was at the hospital carrying out an assessment on a resident who is due to be discharged back to the home. The inspector spent the vast majority of their time on the units talking to staff and residents. The staff were seen to be offering appropriate support and encouraging independence where possible. The inspectors spoke with 18 residents, and 8 staff. The inspector also spoke with the manager on there return from the hospital. Care and administration records were also checked. What the service does well: What has improved since the last inspection? The handover process has changed to ensure that at least one member of staff is on each unit to protect the residents. The manager has introduced additional training especially around medication. The manager has identified areas in need of redecoration and the replacement of carpets in some areas. A plan has been provide to the Commission For Social Care Inspection. Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 Page 6 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 DS0000019413.V265940.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 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 the following standard(s): This area was not inspected on this occasion. EVIDENCE: Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 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 the following standard(s): 7, 9, & 10 The quality of information is generally good but there are areas that need some improvement. The staff provide appropriate support and are knowledgeable about the need of the residents. EVIDENCE: Examination of four care plans showed that two of them required some further information and where the information is recorded this should be crossreferenced to the relevant forms/area within the plan. The manager stated that they were going to be looking at other ways to ensure that the recording is carried out more consistently. A number of photographs were missing although a recommendation was made at the previous inspection to ensure that all care team managers know how to use the camera. This would prevent mistakes of identity. A number of issues were identified with the medication. The deputy manager, who is responsible for the medication, is on long term sick leave and a new member of the management team is being trained. Staff have not been consistently recording the medication that has been brought forward from the previous month. Staff must remember to sign and date any changes or additions which they add to the medication, administration and record sheet Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 Page 10 (MAR). The manager had already identified the need and has arranged for the care team managers to have further training in medication. The assessor for a B-Tec course was visiting the home on the day of the inspection and staff were completing the registration process. It is hoped that this will improve staff competence and lead to a more streamlined medication process. It is hoped that recording, administration, disposal and storage will be vastly improved at the next inspection. Again the information recorded on the social care is limited or not present. See comments in daily life and social activities section for further information. Good interaction was seen during the inspection between staff and residents, support was provided appropriately. Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 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 the following standard(s): 12,13, 14 & 15 Autonomy and choice is promoted within the home. Visitors are welcomed and contact is maintained with the local community. EVIDENCE: Again information on resident’s social care is limited in the information and there are gaps in the dates of the recording. Some files had no information recorded. If residents choose not to take part in activities and alternatives have been sought then it should be recorded as such to ensure a whole picture of care is provided. The manager is hoping that a daily activities co-ordinator will be employed in the very near future. The staff where possible will run activity sessions for the residents where possible. This can be difficult at times due to having minimum staff on duty, usually caused by staff sickness at the last minute. One resident said “the staff really try their best but appear rushed at times with lots of things to do” The residents were very complimentary about the food that is provided and alternatives are offered if they do not like the options available. The lunch was nicely presented and hot. A resident stated, “this is very tasty, I look forward to my food”. Those resident being assisted with eating were supported appropriately and staff were seated and explained to them what was being offered. Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 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 the following standard(s): 16, 17 & 18 Robust procedures are in place to ensure the protection of the residents. All staff need to be clear of the procedure. EVIDENCE: A copy of the complaints procedure is available. Residents were clear who they would speak to if they had any concerns or were unhappy with any aspects of their care or the staff. No complaints had been received since the last inspection. The commission is confident that the manager would deal with any complaints or concerns appropriately. The manager was dealing with a difficult situation at the time of the inspection, this involved a meeting that had been arranged with the family, the resident and included various other people who are involved in the care of the resident. Unfortunately the lead person for arranging the meeting had failed to turn up and understandably the family were extremely unhappy. The manager was then left to deal with the consequences. The situation was dealt with in an very professional manner and that she explained to the family that she would try to find out what had gone wrong. Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 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 the following standard(s): 19 & 26 The home is clean and well maintained and regular checks are carried out on services and equipment. EVIDENCE: There were no odours detected throughout the home on this occasion. There is a rolling programme for the replacements of carpets and for any redecoration. A number of carpets are due to be replaced before the end of March 2006 and further decoration is planned. Residents were very happy with the laundry service and were well dressed. Policies and procedures are in place for the prevention of infection. Certificates are available showing that the equipment is serviced to ensure that it is kept in good working order. Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 29 The procedures for staff are robust and offer protection to the residents living at Greenacres. The staff are deployed in sufficient numbers around the home to meet the personal needs of the residents. EVIDENCE: All the relevant information had been obtained on examination of three newly recruited members of staff. Each member of staff had a full criminal records check, two references had been taken up, and health clearance had been sought. The manager has been exploring the possibility of employing an activities coordinator and this is hoped will happen in the very near future. This it is hoped, will enable the residents to be offered more choice in social activities and on a regular basis. Good interaction was observed between staff and residents. The staff appropriately encouraged residents to be independent. Residents were full of praise for the staff saying “they are really good girls” “couldn’t ask for a better place to live” “everyone is really friendly and helpful”. Since the last inspection the handover process has changed to ensure that each unit always has a least one member of staff available in case of emergency. Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35 & 38 The manager ensures the smooth running of the home. Staff try to ensure that the paperwork is kept up to date and that standards are being mintained, although this is not always the case. The resident’s financial interests are safeguarded. EVIDENCE: The home had recently had an external audit carried out on all monies held in the home. A spot check carried out showed that these are robust with appropriate policies in place. The manager is said to work in an open and transparent manner. The staff stated they felt they could speak to her at any time if they required support or had an issue in their roles. Records for the fire testing were examined. The records only showed a monthly check although the manager confirmed these are carried out on a Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 Page 16 weekly basis. The staff members responsible for the testing must ensure that they are recorded to provide a clear record that all the zones within the home are working effectively. Accidents and incidents are well documented and a monthly audit is carried out to check for any problems with individuals that may require a review of their care and/or risk assessments. The Commission For Social Care Inspection are notified appropriately under regulation 37 of the Care Home Regulations 2001. Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 Page 17 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 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 3 X X X 3 X X 2 Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13(2) Requirement Staff must be trained in the correct handling of medicines. This has been brought forward from the previous inspection. Timescale for action 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP7 OP7 Good Practice Recommendations Care plans should be more detailed and information crossreferenced to the relevant area within the plan. This has been brought forward from the previous inspection Photographs should be placed on each residents file as soon as possible after admission. (More staff should be trained in the use of the camera. This has been brought forward from the previous inspection. 3 4 OP9 OP12& OP27 has been brought forward from the previous inspection The bring forward system should be used consistently to ease with the reconciliation of medication at any time. This This has been brought forward from the previous inspection Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 The manager should continue to look at employing a Daily Activity Co-ordinator to provide a full and varied programme of activities in consultation with the residents. Page 19 5 OP38 All fire testing should be recorded to ensure safety and protection of the residents. Greenacres DS0000019413.V265940.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 DS0000019413.V265940.R01.S.doc Version 5.0 Page 21 - 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. 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