Inspection on 20/06/07 for Greenacres

This inspection was carried out on 20th June 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 04/07/06

Greenacres 17/11/05

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 0BU Lead Inspector Mrs Alison Butler Key Unannounced Inspection 20th June 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 DS0000019413.V344601.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 DS0000019413.V344601.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenacres Address Wellfield Close Hatfield Hertfordshire AL10 0BU 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 www.quantumcare.co.uk 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.V344601.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th July 2006 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, and is situated close to the centre of Hatfield with all its community facilities, health centres and clinics. Fees for the services are £455-£535 per week. Additional charges are made for newspapers, toiletries etc. (this was correct as at 20/06/07). For up to date information, contact the home direct. The accommodation is offered in 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 as two lounge/dining areas, a kitchenette and a night medication storage station. Each wing has an assisted bathroom and assisted shower. Other facilities available include a reception area and an activities/day area. A fully equipped kitchen is located on the ground floor, as is the administrators office and reception desk. On the first floor are the hairdressers’ 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. 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 offers day care to those who live in the community. Greenacres DS0000019413.V344601.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried this inspection during the hours of 10:30 and 16:00 The majority of the inspection was spent talking with those who live at the service, staff, management and visitors. Care and administration records were checked. Where information has remained the same, it has been brought forward into this report. What the service does well: What has improved since the last inspection? What they could do better: Work still needs to be carried out on medication administration and recording to ensure the safety of those using the service. Cleaning microwaves needs to be carried out regularly and all opened food should be dated to protect those using the service from possible food poisoning. Greenacres DS0000019413.V344601.R01.S.doc Version 5.2 Page 6 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 DS0000019413.V344601.R01.S.doc Version 5.2 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.V344601.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable to Greenacres. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures they are able to meet the needs of individuals prior to admission. EVIDENCE: Examination of two newly admitted people revealed that comprehensive assessments had been conducted to ensure that the service would be able to meet the needs of those individuals. This information was used to form the care plans. Their families had been given the opportunity to visit the home as part of the admission process. Greenacres DS0000019413.V344601.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information contained within the care plans is good. Medication procedures must be improved to protect those who use the service. EVIDENCE: Examination of four care plans revealed that a new format had been introduced since the last inspection and considerable work had been carried out to ensure that comprehensive information is recorded. This provides staff with details of the action required to meet individuals’ needs. Discussions took place with the people who use the service and they were complimentary about the care they received although one person had some issues with a few staff. The manager was aware of this and was dealing with the situation appropriately. Examination of the medication revealed a number of errors where written information on the record sheet had not been copied correctly from the dispensing label, (with no strength and no second signature recorded as per the organisation’s procedure). One person had not been given her medication, as the record sheet stated that there was none on the unit, although a supply Greenacres DS0000019413.V344601.R01.S.doc Version 5.2 Page 10 was available in the medication store. It appeared that one person had been given the wrong medication, as neither the inspector nor the manager was able to reconcile the medication. During the inspection, the manager arranged for their company pharmacist to carry out a full audit of their medication procedures and the storage for the following week. The manager has discussed medication within team meetings and hand-overs on a number of occasions. Staff must take care when carrying out the administration of medication and take responsibility for their actions. Although this has been a breach of regulation it is thought that the company procedures will manage the situation appropriately and further staff training will be provided for those not able to follow procedures correctly. Therefore, a requirement has not been made on this occasion. However, any future failure may result in legal action being taken. Good interaction was observed during the inspection where staff were seen to provide support as necessary and encouraging independence where possible. Greenacres DS0000019413.V344601.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those who use the service are encouraged to take part in the activities on offer. Family and friends are welcomed into the home at any time. EVIDENCE: There are two activity co-ordinators who work a total of 45 hours, covering 12 days a fortnight; they have increased the range of activities on offer. The activity co-ordinators are responsible for recording the activities that individuals have taken part in and whether they have enjoyed them or not. This enables them to constantly work towards the best possible programme and provide an evolving service. All staff are responsible for running and taking part in activities. Those spoken to were happy with the activities on offer and were able to choose which ones to join in if they wish. Relatives spoken to were happy with the care that is provided at Greenacres and stated they are always made to feel welcome whenever they came to the home. Following a successful trial of changing the main meal to the evening last year, they are looking at trialling this again before considering introducing it on a more permanent basis. People who live at this home were very complimentary about the food choices and, although it is not always to their taste, they are Greenacres DS0000019413.V344601.R01.S.doc Version 5.2 Page 12 offered alternatives if necessary. During the mealtime, it was noted that staff assisted those needing support with discretion. The staff were seated and explaining what was being offered. Greenacres DS0000019413.V344601.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures are in place to ensure the protection of those who use the service and one for ensure that their views are listened and acted upon. EVIDENCE: Those spoken to were clear whom they could speak to if they were unhappy with any aspect of their care. Some had reported some minor issues in the past and reported that the issues had been dealt with to their satisfaction. All staff receive training in safeguarding adults and this is carried out on a rolling programme. Staff are clear of the procedure to follow if an incident or allegation was reported to them. Greenacres DS0000019413.V344601.R01.S.doc Version 5.2 Page 14 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was generally clean and fresh with the exception of the cleanliness of microwaves. EVIDENCE: Carpets in the corridors, lounges and dining areas have been replaced as required and this has certainly improved the overall appearance of the home. The home was generally clean with the exception of the microwaves which required cleaning. The staff should have no excuse for this. A cleaning rota was introduced following the last inspection, but staff appear to have ignored it on occasions. The team leader dealt with this issue during the inspection. Staff must remember to date food on opening and it was suggested that labels are placed on each unit to enable this to be carried out. The home has been given a grant that they are using for a special bath, a sensory garden and some curtains all for the benefit of those who use the service. Greenacres DS0000019413.V344601.R01.S.doc Version 5.2 Page 15 Those who use the service were happy with the laundry service and felt that they had their clothes returned very efficiently. Greenacres DS0000019413.V344601.R01.S.doc Version 5.2 Page 16 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those who use the service are protected with the robust procedures that are followed for the recruitment of staff. They are supported by adequate numbers of staff on duty at all times. EVIDENCE: A deputy post has still to be filled. Two care team managers are due to retire and one post has been filled with further interviews to be carried out in the next few weeks. There are three staff on the unit that supports those who are diagnosed with dementia. Those who were spoken to commented “the staff help us with care” “they are lovely girls”. Staff were seen knocking before entering rooms. As previous inspections have shown that robust recruitment procedures are in place and are followed staff personal files were not examined on this occasion. Greenacres DS0000019413.V344601.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interest of those who live at the home. Health and safety is promoted and protected through a series of checks. EVIDENCE: A system of regular checks and the reviewing of risk assessments protect the health and safety of all who enter Greenacres. The manager works in an open and transparent way and her office door is always open to anyone who wishes to speak with her. Regular staff meetings are held with a record of the minutes seen during the inspection. Regular supervision takes place and records are held of each session. Each year a homes forum is held where relatives and other professionals are invited to attend to receive a talk on the service and the Greenacres DS0000019413.V344601.R01.S.doc Version 5.2 Page 18 findings from the yearly questionnaires are reported on and any changes or improvements will be made known. All records were well kept and available for inspection. Those who use the service are assured that their financial issues are safeguarded with procedures and policies in place. The Commission is informed appropriately of all events subject to Regulation 37 of The Home Regulations. Greenacres DS0000019413.V344601.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 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 DS0000019413.V344601.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 DS0000019413.V344601.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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. 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