Inspection on 07/07/07 for Greenacres

This inspection was carried out on 7th July 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 15/06/06

Greenacres 22/02/06

Greenacres 17/08/05

Greenacres 18/09/04

Greenacres 14/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Greenacres Green Lane Standish Wigan Greater Manchester WN6 0TS Lead Inspector Judith Stanley Unannounced Inspection 7th July 2008 09:30 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 DS0000005736.V367866.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 DS0000005736.V367866.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenacres Address Green Lane Standish Wigan Greater Manchester WN6 0TS 01257 421860 01257 472133 joy.hogarth@clsgroup.org.uk www.clsgroup.org.uk CLS Care Services Limited 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) Mrs Joy Louise Hogarth Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability over 65 years of age (8) of places Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Within the maximum numbers registered there can be up to 40 OP, and up to 8 PD(E) The service should at all times employ a suitably qualified and experienced Manager who is registered by the CSCI. 11th March 2008 Date of last inspection Brief Description of the Service: Greenacres Care Home (part of the CLS Group) offers care for 40 older people. It is situated in a residential area, close to Standish town centre and other local amenities such as a supermarket, shops, restaurant, pubs and community services. Public transport runs close by. Greenacres is a purpose built two-storey home that offers all single rooms of which four have en suite facilities. There are communal areas, bedrooms, and bathrooms on both floors. Outside garden space with suitable seating is available at the front of the home. Car parking at Greenacres is limited, but street parking is permissible. The current scale of fees for the home is from £312.42 to £380.00 per week. Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. This inspection included a site visit and was unannounced and conducted over 5½ hours on one day. The homes manager was available to assist with the inspection. Part of the time was spent in office looking at information the home holds on residents (care plans) and other information the home needs to keep to ensure the home is being properly run. During the day the inspector had a tour of the premises, met residents and staff and visitors. To find out more about the home we sent comment cards to residents, staff and visitors. Six residents returned comment cards, one said, “Personally I don’t think you can improve this service”, another said, I am settled here, the home is well run and I am happy.” Staff comment cards indicated that staff were happy working at the home, that staff had regular supervision, and are well supported by the manager. Prior to the last inspection of 11 March 2008 the home was sent an Annual Quality Assurance Assessment (AQAA) to complete. This tells us what the home does well at, how they meet the National Minimum Standards (NMS) and in what areas they feel they could develop and improve. For this inspection we continued to use that this information. There had been no complaints made to the manager of the home and no complaints had been made to CSCI. What the service does well: There have been no staff changes in the last six years, so residents are looked after by people they know and can trust. Staff are well trained and show commitment towards giving good care to residents. The home makes sure that before staff start work they are properly checked to make sure they are suitable to care for people living at the home. Residents were very satisfied with the food and the choices offered. Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 6 The home was warm, clean and comfortable making it a pleasant place for people to live at. The home provides excellent information to prospective residents and their relatives. There is a warm and friendly atmosphere which is evident on entering the home. 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. The summary of this inspection report can be made available in other formats on request. Greenacres DS0000005736.V367866.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 DS0000005736.V367866.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): 1,2,3 and 4 were assessed. Standard 6 does not apply at Greenacres, as the home does not provide an intermediate care service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides residents are their supporters with up to date information about the home that helps them in making a decision about moving into the home and the services provided. A full pre admission assessment is carried out prior to admission to ensure the home can meet the needs of the individual. EVIDENCE: The home has a statement of purpose and a service users guide. This is available to all prospective residents and to residents already living at the home. The information is clear and concise and informs people of the services and facilities available such as, the homes approach to care, daily life and social activities, catering, housekeeping and laundry, personal finances and Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 9 possessions, how to make a complaint, the staffing structure within the home and the qualifications of the manager and staff. To accompany this information staff at the home had set up a web site, which has pictures and updates on events and activities in the home throughout the year. This can be viewed on www.greenacres-living.blogspot.com. The inspector looked at the web site during the inspection, and found it to be informative and that it gives an overall picture of what it is like living at Greenacres. There is also a small welcome card, which gives people a brief guide about the home. We selected three care plans to work with throughout the inspection; one file was of the last resident that had moved into the home. We checked to see if those three residents had been issued with a contract/terms and conditions and these were seen to be in place. There was evidence to show that prior to admission a full pre admission assessment had been carried out to ensure that the home and staff could meet the resident’s health, personal and social care needs. Assessments are carried out at the most convenient place for the prospective resident, either in their own home or at the hospital. The assessment format is a pre printed company assessment that covers the residents well being, all areas of risk including history of falls, mobility, continence, bathing, dressing, personal care, oral care, foot care, nutritional status, medication, likes and dislikes and general activities. There is additional space for the homes manager to add any comments regarding the assessment and her findings. The home has some residents with a dementia related illness and staff had undertaken training in this specialised area of care to ensure that they had an awareness of the different types of dementia and how they can meet the individual needs of those residents Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and care needs of the residents were well met and care plans provide clear guidance to staff in each area of the residents care needs, providing staff with the information they need when delivering care. Residents were treated with dignity and there right to privacy was upheld. EVIDENCE: We continued using the same three care plans. All contained comprehensive information relating to residents personal, social and health care needs. Each area of risk has a separate record. Supplementary information includes a personal care and weight record. Daily entries in care notes were completed and gave a good indication of the care provided and residents well being. The plans were easy to read, had been regularly reviewed and set out clear guidance for staff to take when providing care. For some residents at the home who need checking at night more frequently then others there is a Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 11 separate quick reference file. Staff recorded checks in the file, such as resident awake, needed assistance; this is then transferred to the main care notes. Feedback from some residents was very complementary about staff and the care provided. One resident described staff as “excellent” and they would do anything for you. The services of opticians, dentists, district nurses were accessed as required. Records of doctors visits, hospital appointments were maintained. Observation throughout the inspection showed that the personal care needs of the residents were being met. Attention to all residents was given to personal grooming, residents were seen to be clean and ladies had had their hair done and gentlemen were clean-shaven. Staff were seen knocking on bedroom and bathroom doors and waiting for a response before entering. Residents were asked by the manager if it was acceptable for the inspector to look in there rooms. Staff were heard speaking with residents in a friendly and respectful manner. It was evident that good relationships had been formed between the residents and staff. The care team leader gave out the morning medication round, although this was not observed it was given in an acceptable time. The manager and the inspector checked the medication for the three residents files we were working with. One resident was not prescribed any medication. All medication has been given to others as required and had been documented on the individuals MAR chart (drugs sheet). Currently there are eleven residents who have a locked medicines cabinet in their bedroom which contains some but not all of their tablets. Staff that administers medication had received the appropriate training. Two residents spoken with indicated that staff respected their privacy and dignity. During the inspection, staff were observed to treat residents with respect and consideration. Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s interests and links with visitors are encouraged; ensuring residents live as normal life as possible. Meals are good and the needs of the residents are well catered for with a balanced and varied selection of food provided. EVIDENCE: The home has three members of staff who oversee the activities, two members of staff were on duty were spoken with and were obviously enthusiastic about their role and worked hard to make sure there was a wide range of activities available. The activities are displayed on the notice board in the main corridor. Theme days are also arranged and staff had planned a Hawaiian extravaganza that was taking place the day after the inspection, this included decorating the lounge with garlands of flower and posters and offering a range of different foods. Trips out to the home are arranged either as a group activity or one to one. One member of staff was seen accompanying a resident to the local pub in the Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 13 afternoon. The home has a tucks shop facility were residents could purchase a range of goods and toiletries. There is also a range of games, arts and crafts and a small pool table. One resident is very good artist and his drawings and paintings are displayed around the home Residents and staff had become actively involved with the Eden initiative and one resident carefully tends to the tomato plants of which some are in his room and others in the upstairs small lounge. The home has a computer and any resident who wishes to try their IT skills will be assisted by staff. The home welcomes and encourages visitors to the home. There are no restrictions as to when people can visit just that consideration is taken into account with regard to mealtimes. One visitor was spoken with, who said she had only been to the home a couple of times but found everything to fine and raised no concerns. The manager and staff encourage and develop links with the local community and welcomes into the home visits from the local clergy some of whom were visiting the home on the day of the inspection. Menus are planned over a five weekly cycle; the menus were available for inspection. There are always alternatives to the planned meals and likes and dislikes are taken in to account. Any special diets required could be catered for. The home provides a flexible breakfast to allow residents to have a lie in should they wish. A range of hot and cold dishes is available including cereals, porridge, toast and preserves, a cooked breakfast is also offered and tea and coffee served. Lunch is the main meal of the day and residents were offered the choice of savoury minced meat, creamed potatoes and mixed vegetables or soup and corned beef or ham salad with potatoes, followed by dessert. A lighter afternoon tea is served, again with a good variety of alternatives readily available. Suppers are served before residents retire, with of snack offered and drink of their choice. Hot and cold drinks and snacks are available throughout the day. Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 14 Meals are served in the dining rooms on both floors or wherever the resident is most comfortable. The dining tables were nicely set with appropriately cutlery and condiments. Staff were available to assist those residents who needed help with their meal. The inspector spoke with some residents after lunch and all expressed their satisfaction of the quality and quantity of the food served. Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives, can have confidence that residents will be protected from abuse and have their rights to complain, protected by effective staff training and procedures. EVIDENCE: A complaints procedure exists and any records of complaints or concerns would be recorded. There has been no complaints made to the manager of the home and no complaints have been forwarded to CSCI. The complaints procedure is displayed in the home and in the service users guide. There have been no safeguarding issues reported by the home since the last inspection. The manager confirmed that staff had received up to date training in the protection of vulnerable adults. Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,24 and 26 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Greenacres is maintained to a good standard making it a homely, comfortable, clean and pleasant home for residents to live in. EVIDENCE: On arriving at the home residents and visitors are greeting with an array of colour. Someone has been very inventive and using large tanker wheels painted white and has filled them full of plants. There is also a pleasant seating area with table and chairs for residents to sit outside. From a tour of the premises, it was evident that the home has a rolling programme of maintenance. It was noted that the corridor carpet although clean was heavily stained and was looking ‘shabby’, also the carpet in the link Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 17 way to the extension (was the smoking area) is badly burned and must be replaced. The large windows on the staircases would benefit for some blinds or curtains. The windows overlooked the grounds of the property next door with an eyesore of a building that needs some attention. With the permission from residents several bedrooms were looked at and were found to warm, clean and comfortable. Most of the rooms had been personalised with residents own belongings brought with them from home. Systems were in place to control the risk of cross infection. Staff were see wearing different protective clothing when carrying out different tasks. Staff are only allowed in the kitchen area when dressed appropriately with an white coat. The laundry is sited away from food preparation and food storage areas and does not intrude on the residents. The home was clean and free from any offensive odours. Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28, 29 and 30 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be sure that their needs can be met by good staffing levels and with a competent, committed, experienced and well-trained staff team. EVIDENCE: On the day of the inspection there were sufficient numbers of staff on duty to meet the assessed needs of the residents. There are two waking staff on duty throughout the night. The manager should regularly review the number of night staff on duty to ensure that any changes to the resident’s well being is accounted for. On this occasion we did not look at staff files as these were looked at during the last inspection in March 2008 and were found to be completed and up to date and all Criminal Records Bureau checks in place. The manager confirmed that there had been no new staff recruited at the home within the last six years. This is an excellent record for staff staying at the home and their commitment to the home and to the residents living there who are cared for by people they know and can trust. Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 19 From the inspectors’ observations, staff morale appeared to be good and the staff seemed genuinely happy to be working at the home. One member of staff said, “ we are a good staff team, we all work well together”. Staff were well trained with 90 of staff having achieved NVQ level 2 in care or above. Mandatory training is updated as and when required. Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Greenacres is well run by a well-qualified, suitably experienced and competent manager. Residents can be sure their best interests will be the central focus, with a positive and inclusive approach to making the service better. EVIDENCE: The homes manager has a significant number of years experience in working with elderly people and is qualified to NVQ level 4 and also has the Registered Managers Award. Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 21 The manager is committed to her own training as that of her staff team and sees this as an essential element to delivering good quality care for residents. It was evident that from the way in which the manager spoke with residents and with their responses that the manager knew them. Residents spoke favourably about the manager and if the way she ran the home. The way in which the home is managed, and run is open and transparent. The manager operates an ‘open door’ policy so that she may be approached at any time by staff, residents or their families. The office is well organised and the manager is supported by an experienced home services manager. Staff have access to all the paperwork and contact information they need during a shift. Systems are in place for monitoring the service these include satisfaction questionnaires, residents and staff meetings, internal auditing and visits from senior management who under regulation must visit the home monthly and complete a written report. These reports were available for inspection. Policies and procedures have been developed that are based on providing good quality care and accommodation. These are reviewed regularly and revised when appropriate. Some residents have handed over small amounts of money to the manager for safekeeping. We checked some of the monies held and these were found to be in good order and balanced with the record sheets. Records kept and required by regulation were seen to be in good order and up to date, all records were securely stored. Equipment and systems used in the home are serviced and maintained and records kept. Health and safety policies and procedures were in place. Staff had undertaken health and safety training. Accident, incidents and injuries were well documented and CSCI are notified as required. With the pre inspection material (AQAA) the manager provided a list of maintenance and associated records. A number were checked on site such as the lift, hoist, PAT (portable appliances) fire detection systems, electric and gas. Certificates were seen and were valid. Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x 3 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 4 x 3 x 3 x x 3 Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 23 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. 1. 2 Refer to Standard OP19 Good Practice Recommendations The windows on the stairwells would benefit from some blinds or curtains to block out the unsightly building in the grounds next to the home. The carpet on the corridor on the ground floor is heavily stained and needs to be replaced. The carpet on the link to the extension is badly burned with cigarette ends and must be replaced. (Since the inspection the manager has informed CSCI that this work has been completed) OP23 Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Greenacres DS0000005736.V367866.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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