Inspection on 10/09/07 for Greenacres Care Home

This inspection was carried out on 10th September 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 Care Home 21/08/06

Greenacres Care Home 17/10/05

Greenacres Care Home 07/07/05

Greenacres Care Home 21/02/05

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

CARE HOMES FOR OLDER PEOPLE Greenacres Care Home 17-19 Grimsby Road Caistor Lincolnshire LN7 6QY Lead Inspector Doug Tunmore Key Unannounced Inspection 10th September 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 Care Home DS0000053788.V346211.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 Care Home DS0000053788.V346211.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenacres Care Home Address 17-19 Grimsby Road Caistor Lincolnshire LN7 6QY 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) 01472 851989 Mr Terence Alan Shepherdson Mrs Catherine Laverick Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Greenacres Care Home DS0000053788.V346211.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st August 2006 Brief Description of the Service: Greenacres is a care home which provides personal care to persons over the age of 65 years. It is situated at the top of a hill within the small town of Caistor. Local facilities include shops, library, church, chapel and public houses. The registered owner/manager provides transport at no extra charge for residents wishing to access these facilities. The home stands in its own gardens, with parking available at the front of the building. Communal and bedroom (eight single and one double) accommodation is provided on the ground floor. There are separate lounge, large reception area and dining room. Greenacres is a family run business. The previous owners currently occupy the floor of the building, whilst they await the completion of a new bungalow in the grounds of the home. The homes service users guide states that we encourage clients to remain independent as possible; the care staff will support a client to enable them to achieve this. The fees at the inspection visit on the 11/09/2007 ranged from £348:00 to £394:00 each week. Extras are for hairdressing which range from £3:50 upwards, chiropody £11:00, toiletries, personal newspapers and magazines. The provider also makes a charge of £6:00 per hour for escorting residents to hospital. Information about the home can be obtained from the manager of the home. The service user’s guide and the homes terms of condition relating to the stay of residents at this home is given to residents prior to admission. Greenacres Care Home DS0000053788.V346211.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took into account any previous information held by the Commission for Social Care Inspection (commission) including the homes previous inspection reports and their service history. The homes Annual Assurance Assessment, form hereafter in this report referred to as AQAA, was also sent to the home by the commission prior to this inspection. The Commission also sent residents survey forms (Have Your say) to the home and three were returned. The site inspection consisted of case tracking a sample of two residents records and assessing their care. The inspector spoke with two of the people who were being case tracked and one other resident. The inspector also spent time with the provider the manager, a carer and one visitor. At the time of this visit there were eight people in residence. A partial tour of the home and a review of a sample of the records were also included. What the service does well: What has improved since the last inspection? The provider commented that he has addressed all those requirements made in the last inspection. Care plans and risk assessments have been updated and staff have had training in completing care plans. The home now has a activities co-ordinator who works four hours a week. The provider has employed two cooks since the last inspection. The provider has undertaken a basic food hygiene course due to working in the kitchen. Greenacres Care Home DS0000053788.V346211.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Greenacres Care Home DS0000053788.V346211.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 Care Home DS0000053788.V346211.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): Standards 1, 2, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are admitted into the home only after a full needs assessment has been carried out, either by the home and/or health care or social care agencies, so as to ensure that their assessed needs can be met. EVIDENCE: A review of all information available prior to this inspection including previous inspection reports dated August 06 and evidence seen at this inspection in residents files showed that the home does not admit residents without a care needs assessment being undertaken. The provider has developed the preadmission care needs assessments to enable prospective resident to be a part of this process. Greenacres Care Home DS0000053788.V346211.R01.S.doc Version 5.2 Page 9 Prospective residents are written to by the home confirming that they can meet the residents care needs or not. Three residents’ surveys confirmed that they had information about the home prior to admission and the same number also agreed that they had received a contract. The providers AQAA confirms that a comprehensive information pack is sent out to prospective residents including a brochure of the home to enable them to make a choice. Pre-admission visits are encouraged to enable prospective residents to make an informed choice of where they wish to live. The AQAA also confirms that there is a new care needs assessment form, which means that we are better able to meet their needs. The files of those residents who were being case tracked were seen and contained a contract setting out the terms and condition of their stay. The provider does not undertake intermediate care. Greenacres Care Home DS0000053788.V346211.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): Standards 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. The health and welfare needs of people living in the home are fully met. Medication is safely administered. Care plans do not address the intimate care needs of residents or their wishes regarding their privacy and dignity. EVIDENCE: A previous visit undertaken in August 06 found that resident’s files were being updated and showed that residents or relatives had signed their care plans. Admission assessments and monthly reviews were seen and had also been signed by residents agreeing the care given by the home. This visit evidenced that care plans have developed and reflects most of the care needs of residents. Greenacres Care Home DS0000053788.V346211.R01.S.doc Version 5.2 Page 11 We looked at care plans which did not established the intimate care needs of residents and what help they require when bathing or toileting or how their privacy and dignity can be maintained. There must be a discussion with individual residents to establish their individual needs. The manager confirmed that this would be addressed with all residents and carers and implemented as soon as possible. The care plans of those residents who were being case tracked showed that GPs, community nurses and chiropodists visit the home on a regular basis to attend to the health care needs of residents. The questionnaires returned by residents confirmed that they always receive the medical support that they need. The pharmacist visited the home in 2006 and recorded that storage, stock control, a medication review and a spot check of records is carried out appropriately. The Staff are to have further medication training in October 07. Medication was examined and it was found that an accurate record is kept of all medication given to residents on the day of this visit. Three residents stated that they do not self medicate. Two of the tree residents confirmed that they were involved with their care plan and had signed it. They also commented that ‘its very nice here, the staff are friendly and they all look after us very well’. Greenacres Care Home DS0000053788.V346211.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): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and staff make relatives and friends of residents welcome in this home. A range of activities are made available to residents which they have a choice to participate or not. Choices of meals are made available at this home, which are discussed with residents. EVIDENCE: Three residents questionnaires showed that activities are available always. One resident commented that there are activities available and that she likes bingo. She also stated that the vicar visits and gets to know people in the home. Other comments received were that the activities are very well done. A visitor commented that her mother does not join in activities but she is always asked if she wants to. We viewed the activities book and found that, flower arranging, painting by numbers, seasonal card making and cooking takes place. Entertainers also visit the home. The provider confirmed that there is an activities organiser who works three to four hours a week. Those people who were being case tracked confirmed that their visitors are made welcome. Greenacres Care Home DS0000053788.V346211.R01.S.doc Version 5.2 Page 13 The visitor stated that she is always offered a cup of coffee or tea on arrival and that the staff are very friendly. The AQAA stated that we invite family and friends to join in all activities by displaying on a highly visual display in the main entrance all activities. We organise coffee mornings in order to maintain links with the local community. We also provide residents with transport into Caistor to visit friends. On previous visits the inspector joined residents for lunch and found the meal provided to be hot and delicious. During this visit residents confirmed that ‘the food is very good’, ‘meals are cooked well and we have something different every day’. Observations made at breakfast time by the inspector were that the provider offered a variety of choices to each resident. All three surveys confirmed that people always liked the meals. Greenacres Care Home DS0000053788.V346211.R01.S.doc Version 5.2 Page 14 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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies and procedures for addressing and monitoring complaints and concerns are in place and residents are aware of how to make a complaint. Residents feel safe and confident in approaching care staff regarding any concerns that they might have. EVIDENCE: The home has displayed the service users guide, which contains the homes complaint procedures in the entrance to the home. The home has a detailed complaints procedure. The homes AQAA evidenced that no complaints or vulnerable adults issues have taken place. Resident’s surveys recorded overwhelmingly that they were aware of how to make a complaint and knew who to speak to if they were unhappy. Other verbal comments were ‘ I have no complaints and they (the staff) are very kind, ‘I feel safe here as there is always somebody around’. ‘Not anybody is allowed to come into the home’. The manager commented that protecting vulnerable adults training was undertaken in 2006. A carer stated that if she became aware of an abusive situation she would report it to the manager or the commission. She also confirmed that she had not undertaken protecting vulnerable adults training but was aware of the provider’s policy on whistle blowing. Greenacres Care Home DS0000053788.V346211.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in clean, well-decorated, homely and safe accommodation. Any maintenance is promptly addressed. EVIDENCE: A previous visit undertaken in August 06 and this inspection showed that improvements to the homes fabric both internal and external are continually undertaken. A partial tour of the environment found that the home was decorated to a reasonable standard. The home in the last eighteen months has installed a new kitchen with stainless steel work tops/ovens. The providers AQAA state that, we ensure that all residents live within a safe environment. Monthly risk assessments are carried out and any risks are documented in care plans. We have rolling maintenance programme and have installed a new bathroom suite with an adapted toilet. We have recently built a rockery and a fish pond. Greenacres Care Home DS0000053788.V346211.R01.S.doc Version 5.2 Page 16 We looked at peoples files which contained adequate risk assessments with a tick box formula and written notes for care workers to be guided by. The home does not employ a cleaner and carers carryout the domestic duties in the home. A visitor stated that the home is always clean and tidy when she visits and she has not detected any unpleasant odours. All those people seen stated that they were happy with their rooms, which they confirmed are cleaned regularly. They also said that they have personalised their rooms with photographs, televisions and ornaments. The residents survey overwhelming confirmed that the home always smells nice and is clean and is kept tidy. Greenacres Care Home DS0000053788.V346211.R01.S.doc Version 5.2 Page 17 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): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is staffed with carers who were experienced, competent and educated to care for older people. Residents are protected by robust recruitment practices. EVIDENCE: The provider’s AQAA states that, we have not employed new staff in the last twelve months. We also have 100 of staff who have a nationally recognised qualification in caring for elderly people. We also have a thorough recruitment policy and maintain appropriate staffing levels. All carers are encouraged to undertake ongoing training. Previous visits have found that that appropriate checks have been undertaken with prospective carers to ensure the safety of residents. The provider confirmed that all carers are given The General Social Care Council Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults. The homes training plan was seen and found to be up to date. The training record identified those workers who had undertaken statutory training in 2007. A carer stated that she has a qualification in caring for the elderly and is going on to gain further qualifications. She also confirmed that she has undertaken Greenacres Care Home DS0000053788.V346211.R01.S.doc Version 5.2 Page 18 fire training, infection control, first aid and is to attend a moving and handling course in October 07. The homes rota was seen and it was found to be an accurate record is kept. Adequate staffing levels are maintained to meet the needs of residents. There is one waking night staff and one sleeping night worker, who is on call. Daytime staff consist of two carers a manager, cook and the provider. On the day of the inspection staff were observed carrying out their duties in a sensitive and caring manner. The provider and carers were also seen to have a very good relationship with residents with friendly banter being exchanged. Surveys also evidenced that people feel that they get the care and support they need. Residents commented that ‘staff are cheerful and pleasant’, they answer the buzzer quickly as they don’t have far to come’. ‘I think its reasonably good, I choose to come here and I have made the right choice’. Greenacres Care Home DS0000053788.V346211.R01.S.doc Version 5.2 Page 19 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): Standards 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 was well lead by a competent and committed manager. This had resulted in a confident, supported and trained staff team. Records show that residents’ health and general welfare and safety are promoted. The home ensures that the residents have the opportunity to voice their views and opinions. EVIDENCE: The registered manager is qualified and experienced in running this home for ten older people and has successfully completed the registered managers award. She has NVQ (National Vocational Qualifications) 2 & 3 and is completing NVQ level 4. The provider visits the home on a daily basis. Greenacres Care Home DS0000053788.V346211.R01.S.doc Version 5.2 Page 20 Residents and a carer commented that the owner and the manager is very nice and are approachable and supportive’. The home conducts a quality assurance (QA) report. The quality assurance report is posted for the information of residents and visitors, as is the homes last inspection report. The homes internal audit was seen at the last visit and showed that five residents and two relatives had completed the questionnaires, which were very positive in respect to the care provided to residents. The provider confirmed that he is to undertake a wider audit in the future to cover all aspects of the running of the home. The provider was reminded that he should have the minutes of the residents meeting and any audit undertaken available in the home to help inform any inspection that takes place. The provider confirmed that a new computer is to be installed in which this information can be kept. The provider said that he does not deal with resident’s personal allowances. However, payments are made by the home for hairdressing or chiropody, which is then reimbursed by relatives. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. The AQAA evidenced that fire alarm, fire drills and emergency lighting checks have been undertaken. Care staff also receive fire training as part of the homes initial training and as a regular training event. The providers AQAA also evidenced that maintenance and service histories of all aids and adaptations are carried out as required by law. Greenacres Care Home DS0000053788.V346211.R01.S.doc Version 5.2 Page 21 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 3 3 3 X 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 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 Care Home DS0000053788.V346211.R01.S.doc Version 5.2 Page 22 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. 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 Care Home DS0000053788.V346211.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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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