Inspection on 15/08/07 for Greenacres Care Home

This inspection was carried out on 15th August 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 22/08/06

Greenacres Care Home 08/12/05

Greenacres Care Home 09/08/05

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

CARE HOMES FOR OLDER PEOPLE Greenacres Care Home Greenacres Care Home Ltd 71 Cameron Street Heckington Lincolnshire NG34 9RP Lead Inspector David Bacon Key Unannounced Inspection 15th August 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 DS0000063741.V344632.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 DS0000063741.V344632.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenacres Care Home Address Greenacres Care Home Ltd 71 Cameron Street Heckington Lincolnshire NG34 9RP 01529 460935 01529 469162 greenacres_carehome@hotmail.com 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) Greenacres Care Home Ltd Post vacant Care Home 28 Category(ies) of Dementia - over 65 years of age (11), Mental registration, with number disorder, excluding learning disability or of places dementia (1), Old age, not falling within any other category (28) Greenacres Care Home DS0000063741.V344632.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories:Old age, not falling within any other category (OP) (28) Dementia - over 65 years of age (DE[E] (11) Mental disorder, excluding learning disability or dementia (MD) (1) The category MD applies to one named person aged over 58 years who is named in the notice of proposal to register dated 21st November 2003. Date of last inspection 22nd August 2006 Brief Description of the Service: Greenacres Care Home is privately owned and managed and is situated in the village of Heckington, with access to local amenities, which include shops, a hairdresser, GP practice and dental surgery. A mobile library visits the home. The home is a detached house in the centre of the village, near to the church and has been adapted and extended from formally being domestic premises to provide the present accommodation. The first floor is used for storage and office accommodation. The home provides personal care for up to 28 people over 65 years, some with a Dementia and one being a named person under 65 years and with a defined mental health need. The home provides four day-care places. All bedrooms are single apart from 2 double bedrooms. There are en-suite facilities in 6 bedrooms. There is an enclosed courtyard and a large garden to the rear of the home, which includes an orchard, gazebo, garden chairs, trees, shrubs and a large lawn. A small car parking area is located to the side of the home close to the entrance. Copies of inspection reports are maintained in the entrance to the home for service users and members of the public. The range of fees is from £440 to £510 per week. Greenacres Care Home DS0000063741.V344632.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place during August 2007 and the visit to the home was undertaken over approximately 4 hours. The care received by three service users was looked at in detail. This process is called “case tracking” and individual service users care records and general home records were looked at as part of this along with discussions with service users about their experience of life within the home. The inspector spoke with five service users, four staff members, the acting manager and registered provider. Two quality satisfaction questionnaires completed by service users and their representatives were received prior to the visit and seventeen of the homes own recently completed surveys were viewed. Notifications received were also viewed as part of the overall information gathering regarding the service. A partial tour of the premises was conducted including areas relating to the service users who were case tracked. Service users care records and staff records were inspected along with policies/procedures and administrative systems. Since the previous inspection new acting management arrangements are in place. It is noted that staff have worked hard to maintain standards of care for service users and to learn administrative procedures to maintain the smooth operation of the home. What the service does well: What has improved since the last inspection? The staff members spoken with said that they felt that the staff were working more consistently together as a team to provide better standards of care to service users. The kitchen has been refurbished and now provides adequate catering facilities. Greenacres Care Home DS0000063741.V344632.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 DS0000063741.V344632.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 DS0000063741.V344632.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, 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some systems are in place for the introduction of service users to the home although service users care needs are not clearly assessed and they are not fully involved in this process. EVIDENCE: A statement of purpose and service user guide have been produced although the statement of purpose did not include the current management arrangements of the home. A copy of the service users guide is maintained in each bedroom. The care records viewed evidenced that a basic assessment of each service users care needs had been undertaken, which identified some general risks although individuals detailed needs and general preferences were not fully identified. For example, one service users care plan noted that they were prone to wandering and aggressive behaviour although this was not recorded Greenacres Care Home DS0000063741.V344632.R01.S.doc Version 5.2 Page 9 within the assessment information. Another service users notes stated, “uses stick, has fallen” although instructions for staff to minimise risks were inadequate. Discussions held with service users confirmed that they were satisfied with the homes admission arrangements. Comments included: “They helped me settle, they were very good with me, I’ve no complaints”. “I was poorly when I arrived but they did a grand job in helping me settle, with everything”. “It is not easy to remember but the carers were and are marvellous”. Service users were not fully aware if they had been involved in the assessment process, which was further evidenced in the records seen. Greenacres Care Home DS0000063741.V344632.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, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users feel that care staff treat them respectfully and they are satisfied with the care provided although care records overall only provide staff with limited information about service users care needs. Appropriate procedures are in place for the administration of medication. EVIDENCE: The service users spoken with said that staff were caring and respectful and that staff promoted their privacy and dignity. Service users also confirmed that their care needs were adequately met. Comments included: “I am happy with how they look after me, treat me, they are very good”. “I’ve no complaints about the care here, you don’t know what to expect but they do treat you very well”. “Yes, they are respectful, they help you but you have your say”. “I am impressed with the carers, they are all kind and helpful”. Comments seen in the satisfaction surveys completed by service users indicated that service users/representatives were satisfied overall with the care Greenacres Care Home DS0000063741.V344632.R01.S.doc Version 5.2 Page 11 provided. Staff were observed talking with service users and delivering care in a friendly and respectful manner. The information within the care records seen was brief overall and did not provide staff with sufficient information about service users care needs. Service users or their representatives (where appropriate) had not all been consulted with or involved in the devising of their individual plan and regular reviews of each plan were not undertaken. Care records did not fully identify all specific health needs of service users or how these were met by supporting health agencies. For example, one service user had received community support regarding their mental health although there were no instructions or guidance for staff recorded in their care plan. Service users care records were updated each day although these did not provide a real insight as to their overall wellbeing or the care provided. For example, the records of one service user concentrated on their wellbeing during the night although no special needs had been assessed regarding this. It is acknowledged that senior staff were keen to improve the homes care recording systems. The homes medication system was appropriately maintained with records documenting medicines as received, as administered and as disposed. Staff whom administer medicines have recently received updated awareness training regarding this subject matter. Greenacres Care Home DS0000063741.V344632.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, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users can choose how they spend their time although their recreational needs are not fully provided for. They enjoy the meals provided overall although their views regarding meals are not fully sought. EVIDENCE: Service users said that they were able spend their time as they liked, that there were no restrictions regarding this and that their visitors were made welcome. Service users were not aware of regular activities taking place within the home and comments received regarding activities included: “The recent fayre was very good, good fun”. “There’s not much to keep mentally alert”. “I’m not aware of any activities”. “We do sit a lot but there’s music and television”. A record of any activities undertaken is maintained for each service user although these were not regularly updated. Senior staff agreed to address this. The home cook confirmed that service users dietary needs were ascertained upon arrival but that records of these were not maintained. The service users care records seen only briefly identified individuals dietary needs and preferences. A four-week rolling menu is in place and a record of meal and Greenacres Care Home DS0000063741.V344632.R01.S.doc Version 5.2 Page 13 equipment temperature records is maintained. Service users comments regarding meals included: “The food is very good, I’ve no complaints”. “It couldn’t be improved upon”. It’s tasty, I’m certainly satisfied with it”. “I’m not sure of a choice but if you don’t like something then they do make you something different”. “I usually enjoy my meals”. No suggestions were made. Cooked breakfasts are not currently made available although the acting manager said that this would be addressed and it is recommended that the cook regularly communicates with service users to further ascertain their views regarding the provision of meals. Greenacres Care Home DS0000063741.V344632.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): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel able to comment or complain about the care they receive and staff are made aware of the systems in place to protect service users from abuse. EVIDENCE: Records show that there have been no complaints or safeguarding adult’s referrals since the last inspection visit. The service users spoken with said that they felt able to express their views regarding the care provided and that any comments would be appropriately acted upon, which was further confirmed in the quality satisfaction surveys seen. Comments included: “I enjoy it here and have no complaints”. “Yes, I could go to the staff with any problems, they are approachable”. “If I complained then I think they would deal with it”. Information detailing how to complain about the services provided is located in each bedroom. The pre inspection information received identified that policies and procedures were in place to safeguard service users and information regarding these is displayed in the home and provided to service users. The staff members spoken with explained the correct action to be taken in the event of an issue of abuse being suspected but could not fully recall being made aware of formal policies and procedures regarding this subject matter. Greenacres Care Home DS0000063741.V344632.R01.S.doc Version 5.2 Page 15 The acting manager agreed to address this along with providing formal safeguarding adults training. Greenacres Care Home DS0000063741.V344632.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, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users benefit from a hygienic, comfortable and well-maintained environment with the organisation ensuring the safety of each area of the home. EVIDENCE: The environment was clean, tidy and well maintained throughout all the areas seen. The manager said that a rolling programme of maintenance and decoration was in place, which was evidenced throughout. The service users spoken with were satisfied with the cleanliness of the home and comments seen in the homes completed satisfaction questionnaires further confirmed this. Comments included: “The cleanliness couldn’t be improved upon”. “My room is kept nice and clean, there’s no problem”. “The staff clean and its nice and homely”. Greenacres Care Home DS0000063741.V344632.R01.S.doc Version 5.2 Page 17 Service users are supported to personalise their own rooms. Call bells were within easy reach of beds and seating in the bedrooms. The pre inspection information received identified that new walling and paving has been laid to create a safer external environment for service users and that the fire system has been renewed. Greenacres Care Home DS0000063741.V344632.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, 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 being staffed to meet the current needs of residents. Recruitment procedures and some staff training is in place although improvements are needed with these. EVIDENCE: The service users spoken with confirmed that there were adequate numbers of staff and that their care needs were met, which was further evidenced during the visit. Comments included: “You can rely on them, they are a great support”. “You just ask for help or they will come to you before you ask”. “You may wait a short time, sometimes but not too long”. The records viewed evidenced that recruitment checks had been undertaken prior to staff commencing work at the home. The checks included criminal record bureau checks, obtaining professional references and staff completing application forms. However, only one reference had been received for one staff member recently recruited. Records detailed where newly appointed staff had received a basic formal induction, which was further confirmed by the staff members spoken with who also confirmed they received adequate training to undertake their roles. Greenacres Care Home DS0000063741.V344632.R01.S.doc Version 5.2 Page 19 The pre inspection information received identified that at least 50 of staff have undertaken nationally recognised awareness training and the staff members spoken with that they received training specific to the needs of service users although the overall training programme had not recently been reviewed in the aim of more fully meeting the needs of service users. Greenacres Care Home DS0000063741.V344632.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, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to ensure that care is provided in a safe and appropriate manner although a registered manager must be in place. Service users are supported to express their views regarding the care they receive. EVIDENCE: The areas viewed during the visit were well maintained of which records are kept and a risk assessment of the premises had been undertaken, which was updated as necessary. The service users spoken with confirmed that they were satisfied with the management of the home, the care provided and that they felt able to express Greenacres Care Home DS0000063741.V344632.R01.S.doc Version 5.2 Page 21 their views and that these would be acted upon. Quality satisfaction questionnaires are sent to service users once each year, which are assessed and acted upon. Service users comments included: “I have no desire to live anywhere else”. “I’m happy here”. “I could talk with any of them, they are approachable”. The staff members spoken with said they received good management support and that their views were respected. However, there is no registered manager in post to oversee the smooth and effective operation of the home and confirmation is now required that this matter is being addressed. Policies and procedures are in place to protect service users where the home has any involvement in their finances. Monies are kept separate and receipts and records of transactions and totals are maintained. Fire safety tests were appropriately maintained and the home staff receive regular awareness training. The home recently received a visit from the fire safety officer of which the report was satisfactory. Safety tests had been undertaken regarding legionellosis and risk assessments were in place regarding this. Water temperatures were regularly checked. Substances identified as being potentially hazardous to health are stored appropriately, and there are information sheets and risk assessments in place providing guidance for staff. Greenacres Care Home DS0000063741.V344632.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 2 X 2 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 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 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Greenacres Care Home DS0000063741.V344632.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4 Requirement A statement of purpose must be in place to provide service users with detailed information about the services provided. An assessment of each service users care needs must be undertaken to ensure service users care needs can be adequately met. A comprehensive care plan must be completed for each service user, which clearly identifies each care need met. Service users must be involved in the plan, where possible. Service users recreational needs must be provided for. References must be obtained for all staff prior to commencing work at the home. Confirmation is required of the training plan being put in place, including abuse awareness. Confirmation is required of the action being taken to appoint a manager for the home. Timescale for action 15/09/07 2 OP3 14 (1) 15/09/07 3 OP7 15 (1) 15/09/07 4 5 6 7 OP12 OP29 OP30 OP31 16 (m) Schedule 2 (5) 18 8 15/09/07 15/09/07 15/09/07 15/09/07 Greenacres Care Home DS0000063741.V344632.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP15 Good Practice Recommendations It is recommended that cooked breakfasts are made available and that service users are involved in the planning of meals. Greenacres Care Home DS0000063741.V344632.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Care Home DS0000063741.V344632.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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