Inspection on 21/08/06 for Greenacres Care Home

This inspection was carried out on 21st August 2006.

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 10/09/07

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 Mr Doug Tunmore Unannounced Inspection 21st August 2006 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 Care Home DS0000053788.V308728.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.V308728.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.V308728.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th October 2005 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 current scale of charges at this home is from £335.00 to £379.00. Greenacres Care Home DS0000053788.V308728.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 Commission for Social Care Inspection (CSCI) including the homes previous inspection reports, their service history, the homes preinspection questionnaire and residents questionnaires sent to the home by the Commission prior to this inspection. The site inspection consisted of case tracking a sample of two resident’s records and assessing their care. The inspector spoke with one of the residents who was being case tracked and joined two other residents for lunch. The inspector also spent time with the proprietor, the manager and one member of staff. The community nurse was also seen during this inspection. A partial tour of the home and a review of a sample of the records was also included. What the service does well: What has improved since the last inspection? The provider stated that since the last inspection he has introduced new employment policies, which ensure that the correct procedures are undertaken when appointing new care staff. The kitchen has been modernised with stainless steel workbenches and new cookers. The provider has addressed those requirements made in the last inspection. Greenacres Care Home DS0000053788.V308728.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. Greenacres Care Home DS0000053788.V308728.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.V308728.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 & 6 The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The home does not produce comprehensive care admission assessments, which assures that residents needs will be met. EVIDENCE: A review of all information available prior to this inspection including previous inspection reports dated 07/07/05 and 17/10/05 and evidence seen at this inspection in residents files showed that the home does not admit residents without a care needs assessment being undertaken. However, the homes preadmission care needs assessments do not demonstrate that the homes care assessor has opened any discussion with prospective residents regarding their needs or wishes regarding the care that they feel they require. Prospective residents are written to by the home confirming that they can meet the residents care needs or not. The Commission sent resident’s questionnaire forms to the home prior to this inspection and five were Greenacres Care Home DS0000053788.V308728.R01.S.doc Version 5.2 Page 9 returned, all questionnaires confirmed that residents had information about the home prior to admission and the same number also agreed that they had received a contract. One resident said that she was not aware that her care needs had been assessed but stated that she had spent time in the home prior to her last admission. A sample of a contract was sent to the commission and the two residents who were being case tracked had a contract in their files setting out the terms and condition of their stay. Greenacres Care Home DS0000053788.V308728.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans that are in place do not provide information to enable residents to develop their lifestyles as they may wish. EVIDENCE: A previous inspection undertaken on the 17/10/05 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. Care plans also 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 showed that all five felt that they always receive the medical support that they need. A community nurse commented that staff are competent and friendly and will ask if they don’t know how to undertake a medical procedure. Greenacres Care Home DS0000053788.V308728.R01.S.doc Version 5.2 Page 11 This inspection found that; care plans had limited information available regarding resident’s likes and dislikes. This area of care planning is centred around food preferences and not those aspects of residents daily living requirements or residents expectations. Residents need to be engaged in a discussion about the care they require if an holistic care package is to be delivered. Individual care plans evidenced that accidents are recorded in the homes’ accident book, daily notes and body maps. The provider has kept the commission informed in writing about accidents to residents, which was found to correspond with the homes service history kept by the commission. Resident’s questionnaires showed that five felt that they received the support that they need and four said that staff listened to them and acted on what they said. One resident wrote that staff only sometimes listen to her. This commented was drawn to the provider’s attention. Four residents commented that they felt that staff are always available when they need them and one felt that staff are usually available when she needs them. One resident commented in the questionnaire that ‘I am very happy with the care’ another wrote that the care received is excellent and I cannot wish to be anywhere else’. A resident stated that ‘staff are very nice and knock on my door before entering’. The commission has received copies of written accolades concerning the home from relatives voicing praise for the services provided. Samples of these are as follows; ‘thank you all for the tender loving care you gave to my mum’. another wrote ‘its been appreciated love from all the family’. The pharmacist inspected the home in July 06 and recorded four minor issues were action was required. The provider confirmed that action was taken on the day of the inspection. The homes training plan indicated that updating on medication training for staff had been undertaken on the 20/06/06. Greenacres Care Home DS0000053788.V308728.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 &15 The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The experience of resident’s lifestyle in the home does not always meet their expectations in regard to activities and outings. EVIDENCE: Five residents questionnaires showed that three felt that activities are available always and two residents commented that activities are usually available. The commission has received prior to this inspection the minutes of residents meetings and the homes activity list and planned events for July 06. Activities include bingo and dominoes. The hairdresser visits the home on Thursdays and Fridays. Arrangements have been made for a clothes and underwear party, shoe and jewellery party and entertainment at least monthly. The range of activities listed appears to be limited and unimaginative and greater efforts should be made to address the issue of offering other stimulating activities other than what has been mentioned above. Neither the minutes of the residents meetings nor the activities list has mentioned residents going on any type of outing. However, in July 06 the home has held a coffee morning, a barbecue for residents, families and staff. Greenacres Care Home DS0000053788.V308728.R01.S.doc Version 5.2 Page 13 One resident stated that she doesn’t do her exercises any more and would like some exercises to keep mobile due to breaking her hip. She also confirmed that the vicar comes to the home monthly but that she has not been on any outings. Further comments related to her son who visits regularly and is made welcome with cups of tea or coffee. The inspector joined two residents for lunch and found the meal provided to be hot and delicious. A resident said that she looks forward to meal times, especially Fridays when they have fish and chips. One resident questionnaire commented that the home has an ‘excellent cook’. All resident’s questionnaires evidenced that they always liked the meals. Greenacres Care Home DS0000053788.V308728.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe environment in which residents are protected from abuse. EVIDENCE: Previous inspections undertaken at this home has found that the home displays the service users guide, which contains the homes complaint procedures in the main entrance. The home has a detailed complaints procedure and the preinspection questionnaire received from the home showed that no complaints have been made in the last twelve months. Care workers seen at previous inspections were aware of the homes ‘Whistle Blowing’ policy and spoke knowledgeably about abusive practices and what action they would take if this came to their attention. All staff received adult protection training in 2006. Residents said that ‘I have no complaints and I feel safe here with lovely walks in the grounds’. A new member of staff confirmed what action she would take if abuse of a resident came to her attention and that was to ‘inform the provider and manager immediately’. Greenacres Care Home DS0000053788.V308728.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well maintained and is clean and tidy, with a pleasant smell throughout. Risk assessments need to be explicit as to the risk and action to be taken regarding the safety of residents. EVIDENCE: A previous inspection undertaken in October 2005 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 has since the last inspection installed a new kitchen with stainless steel work tops/ovens. Resident’s files did not contain adequate risk assessments, they were limited to a tick box formula without written notes for care workers to be guided by. The home needs to carry out further risks assessments on those residents who Greenacres Care Home DS0000053788.V308728.R01.S.doc Version 5.2 Page 16 have a history of falls detailing action to be taken by care workers to ensure a safe environment. The home employs one cleaner who works eighteen hours in three days each week. The community nurse stated that the home is always clean and tidy when she visits and she has not detected any unpleasant odours. A resident commented that ‘the Hoover never stops’. The residents survey overwhelming confirmed that the home always smells nice and is clean and tidy. Greenacres Care Home DS0000053788.V308728.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. The home maintains appropriate staffing levels and has a robust recruitment and training practices. EVIDENCE: Information received by the commission and files seen during this inspection showed that; two carers personnel files had appropriate checks made to ensure the safety of residents. One carer confirmed that she had Criminal Bureau Checks and had supplied two references to the home before starting work. The provider stated that since the last inspection the home now keeps a record of all interviews with prospective carers. The carer also said that she had been 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 2006. The care manager has NVQ (National Vocational Qualifications) 2 & 3 and is awaiting her registered managers award. Six care workers have NVQ level 2 & six other carers are currently undertaking NVQ training. One carer stated that she had undertaken; fire procedures, manual handling, first aid and health and safety training. She also confirmed that she is undertaking NVQ training level Greenacres Care Home DS0000053788.V308728.R01.S.doc Version 5.2 Page 18 2. This home now meets the standard for the number of care staff trained to NVQ level 2. The carer was able to demonstrate a clear understanding of her role and responsibilities. The homes rota was seen and it was found to be an accurate record and showed that 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. During the day of the inspection staff were observed carrying out their duties in a sensitive and caring manner. The visiting community nurse stated that residents always seem happy and care workers are attentive to their needs. The residents said that ‘we are well looked after here’. Greenacres Care Home DS0000053788.V308728.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in a manner that promotes residents health and safety needs. Records are well maintained with policies and procedures regularly updated. EVIDENCE: The registered manager is qualified and experienced in running this home for ten older people and has successfully completed the registered managers award. The provider visits the home on a daily basis and has a hands on presence at the home. Greenacres Care Home DS0000053788.V308728.R01.S.doc Version 5.2 Page 20 A resident commented that the ‘staff are very good here and the manager is very nice and very approachable’. The home conducts a quality assurance (QA) report. The quality assurance report is posted for the information of residents and visitors, as is the last Commission for Social Care Inspection report. The homes internal audit was seen 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 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. One resident stated that she deals with her own finances. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. The homes pre-inspection questionnaire 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 homes pre-inspection questionnaire has evidenced that maintenance and service histories of all aids and adaptations are carried out as required by law. Greenacres Care Home DS0000053788.V308728.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 x 3 2 x x x 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 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.V308728.R01.S.doc Version 5.2 Page 22 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. 1. OP3 Standard Regulation 14(a) Requirement Timescale for action 25/10/06 2. OP7 15 3. OP19 13(4) The manager must ensure that a full pre-admission care assessment is undertaken for all service users who are supported in being actively engaged in their assessment. The manager must undertake a 25/10/06 comprehensive and in depth care plan, which is developed with residents and reflects their care needs and aspirations. The provider must ensure that 25/10/06 all risks to residents are identified and that risk assessments are in place for the information of care staff and the safety of residents. 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 OP12 Good Practice Recommendations The provider should show that there has been consultation DS0000053788.V308728.R01.S.doc Version 5.2 Page 23 Greenacres Care Home with residents regarding social stimulation and community involvement including outings for residents. Greenacres Care Home DS0000053788.V308728.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Greenacres Care Home DS0000053788.V308728.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!