Inspection on 22/08/06 for Greenacres Care Home

This inspection was carried out on 22nd 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 15/08/07

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 Julie Western Unannounced Inspection 22nd August 2006 09:00 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.V308731.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.V308731.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 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 Mrs Angela Walker 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.V308731.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 8th December 2005 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 a former 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. On the day of the inspection the home was accommodating 27 residents. The home provides four day-care places, one of which was being used on a regular basis. All bedrooms are single apart from 2 double bedrooms. There are ensuite 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. There is a small car park area to the side of the home close to the entrance. Greenacres Care Home DS0000063741.V308731.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, was carried out over three hours and took into account any previous information held by CSCI including the home’s previous inspection reports, its service history and residents’ questionnaires sent to the home by the Commission prior to the inspection. The site inspection consisted of case tracking a sample of residents’ records and assessing their care. Some policies and procedures were examined and some records concerning the safety of the home were also seen. Three residents, two care and ancillary staff and two visitors were spoken with. The Manager was present throughout the inspection. What the service does well: What has improved since the last inspection? The rolling maintenance programme continues, with the redecoration of bedrooms as they became vacant. A new patio has been developed and there is a new fence and gate to the side of the garden to enable more privacy for residents. The courtyard gardens have been levelled and the mature trees taken out to provide more light in residents’ rooms. On the day of the inspection a new pump for the boiler and thermostatic valves for wash hand basins in residents’ rooms were being installed. Service user guides are now in each bedroom and care plans contain a brief past history for each resident. Greenacres Care Home DS0000063741.V308731.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 DS0000063741.V308731.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.V308731.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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home clearly sets out what it intends to do for its residents and this information is freely available to residents. A comprehensive initial assessment ensures that the needs of residents can be met. Prospective residents are encouraged to take time before making the decision to move into the home on a permanent basis. EVIDENCE: The statement of purpose was examined and was clear and comprehensive. A copy of the service user guide was kept in each room. It was recommended that some thought was given to making the service user guide easier to understand for residents. The Manager said that prospective residents were offered one month’s trial on both sides. The day care facility gave residents the opportunity to experience the home before permanent placement and one resident described how she had been to the home for respite care before being admitted on a permanent basis. Greenacres Care Home DS0000063741.V308731.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home’s records give a clear indication of the needs of residents and enable staff to meet their needs with sensitivity and regard for their privacy and dignity. EVIDENCE: The three care plans looked at in depth contained concise but clear assessments, including risk assessments. Other information was kept in a separate folder in a locked cabinet. There was a clear medication policy and the most recent visit from the pharmacist was 2/02/06, from which there were no concerns recorded. The Manager confirmed that only trained staff administered medication. Residents said they felt safe and well looked after; one said ‘The staff couldn’t do enough for you’. The staff team were observed carrying out their duties with patience and sensitivity towards the residents, especially when attending to their personal needs. A visiting district nurse said that the standard of care at the home compared very well with other homes in the area; the carers were knowledgeable and always available to discuss her patients. She was quite impressed with the standard of hygiene in particular. Greenacres Care Home DS0000063741.V308731.R01.S.doc Version 5.2 Page 10 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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Social activities are extensive and create a variety of events and activities which residents are informed about. The residents exercise choice about which activities, if any, they wish to participate in and what meals they want to eat. EVIDENCE: The Manager said that one of the senior carers was responsible for arranging activities and events, which were advertised on the doors of the home. The home has an eight-seat ‘people-carrier’, which is used to take residents out on weekly trips to Boston market, Lincoln or to local shops and garden centres. Regular activities included craftwork, music, reminiscence therapy board games, floor dominoes and Bingo. The home also received visits from outside clothing retailers, entertainers including slide shows, black and white films and country and western singing. The home has a newsletter advertising future events; the aim is for residents to contribute to it. A resident described the recent garden party and the Manager said that future events included a buffet evening to which relatives and friends were invited. The midday meal was balanced, nutritious and easy for older people to eat, with a use of fresh fruit and vegetables. Menus were balanced and showed a choice and a variety of meals; the day’s menu was displayed in the entrance hall and in the lounge. Bowls of fresh fruit were in the lounges. Residents all Greenacres Care Home DS0000063741.V308731.R01.S.doc Version 5.2 Page 11 said they enjoyed the meals and the buffets and evening trolleys were praised in particular. They said they were frequently asked for their input to the menu. Greenacres Care Home DS0000063741.V308731.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home’s complaints procedure is clear and gives residents and their relatives the confidence that comments and concerns will be listened to; there is a robust adult protection procedure EVIDENCE: Residents and visitors to the home all said they did not wish to complain but knew how to make a complaint. The home had received no complaints in the last twelve months. There was a clear adult protection procedure, which was linked to the Local Authority procedures. All staff members spoken with had received training on adult abuse through the NVQ training and were knowledgeable about complaints. All residents were on the electoral register and exercised their rights to vote if they wished. Greenacres Care Home DS0000063741.V308731.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The residents live in a comfortable and pleasant environment with both private and communal space, which is generally suitable for their needs. EVIDENCE: There are adaptations such as raised toilet seats, grab rails and corridor rails and a call system is installed throughout the home. The home has a rolling maintenance rota and risk assessments are carried out on the premises to ensure that residents are safe from any potential hazards. Since the last inspection a new patio has been created and there is a new fence and gate to the side of the garden to enable more privacy for residents. The courtyard gardens have been levelled and the mature trees taken out to provide more light in residents’ rooms. On the day of the inspection a new pump for the boiler and thermostatic valves for wash hand basins in residents’ rooms were being installed. Overall, the standard of decoration was good and afforded residents a great degree of comfort. The gardens and grounds were wellGreenacres Care Home DS0000063741.V308731.R01.S.doc Version 5.2 Page 14 maintained and contained summerhouses and places for residents to sit out in good weather. One resident disliked the gravel drive because it was noisy at night and staff members said it was hard to push wheelchairs on it. The Manager said that there were plans to resurface the drive eventually. The door to the bathroom in room 19 could not be locked. Greenacres Care Home DS0000063741.V308731.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to the service. Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff members are suitably trained, qualified and competent. EVIDENCE: The staff rota showed that there were enough staff numbers according to the staffing matrix and shifts were arranged to accommodate the needs of residents; staff and residents spoken with confirmed that there were enough staff members on duty to complete their tasks. There were currently no full time vacancies. The most recent staff member to be appointed said she had given two references, which were followed up, had a CRB check and had undertaken an induction programme before commencing work. The induction format was not available. Training records showed that four carers had achieved the National Vocational Qualification, a professional award, at Level 2 , with a further six working towards it and two had achieved it at Level 4 with one working towards it. One staff member was also working towards the Assessors award. The training plan showed an ongoing programme of training, which was held by external trainers. Future planned training included health and safety, handling aggression and dementia awareness. Greenacres Care Home DS0000063741.V308731.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home is managed competently and the staff are supported and supervised in carrying out their respective roles. The views of residents are listened to and they are involved in decisions affecting them. EVIDENCE: The registered Manager is an RGN, has completed the NVQ Manager’s award at Level 4 and has the Assessors Award. She has had 36 years’ experience in caring and has managed this home for the past 18 years. Residents spoken with said they were constantly asked for their views on matters concerning the running of the home and there were questionnaires which had been completed by residents or their relatives. Residents’ finances were controlled by the Manager and audited by the owner. The majority of the policies and procedures have been updated. Greenacres Care Home DS0000063741.V308731.R01.S.doc Version 5.2 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 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 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Greenacres Care Home DS0000063741.V308731.R01.S.doc Version 5.2 Page 18 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. 1 2 Refer to Standard OP1 OP19 Good Practice Recommendations It is a recommendation that some consideration is given to developing a service user guide that is easier for the residents to read. It is a recommendation that the home considers resurfacing the pebble drive with a surface that is easy for wheelchair users to use. Greenacres Care Home DS0000063741.V308731.R01.S.doc Version 5.2 Page 19 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 DS0000063741.V308731.R01.S.doc Version 5.2 Page 20 - 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. 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