Inspection on 09/08/05 for Greenacres Care Home

This inspection was carried out on 9th August 2005.

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 22/08/06

Greenacres Care Home 08/12/05

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

CARE HOMES FOR OLDER PEOPLE Greenacres Care Home 71 Cameron Street Heckington Lincolnshire NG34 9LP Lead Inspector Julie Western Unannounced 9 August 2005 09.30 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 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 C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Greenacres Care Home Address 71 Cameron Street Heckington Lincolnshire NG34 9LP 01529 460935 01529 469162 Telephone number Fax number Email 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 (DE(E)) - 11 registration, with number Mental Disorder (MD) - 1 of places Old Age (OP) - 28 Greenacres Care Home C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 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 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 of whom have a Dementia and one of whom is a named person aged 59 years. On the day of the inspection the home was fuly occupied. The home is also registered for up to six day care places; this facility was not inspected. All bedrooms are single apart from 2 double bedrooms. There are en-suite facilities in 6 bedrooms. There is an enclosed courtyard and a 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 C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 4 hours. A partial tour of the building took place and care records were inspected. The main method of inspection used was called ‘case-tracking’; this involved selecting three residents and tracking the care they received through the checking of their records, discussions with residents and care staff and observation of practices. Some policies and procedures were examined and records concerning the safety of the home were also seen. Four of the 28 residents and five of the 28 care and ancillary staff were spoken with. The Manager, the assistant Manager and the owners of the home were present throughout the inspection What the service does well: What has improved since the last inspection? The rolling maintenance programme is in progress, with the exterior paintwork being renewed on the day of the inspection and the installation of new curtains and hand-rails in some corridors. The new owners have bought an eight-seat ‘people-carrier’ for the use of residents. They have also commenced the installation of a new IT system in the office. The Manager of the home now has the responsibility for weekly ordering and purchasing of foodstuffs. Greenacres Care Home C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 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 C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Greenacres Care Home C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 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 standard(s) 1-5 The home clearly sets out what it intends to do for its residents and this information is freely available to residents. 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 comprehensive but needed updating. The owner said that the service user guide was also going to be updated and revised. 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 a visitor whose mother was using the day care facility said that her mother enjoyed being in contact with other residents and it gave them both a chance to experience life in the home. Greenacres Care Home C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 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 standard(s) 7,9-11 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, containing risk assessments. There was a clear medication policy and the most recent visit from the pharmacist was 10/3/05, 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 ‘It’s the best home in the area and the staff here are really very kind’. 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 was good and the carers were knowledgeable. The Manager said that either she herself or the Assistant Manager were present when a resident was dying. Greenacres Care Home C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 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 standard(s) 12-15 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 new owners have recently purchased 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. Activities in the home included craftwork, music, board games which included reminiscence therapy games and Bingo. The home also received visits from outside clothing retailers, entertainers including slide shows, black and white films and country/Irish dancing. The home would benefit from a newsletter advertising future events and to which residents could provide poems, stories, recipes etc. The midday meal was balanced, nutritious and easy for older people to eat, with a use of fresh fruit and vegetables. The menu was balanced and showed a choice and a variety of meals. Residents all 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 C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 16-18 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. Solicitors were actively involved with the affairs of at least four residents and one resident who had no relatives had regular visits from advocates arranged by the home and Social Services. Greenacres Care Home C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 Page 12 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 standard(s) 19,23,24,26 The residents live in a comfortable and pleasant environment with both private and communal space, which is generally suitable for their needs. EVIDENCE: 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. One resident said ‘I’m comfortable and safe here’. Recent renovation included hand rails and curtains to some of the corridors and on the day of the inspection the exterior paintwork was being renewed. The Manager said that the next rooms to be redecorated were the dining room and office. Overall the standard of decoration was good and afforded residents a great degree of comfort. The gardens were particularly well maintained with hanging baskets on the building; the grounds were extensive and had summerhouses and places for residents to sit out in good weather. Greenacres Care Home C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,30 Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff members are suitably trained, qualified and competent; they undergo an induction programme before commencing their duties EVIDENCE: The residents were very positive about the care they received from the staff. One said ‘they’re all kind and nothing is too much trouble for them’. The most recent staff member to be appointed confirmed that she had given two references, which were followed up, a CRB check and undertaken an induction programme before commencing work. Training records showed that statutory training was completed with recent specialist training being in safe handling of medicines and infection control. One staff member had National Vocational Qualification at Level 2 with five currently undertaking it. One domestic staff member was undertaking NVQ Level 2 in housekeeping. The assistant Manager was undertaking NVQ training at Level 4 and the Assessor’s Award. The owner said that a full staff meeting was due to be held and the Manager said that informal meetings were often held. The staff rota showed that there were enough staff numbers according to the staffing matrix and shifts were staggered to accommodate the needs of residents. Greenacres Care Home C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 Page 14 Training records showed that statutory training was being undertaken, with the most recent training being First Aid and the next being training in the safe handling of medication. Greenacres Care Home C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,37 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 is currently working towards the Assessors Award. She has had 34 years’ experience in caring and has managed this home for the past 15 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. The policies and procedures were in the process of being updated; this standard will be viewed at the next inspection. Greenacres Care Home C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x 3 3 x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 x x 2 2 x Greenacres Care Home C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 Page 17 None 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[1][2] Requirement The registered person must update the statement of purpose and residents guide to reflect the new ownership information. The registered person must ensure that care staff receive formal superision at least 6 times a year. The registered person must review all policies and procedures and ensure that they are up to date and accessible to staff. Timescale for action 4th October 2005 4th October 2005 4th October 2005 2. OP36 18[2] 3. OP37 17 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 OP14 Good Practice Recommendations It is a recommendation that the home develops a newsletter advertising future events and activities and to which residents could provide poems, stories, recipes etc. Greenacres Care Home C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection Unity House, The Point Weaver 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 C53 C04 S63741 Greenacres V243306 090805 Stage 4.doc Version 1.40 Page 19 - 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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