Inspection on 21/04/08 for Greenauns

This inspection was carried out on 21st April 2008.

CSCI found this care home to be providing an Adequate service.

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

Greenauns 12/06/07

Greenauns 01/06/06

Greenauns 08/03/06

Greenauns 27/09/05

Greenauns 29/11/04

Greenauns 13/07/04

Greenauns 09/03/04

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

CARE HOMES FOR OLDER PEOPLE Greenauns 81 Fountain Road Edgbaston Birmingham West Midlands B17 8NP Lead Inspector Ann Farrell Key Unannounced Inspection 21st April 2008 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 Greenauns DS0000016770.V362484.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. Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenauns Address 81 Fountain Road Edgbaston Birmingham West Midlands B17 8NP 0121 420 3361 0121 420 3361 greenaunscarehome@yahoo.co.uk 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) Mrs Mary Loftus Mr James Patrick Loftus Mrs Mary Loftus Care Home 8 Category(ies) of Old age, not falling within any other category registration, with number (8) of places Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The home is registered for 8 service users requiring care and accommodation for reasons of old age. The home may accommodate one named service user who at the time of admission was under 65 years of age. The home may accommodate two named service users who have dementia until such time that their needs are no longer met at the home. No other service users suffering with dementia will be admitted to the home. 12th June 2007 Date of last inspection Brief Description of the Service: Greenauns is a small family run home for eight older people situated in a residential area of Edgbaston. The home is a five- minute walk from the main Hagley Road, from which one can travel into Birmingham by bus in one direction. In the other direction one can travel to Kidderminster and access the M5 motorway. The home is registered to care for older people who are frail and require 24hour care, excluding people in need of care for reasons of dementia, learning disability and other categories. It provides a homely environment with consistent carers who know the residents well. There are two double bedrooms and four single rooms decorated in individual style and with people’s personal belongings evident. All of the bedrooms have an en-suite facility consisting of toilet and wash hand basin. A lounge/dining area is situated on the ground floor that leads on to a small conservatory, which overlooks the garden. The garden is flat, has a patio plus table and chairs where residents can sit when the weather permits. A bathroom is situated on the ground floor that has an assisted bathing facility, but there is limited space. A stair lift gives access to the first floor and grab rails are available in toilets to provide assistance to residents with mobility problems. The home is generally well maintained with off street parking for two cars to the front of the property. Staff have developed a welcome pack, which provides information about the services and facilities for people who are considering moving into the home. However, it needs further development, as it does not include information Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 5 about the range of fees and the arrangements for any additional costs to the fees. Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is one star. This means that the people who use this service experience adequate quality outcomes. The focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that needs further development. The fieldwork visit to the home was undertaken over one day and a senior member of staff was available and assisted throughout. There were 4 people living at the home on the day of the visit. Information was gathered from speaking to and observing people who lived at the home. Two people were “case tracked” and this involves discovering their experiences of living at the home by meeting or observing them, looking at medication and care files and reviewing areas of the home relevant to these people, in order to focus on outcomes. Case tracking helps us to understand the experiences of people who use the service. Staff files, training records and health and safety files were also reviewed. Prior to the inspection the Registered Manager had completed an Annual Quality Assurance Assessment (AQAA) and returned it to us. This gave us some information about the home, staff and people who live there, improvements and plans for further improvements, which was taken into consideration. What the service does well: The home continues to provide care to the residents in a homely environment in a family setting. People who live in the home stated that they were happy with the food provided. One resident stated, “ I have put on weight since of have been here”. People who live in the home were happy living there and stated, “They look after us well”. There had been no changes in staff since previous inspections. They know the people living in the home well, so providing good continuity of care for them. People stated, “Staff do a good job, all of them.” Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 7 Visiting is flexible enabling relatives to visit at any time to suit themselves, so people who live in the home can maintain links with family and friends. . Written feedback was seen from relatives and a social worker. All praised the home and standard of care provided. One stated, “It was like a home from home for Gran. The décor, atmosphere, smell of a fresh brew and even the old western showing on the TV”. The care plans, which outline the support people who live in the home require were of a good standard and personalised to individuals. Regular comprehensive reviews are undertaken, so ensuring their needs are monitored and changes made where necessary. Staff liaise with health care professionals, so ensuring peoples health care needs are met appropriately. There was evidence of pressure relieving equipment in place so reducing the risk of pressure sores and demonstrating liaison with the district nurse team. The management of medication was of a good standard ensuring people who live in the home receive the medication prescribed. Concerns/complaints are taken seriously and acted upon. This demonstrates people who live in the home are listened to, concerns are addressed and learning is achieved, so there are no further re-occurrences. The proprietors have a computer, which helps in developing records, care plans etc. so ensuring they are more accessible and auditable. There is a range of games, CD’s and DVD’s for indoor activities and this is constantly being added to, so providing stimulation for residents. The arrangements for the servicing and maintenance of equipment has been undertaken in a timely manner ensuring people who live in the home, visitors and staff are protected. What has improved since the last inspection? Staff are now undertaking risk assessments in respect of tissue viability, and taking advise, so reducing the risk of pressure sores developing. All residents have been consulted about having a lock on their bedroom door so enhancing arrangements for privacy. It was stated that any new residents to the home would also be consulted on admission. Two members of staff have completed the Registered Managers Award; providing them with the knowledge and skills to meet residents needs. It was Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 8 also stated that one member of staff had just commenced NVQ level 4 in care also. Some new items of furniture, re-decoration and an audit of linen, pillows etc had been undertaken and replaced where necessary, so enhancing the environment for people who live in the home. It was stated the aim was to achieve a familiar yet retro look, for example, many of the pictures are 1960’s originals. People who live in the home had been consulted and involved in making decisions about the décor etc. The bottom end of the garden has been made safe, so reducing the risk of accidents. Although there have not been any new people moving into the home in the last twelve months staff have the appropriate systems and records in place for anyone wishing to move in to ensure appropriate assessments are completed and their needs are met upon moving in to the home. What they could do better: Staff should undertake nutritional risk assessments for all people living in the home, so that it can be identified if any one is at risk and appropriate advice or interventions actioned. Some improvements in recording details in files is required, to demonstrate appropriate follow up and action taken. Some re-organisation of documents and files is required to enable easier retrieval of information. The statement of purpose and service user guide could be enhanced so providing more comprehensive up to date information about the services and facilities, so enabling people to make an informed choice about moving into the home. Senior staff have acknowledged that they are considering alternative formats for information to make it more accessible to people living or visiting the home. There are plans to further enhance the music and film collection and the garden for use in the summer. Further improvements in the activities outside the home would provide more variety and stimulation for people living in the home. It was stated that there has been an interest in using the Internet for shopping by people in the home Suitable bathing facilities are required on both floors to enhance privacy and accessibility for people with mobility problems. The garden paving slabs are to be replaced when the weather improves. The information provided by the Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 9 home also indicates they are looking to provide decking, furniture, sculptures etc to enhance the area for people living in the home. All staff must undertake updated core training in respect of fire prevention, basic food hygiene, infection control, moving and handling plus first aid to ensure they have the appropriate skills and knowledge to care for residents. Staff also need to undertake training in respect of the Mental Capacity Act, which has recently come into force, to ensure staff are fully aware how to support people who lack capacity. The quality assurance system needs further development in order to achieve continuous improvement for people who live in the home. 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. Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 10 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 Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 11 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): 1,3,6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information about the home is being further developed to enable people to make an informed decision about moving into the home. There is a stable group in the home, with no new people moving in since the last inspection. Suitable arrangements are in place for assessing people’s needs prior to moving into the home. EVIDENCE: The home admits people for long-term care or respite care only. Since the last inspection a welcome pack has been developed, which is available in the home and provides information about the services and facilities available. This enables people to make an informed choice about moving into the home. However, it does not include information about the range of fees, and the arrangements for any extra costs not included in the fees. Staff are still in the process of developing the statement of purpose, which outlines the range of needs that the home can cater for. They have stated in the information that Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 12 they are considering providing the information in alternative formats to ensure it is accessible to anyone wishing to move into the home. No new people have been admitted to the home since the last inspection. On discussion with a senior member of staff a satisfactory admission process was outlined that included an initial visit to the home, pre admission assessment, discussion with other residents and staff to determine if the placement was suitable and their needs could be met. Following admission to the home a trial period of one month is also available. A pre admission assessment form was available and it was recommended that they may wish to consider obtaining a copy of the Social Workers assessment, so that they have a good range of information so they can determine if they can meet peoples needs before they move into the home. The senior member of staff discussed the possibility of admitting people with dementia and it was explained that they would need to consider the primary needs of the person on admission. If the primary needs were that of an older person they would have to determine if they could meet their needs through assessment. However, if the primary needs were of dementia they would need to apply to us to change their category of registration. They would also have to demonstrate appropriate staff training and knowledge and the statement of purpose would have to clearly state the range of needs being met. Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 13 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 good. This judgement has been made using available evidence including a visit to this service. Care plans were of a good standard reflecting the current care needs of people living at the home. Health and personal care needs were well managed. The management of medication was good ensuring people receive their medication as prescribed. EVIDENCE: Each person had a written care plan. This is an individualised plan about what the person is able to do independently and states what assistance is required from staff in order for the person’s needs to be met. Two care plans were looked at in detail and they were found to include good detail about a number of areas of need e.g. mobility, exercises, assistance required etc. However, some areas were not in such details such as diet and health conditions. The care plans also included risk assessments in respect of manual handling, tissue viability and eating with good detail as to how to manage/reduce the risk, so that people were not in danger. Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 14 The care plans are reviewed on a monthly basis and the information was comprehensive. There was evidence that the person living in the home or their relative had been included in the discussion and on discussion with people living in the home they were aware of the records being kept. They stated, “ All the staff do a good job- they look after us well”. People living in the home were weighed on a regular basis, so that there welfare was monitored. It was noted that one person had slowly been loosing weight over a number of months and there was no nutritional risk assessment in place. The person had been prescribed minimal nutritional supplements and records of food indicated that milky drinks were being given to improve calorie intake. Also records stated that the diet had been discussed with the district nurse, but it was not clear if the nurse had been made aware of the persons weight loss. Care must be taken to ensure records clearly indicate all areas discussed and aspects of care to demonstrate interventions. It was also recommended that a full diary of all food and drinks be recorded for a week and further discussion is held with health professionals. All people were registered with a local GP who visits the home and there was evidence of people receiving visits from external healthcare professionals such as district nurse, optician and chiropodist. The services of the dentist had been discussed with one person, but there was no evidence of health professionals visits on the second file. It was stated that there were private arrangements in place. The member of staff was advised that these visits should also be recorded in order to ensure that health care was being satisfactorily maintained. Staff encourage people who live in the home to maintain their independence and mobility, so they maintain their abilities and promote well being. People appeared to be well supported by staff to choose clothing appropriate for the time of year which reflected individual cultural, gender and personal preferences. They were observed to be given choices and on discussion with some they stated they could do as they wished. The homes medication system consisted of a blister and box system with printed Medication Administration Record (MAR) sheets being supplied by the dispensing pharmacist on a monthly basis. The home had copies of the original prescription (FP10’s) for repeat medication, so they were able to check the prescribed medication against the MAR chart when it entered the home. On inspection of the medication for the current month it was found to be of a good standard and all audits were correct ensuring residents receive the medication prescribed to them appropriately. The dispensing pharmacist also undertook regular audits and records indicated they were excellent. The home has a hands free telephone and it was stated that people living in the home could use it wherever they wished, so ensuring their privacy. There was screening available in shared bedrooms and all bedrooms had en-suite Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 15 facilities consisting of a toilet and wash hand basin, so enhancing the arrangements for privacy. Since the last inspection people who live in the home have been consulted about lockable facilities and locks to doors and their wishes have been followed. The member of staff stated that when any new people moving into the home will be given the choice of having locks on bedroom doors and lockable facilities if they wish. Staff were seen to spend time with people living in the home and interacted well. Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 16 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 good. This judgement has been made using available evidence including a visit to this service. People are able to choose the activities that they participate in which promotes their individuality and independence. People are offered a choice of meals to meet their dietary, cultural needs or preferences. EVIDENCE: There was no evidence of any restrictions and people were free to come and go as they wished with assistance from staff. It was observed that they were given choices and they stated they could get up when they wanted, go to bed when they wished and had a choice of meals etc. Written comments from relatives also confirmed this. Visiting was flexible enabling relatives and friends to visit at a time that suited them, so contact can be maintained with family and friends and this was confirmed on discussion with people living in the home. People are able to bring personal items of furnishings etc. into the home so providing a home from home atmosphere. They are also consulted about aspects of redecoration and refurbishment enabling them to have control over their environment. Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 17 There was evidence that one person went out to the shops with a member of staff. On the day of inspection people were sitting in the lounge watching television, films and chatting to the staff. There were a range of games, DVD’s, videos and CD’s available to play. One person stated they really enjoyed the quiz programmes on the television. At the last inspection staff had developed a reminiscence corner in the lounge with a range of books etc. This had been abandoned, as the people living in the home were not interested in it. Staff were developing the DVD and CD collection instead as they enjoyed films and music. Records indicated that special days such as Christmas, birthdays, Easter and St Patrick’s Day had been celebrated in house. Formal residents meetings are not held due to the small number of people living in the home and the informal atmosphere. However, there is regular dialogue with them and they are consulted about various aspects of the home. There were no set menus for meals so enabling more flexibility. Staff retain a record of food taken by people living in the home and were observed to offer people a choice of meal and drinks. On discussion with people who live in the home they stated the food was good and one person stated “I was underweight when I came here and I have put weight on now”. A member of staff is a qualified hairdresser and was seen to be attending to a person’s hair, so enhancing self esteem. Religious ministers visit the home so that people can continue with their religious beliefs if they choose to. Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 18 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 adequate. This judgement has been made using available evidence including a visit to this service. The complaints procedure is comprehensive and all concerns are taken seriously, ensuring people who live in the home are listened to. Staff require training in respect of safeguarding and the Mental Capacity Act to ensure all people who live in the home are safe. EVIDENCE: A large print complaints procedure was on display in the dining room advising of the procedure to be followed. We have not received any complaints about the home. Staff had recorded seven areas of concern that had been raised by people living there. The records indicated that action had been taken to address the concerns. People in the home stated they were happy and felt safe. One person stated “If I had any problems I would tell the man in charge and it would be sorted out”. Another stated, “I would tell them if there was anything I wanted”. There was an adult protection policy and a copy of the Local Multi Agency Guidelines, so that staff have guidelines to follow in the event of an allegation of abuse. Two of the five staff working in the home had received training in this area. The procedure was discussed with two members of staff, but one was unable to demonstrate a satisfactory knowledge of the procedure. The senior member of staff who assisted with the inspection stated that training Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 19 was in the process of being arranged for all staff to ensure they have knowledge of the procedures. Staff will also require training in respect of the Mental Capacity Act, so they have the appropriate knowledge to ensure all people who live in the home are safeguarded if they lack capacity. When the training has been completed a review of policies and procedures should be undertaken to ensure they all comply with the Mental Capacity Act. Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 20 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): 19,20,21,24,25,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The physical layout of the home was suitable for meeting the needs of people currently living in the home, as they have adequate mobility to move around the home. There have been a number of improvements, so enhancing the environment for people who live there. There were some adaptations in the home to assist in meeting needs. EVIDENCE: Greenauns is a detached three-storey building with off road parking for two cars to the front of the property in a quiet residential area. A CCTV camera is in place for the external perimeter of the home and also the landing area for added security reasons. Accommodation is provided for eight people over the ground and first floor. The second floor is used as a private flat for the owners. The home was generally well maintained, warm, odour free with a homely atmosphere Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 21 providing a home from home environment. On discussion with people living in the home they stated the home was always clean, warm and lit appropriately for them. Communal accommodation consists of a lounge/dining room and conservatory, which was homely and domestic in character. They had been redecorated and refurbished, so improving facilities for people who live in the home. There was one assisted bathing facility on the ground floor, which was available for use. However, it was rather small and although it had a bath seat it was only suitable for individuals with a fairly good degree of mobility. The bathroom on the first floor is still not available and it was stated that they hope to provide a new shower room to enhance bathing facilities. Corridors were narrow with grab rails to assist people with mobility problems. Access to the first floor is by a stair lift, which has one step at the top of the stairs that needs to be negotiated, therefore people who live in the home need to have a degree of mobility to assess the first floor. The most recent service indicated that a spring is required for the footrest. The home has four single bedrooms and two double bedrooms all with en-suite toilet and wash hand basin, but some were rather small necessitating people to have a degree of mobility. All bedrooms had a call bell system to enable assistance to be summoned when required and double rooms had curtains between beds to provide privacy. Some mattresses, linen and pillows had been replaced since the last inspection, so improving facilities for residents. Bedrooms are individually and naturally ventilated and windows are provided with restrainers for safety and security reasons. Radiators and the temperature of water from hot water taps were controlled to reduce the risk of scalding to people who live in the home. People can take their own belongings into home, so providing a more homely atmosphere and reflecting their individual tastes, gender and preferences. There is a domestic style kitchen, which had been upgraded, and a laundry area on the ground floor, which were adequate for the size of home. Fridge and freezer temperatures were recorded regularly, so ensuring affective kitchen hygiene procedures. There was a pleasant garden to the rear of the property with patio, table and chairs for use when the weather permits. Since the last inspection, the summerhouse and gated area at the bottom of the garden have been secured so reducing the risk of accidents. The paving slabs are to be replaced when the weather improves, as they are uneven and could pose a risk. Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 22 Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 23 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. A consistent staff group have been working in the home for a number of years and they are well aware of people’s needs. Some staff had undertaken training and arrangements had been made for training to be extended to all remaining staff to ensure they had the skills and knowledge to care for people living in the home. EVIDENCE: The duty rota indicated there were two staff on each shift during the day and one member of staff awake overnight plus a sleep in member of staff. The staff team consisted of four family members and a friend. All staff undertake a multi-task role including care, cooking, cleaning and laundry. The small number of staff improves areas such as consistency of care, it enables relationships to be built and staff have a good knowledge of people living in the home. There is a very stable staff group and no new staff have been employed in the home for a number of years. It was stated that recruitment documents were available if there was a need to recruit new staff. Criminal record bureau checks had been undertaken for all staff currently working in the home. There was no record of induction training as staff had worked in the home for a number of years. Two members of staff had undertaken a range of training Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 24 including the Registered Managers Award, nutrition, tissue viability and medication over the past two years. One of them had also completed the safer food better business training recently and cascaded the training down to other staff in the home to provide them with knowledge about good food hygiene practices, so ensuring safe handling and preparation of food. Training is required in other core areas such as manual handling, infection control, fire safety and safeguarding to ensure all staff have up to date knowledge and are able to meet peoples needs in a safe manner. The senior member of staff stated that training had been arranged in the coming year and also a training manual had been purchased to assist with developing in house staff training. Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 25 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 adequate. This judgement has been made using available evidence including a visit to this service. Staff continue to strive to make improvements in the best interests of the people who live at the home. The management of health and safety was of a good standard, so ensuring the safety of people who live in the home, staff and visitors. EVIDENCE: The manager was not available at the time of inspection. Their son, who has completed the Registered Managers Award, was available and assisted with the inspection. At the last inspection it was stated that he would take over as the manager. On discussion with him it was stated that he was now undertaking NVQ 4 in care and may apply for registration at a later date. Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 26 Staff are in the process of developing a quality assurance process and are drawing up a policy. There was evidence of letters from the past where relatives had made comments which included areas such as the patience of staff, good standards, that meal requests were met at a time that suited, there was a calm and friendly atmosphere and people were well cared for. Prior to the inspection an Annual Quality Assurance Assessment (AQAA) was completed by the staff and returned to us. This gave us some information about the home, staff and people who live there, improvements and plans for further improvements, which was taken into consideration. The inspector was informed that the home did not manage any monies on behalf of the residents. Health and safety maintenance checks had been undertaken in the home to ensure that the equipment was in safe and full working order. Maintenance checks were completed on the fire system and equipment, so that people are safe in the event of a fire occurring. Accident records were reviewed; no trends were identified and where an area of improvement was noted action was taken to address it. Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 27 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 N/A X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 2 2 3 2 X X 3 3 3 STAFFING Standard No Score 27 3 28 2 29 N/A 30 N/A MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X N/A X X 3 Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 28 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 OP18 Regulation 13(6) Requirement All staff must undertake training in respect of safeguarding to ensure they have the knowledge and skills to protect people living in the home. The paving slabs in the garden must be made safe to reduce any risks when the area is used. Suitable assisted bathing facilities must be provided on all floors where people live to enhance privacy. Timescale for action 30/07/08 2 3 OP19 OP21 23(2)(o) 13(4) 23(2)(n) 30/07/08 30/12/08 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 OP1 Good Practice Recommendations The statement of purpose and service user guide (welcome pack) must be up to date and include the arrangements for fees etc. This is to enable people visiting or wishing to move into the home to have accurate DS0000016770.V362484.R01.S.doc Version 5.2 Page 29 Greenauns 2 3 OP3 OP7 4 OP7 5 6 OP8 OP18 7 8 OP28 OP33 and up to date information about the services and facilities. It is recommended that staff request a copy of the social workers assessment for any new people moving into the home. All action required by staff to meet people’s needs should be compiled in one area of the care plan and they should be signed and dated to ensure the information is easy to access by all staff. Nutritional risk assessments should be undertaken on all people living in the home and reviewed on a regular basis. This will enable staff to identify people who are risk and take appropriate action to reduce the risk. A record should be kept of all health professionals’ visits or appointments in adequate detail, so that people’s health can be monitored and complications prevented. All staff should undertake training in respect of the Mental Capacity Act to ensure people living in the home are safeguarded. Once training has been completed policies and procedures should be reviewed to ensure they are in line with the legislation It is recommended that 50 of care staff complete a recognised care qualification so that people receive care from a knowledgeable and skilled workforce. The quality assurance process should be developed further to enable continuous improvement form feedback for the benefit of people who live in the home. Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Greenauns DS0000016770.V362484.R01.S.doc Version 5.2 Page 31 - 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!