Inspection on 04/05/05 for Greenaways Rest Home

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Greenaways Rest Home 15/05/07

Greenaways Rest Home 08/06/06

Greenaways Rest Home 04/10/05

Greenaways Rest Home 05/01/05

Greenaways Rest Home 17/08/04

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

CARE HOMES FOR OLDER PEOPLE Greenaways 56 Collington Avenue Bexhill on Sea East Sussex TN39 3RA Lead Inspector Andy Denness Unannounced 4 May 2005 13:00 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. Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Greenaways Address 56 Collington Avenue Bexhill on Sea East Sussex TN39 3RA 01424 210899 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) Mrs Jacqueline Brittain Mrs Jillian Lawrence Care Home (CRH) 12 Category(ies) of Dementia (DE) 12 registration, with number of places Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated is twelve (12) Date of last inspection 5 January 2005 Brief Description of the Service: Greenaways is a detached property situated approximately one mile from Bexhill town centre. Service user accomodation is provided on two floors; a stair lift is fitted to assist service users to access first floor rooms. The home shares a large pleasant rear garden with another care home next door owned by the same proprietors. Greenaways is registered to accommodate up to twelve older people with dementia. The registered provider is Mrs J Brittain. Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Inspection took place over an afternoon in May and lasted 4.25 hours. To help gather evidence on how the home is performing the Inspector with met staff and the home’s manager, examined a range of records and written information and undertook an inspection of the premises. Discussions took place with six service users and one relative who was visiting the home. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 Page 6 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 Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 Page 7 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) 3 & 5. Current pre-admission procedures are satisfactory and help ensure that service users are appropriately placed in a service that is suitable to meet their needs. EVIDENCE: Records examined confirmed that an assessment of service users’ needs is undertaken prior to their admission to the home; the quality of the written assessments was satisfactory. A relative spoken to during the inspection confirmed that they had visited the home and assess the service prior to their relative’s admission. Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 Page 8 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) 7,8 & 9. Current arrangements regarding the provision of identifying and meeting personal care needs is not satisfactory and results in some instances in needs not being met. Procedures and practice regarding medication were generally satisfactory. EVIDENCE: Records examined indicated a poor quality of the individual plans which provide guidance for staff on how to meet service users’ needs; the plan for one service user contained no mention of the fact that they wore dentures and therefore no guidance for staff on denture care; details of how personal care should be delivered was minimal, with for example no guidance regarding service users preferences when being bathed; another plan contained no guidance for staff on how to manage aggressive situations; in several instances care plans were not fully complete and in the instance of one recent respite service user no care plan had been compiled. Records of care delivered were poor and it was not possible to ascertain if the care identified in plans had been provided. One male service user had not been shaved for several days, records indicated that his shaver was broken; nothing had been done to replace this. At the last inspection a requirement was made regarding nutritional screening, this has not been done and dietary needs were not Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 Page 9 identified in at least one care plan. Medication storage and records were examined, these were generally in order however it has been required that written guidance is introduced for staff to follow regarding PRN or ‘when required’ medication should be dispensed. Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 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, 13 & 15. Although, because of their mental health needs, it was difficult to obtain views from all service users regarding daily life, social activities and meals, satisfactory standards were noted in this area. EVIDENCE: Observations made during the inspection indicated that service users are given choices in areas of their daily living and records examined confirmed the provision of some recreational activities for them. Visitors were seen to be made welcome. Menus examined indicated a varied and wholesome provision of food; this was confirmed in discussions with service users whose comments included “food is excellent” and “no complaints”. Service users were served with tea and homemade cakes during the Inspection, which they obviously enjoyed. Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 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 Procedures and practice ensure that complaints and adult protection matters are responded to appropriately by the home. EVIDENCE: A written complaints procedure is in place; records examined confirmed that complaints are responded to appropriately. Following a recent alleged incident, the registered provider showed that they follow correct procedures regarding adult protection matters. Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 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, 20, 21, 23, 24, 25 & 26 Physical standards in the home were generally satisfactory, with accommodation being provided in a small family type, safe environment. However current arrangements do not ensure a good standard of hygiene and cleanliness. EVIDENCE: An inspection of all areas of the home was undertaken. Service users have the use of a large lounge/dining room; this was decorated and furnished to a satisfactory standard in a domestic style. Bedrooms were furnished and decorated to a satisfactory standard, with many service users bringing their own furniture and belongings with them. Standards of hygiene were not good; in three bedrooms there was a strong unpleasant odour. The home has sufficient bathrooms and WCs to meet service users’ needs, however again these areas were untidy and dirty. The manager said that this was due to the lack of a cleaner on the day of the inspection. Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 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, 29 & 30. Current staffing arrangements are unsatisfactory and result in some instances to care needs not being met. EVIDENCE: On the day of the inspection only two care staff were on duty on the early shift and two on the late shift. These staff undertook all caring, cleaning and catering duties; one of the care staff on duty was the manager. Standards of cleanliness were poor and duties that should have been undertaken by the manager were not being completed properly. At the last inspection it was required that improvements were made to induction and foundation training, it was not possible to ascertain if this has yet happened as recruitment records were not kept on site. One member of staff said that they had not been trained in moving and handling matters and the manager said that 50 of staff are not yet trained to NVQ level 2 as is required. Recently because of poor practice regarding recruitment procedures a formal legal notice was served against the home requiring them to take immediate action to address problems in this area. A separate inspection of records since this inspection confirms that matters are now satisfactory. Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 Page 14 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, 37 & 38. The lack of time available to the manager to spend on her managerial responsibilities is having a detrimental effect on the standard of care provided for service users. EVIDENCE: It was evident from discussions with the manager, staff and service users that the manager is hard working and respected. However from records examined it was clear that as she is on shift every day as a carer, that she does not have sufficient time to spend on her management duties. This has resulted in particular in a poor standard in care planning and recording. The manager said that she has not yet started her required management-training course. A selection of health and safety records were examined these were in order. It was noted that food is currently being stored in the laundry, because of the risk of contamination it has been required that this practice ceases immediately. Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 Page 15 Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 x 1 STAFFING Standard No Score 27 1 28 x 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 1 x x x x x 2 1 Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 Page 17 Yes 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 7 Regulation 15 Requirement That improvements are made to the care planning system to ensure that; care plans are in place for all servcie users and that all sections are completed; the plans must include full details of how personal care needs will be met, a photograph of each service user, a nutritional assessment , details of dietary needs and guidance for staff of how to manage challenging incidents. That clear written guidance is provided for staff on when they should administer PRN (when required) medication. That satisfactory standards of cleanliness and hygiene are maintained at all times in all areas of the home. That staffing levels are increased to ensure catering and cleaning dities do not impinge on care duties. That 50 0f staff are trained to NVQ level 2 by the end of 2005. That training files are kept up to date and on site and that induction and foundation training complies with TOPPS Timescale for action 4/6/06 2. 9 13(2) 4/6/05 3. 26 23(2)(d) 4/5/05 4. 27 18(1)(a) 4/6/05 5. 6. 28 30 18(1)(a) 18(1)(a) 1/1/06 4/6/05 Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 Page 18 specifications. 7. 8. 30 31 13(5) 18(1)(a) That all staff are trained in moving and handling. That the manager is provided with daily hours when she is not on shift when she can complete her managerial responsibilites and that she completes her required NVQ management training. That records are maintained of all care provide for service users. That all staff are trained in fire prevention matters. That with immediate effect the food currently stored in the laundry is removed and more appropriate storage found. 4/9/05 4/6/05 9. 10. 11. 37 38 38 17 23(4)(e) 16(2)(g) 4/5/05 4/8/05 4/5/05 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 26 Good Practice Recommendations That the laundry is fitted with an extractor fan. Greenaways H59-H10 S21119 Greenaways V225013 040505 Stage 3.doc Version 1.20 Page 19 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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