Inspection on 18/10/05 for Greenbank Care Home

This inspection was carried out on 18th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Greenbank Care Home 24/02/09

Greenbank Care Home 07/03/07

Greenbank Care Home 26/04/05

Greenbank Care Home 15/09/04

Greenbank Care Home 14/04/04

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

CARE HOME ADULTS 18-65 Greenbank Care Home 485 Bolton Road Bury Lancs BL8 2DJ Lead Inspector Sue Evans Unannounced Inspection 18th October 2005 09:00 Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 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 Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 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 Adults 18-65. 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. Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Greenbank Care Home Address 485 Bolton Road Bury Lancs BL8 2DJ 0161 764 7925 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 Margaret Elizabeth Basham Mrs Margaret Elizabeth Basham Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th April 2005 Brief Description of the Service: Greenbank is a small, family run care home for three adults with mental health needs. The owner and her husband live on the premises. The owner provides most of the support that the residents need, with assistance from one of her daughters who works in the home for about 16 hours per week. The house is located in a residential area of Bury approximately a mile and a half from the town centre, close to bus routes, local shops, and pubs. It is in keeping with other houses in the neighbourhood. The home has well kept gardens at the front and back. Bedrooms are single and residents have exclusive use of a lounge and bathroom. The dining room and gardens are shared with the family. Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took 4 hours. Most of this time was spent watching what went on in the home and talking to the 3 residents, the owner and her daughter. The inspector also looked round the home, examined some key records, and looked at how medication was given. This inspection was the second to take place in the current inspection year. In order to gain a fuller picture of the home, this report needs to be read in conjunction with the report of the previous inspection of April 2005. What the service does well: What has improved since the last inspection? In order to further promote the well being of the residents, the owner has made some additions to the written information covering the privacy of residents’ personal information, and gifts. She has also completed training in the safe handling of medicines. The purchase of some new bedroom furniture has improved the rooms of 2 of the residents. Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 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. Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None None of the above standards were assessed this time. EVIDENCE: Standards 2, 3 and 5 were assessed in April 2005. Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9 and 10 Residents know about their care plans, and are aware that these are regularly updated to reflect any changes in their needs. The home encourages residents to be as independent as possible, helping them to keep any risks to their health and welfare to a minimum. However, the written information about the action needed to minimise risks needs to be updated. Residents have seen the home’s written information about privacy of information, and they know that their personal records are kept locked away. EVIDENCE: Standards 6, 7 and 10 were assessed in April 2005. All 3 care plans were looked at. They gave brief details of individual support needs, and guidance on how the support should be given. They had been agreed and signed by the individual resident. They were adequate for this type of family home. The care plans were updated every six months to reflect any changes in residents’ needs. Progress was recorded in daily reports which included details about peoples’ lifestyles, and their physical and emotional health. All three residents knew about these records and knew that they could look at them if they wanted to. Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 10 The owner and her daughter clearly knew each service user very well, and they spoke knowledgeably about the support that the residents needed with both their practical needs and their specific mental health needs. They were fully aware of any areas of risk and spoke about how they tried to support residents in keeping risks to a minimum. However, this knowledge and support was not always evident in the written information on personal files. The written information about one of the residents needed expanding so that it clearly described the action needed to reduce risks. Another resident’s risk management plan needed updating. Residents were satisfied with the support provided by the owner and her family. They knew that their personal information was stored safely. During the last inspection, in April 2005, they had seen the written information covering privacy of information. At that time, the owner had been asked to include a paragraph in this document to explain that, in exceptional circumstances, information might need to be shared with others, for example if someone was at risk. This had been done. Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 15 Residents choose how they spend their time, and take part in activities that they enjoy doing. They participate in the community, enabling them to lead fulfilling lifestyles. Contact with families and friends is supported. EVIDENCE: Standards 12, 13, 14, 16 and 17 were assessed in April 2005. Residents followed their own daily routines. During the inspection, they were seen coming and going from the home independently. They said that they chose how they spent their time both outside and inside the home, and that they were generally satisfied with their lifestyles Residents gave examples of the community facilities that they used such as public transport, shops, cinema, and library. One resident described how he regularly went to a local drop-in centre, and undertook occasional, casual employment. Another had a part time job on 2 afternoons each week. Another liked to keep fit by taking daily walks in the locality. Residents said Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 12 that they had received polling cards so that they could, if they wished, vote in the elections. It was clear, from discussions with the owner, that residents were assisted to maintain contact with family and friends if they wanted to do so. One resident said that he had recently spent a long weekend with his family. Another talked about how he visited his brother at weekends. Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 20 Residents attend to their own personal needs, with prompt and encouragement if needed. Medication procedures promote good health and safety. EVIDENCE: Standards 19 and 20 were assessed in April 2005. In respect of personal needs, residents were very independent and able to manage for themselves. The owner said that sometimes prompt and encouragement was needed. Residents said that they had choices about their daily routines, for example what time they got up. On the day of the inspection, 2 of the residents were still in bed, having a lie in, when the inspector arrived at 9. 00 am. Residents said that they were satisfied with the way that the owner and her family treated them, and the way they spoke with them. The home had a basic medication policy, suitable for this family run home. Medication was securely stored. Medication Administration Records (MAR) were kept. There were clear records of medication received, administered, and disposed of. The records included details of medication taken out of the home, for example if a resident went away for the weekend. None of the residents Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 14 looked after their own medication. Residents had signed a “Consent to Medication” form. As required at the time of the last inspection, the owner had been on medication training. Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Residents know about the complaints procedure, and they feel that any concerns would be listened to and dealt with. The protection procedures that are in place mean that the home has the means to respond properly to any suspicion or allegation of abuse. EVIDENCE: Standards 22 and 23 were assessed in April 2005. A complaints book, together with the complaints procedure, was kept in the residents’ lounge. The procedure included the address and telephone number of the CSCI. Residents knew about the procedure, and knew where the book was kept. Residents said that they had no complaints, but they would speak to the owner if they had. They felt that she would do something about their concerns if she could. No complaints had been made either to the home or to the CSCI during the past year. The home had written procedures covering adult protection and how to respond to any suspicion or allegation of abuse. Since the previous inspection, the owner had expanded the gifts policy to include a statement about borrowing and lending. Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 and 30 Greenbank provides its residents with a safe, clean, comfortable and homely environment, suited to their needs. EVIDENCE: Standards 24, 26, 27, 28 and 30 were assessed in April 2005. Greenbank is a homely, comfortable, well-maintained home, situated within reach of bus routes and local amenities. The house is in keeping with other domestic properties in the area. Redecoration and refurbishment is ongoing to ensure that standards are maintained. No obvious hazards were seen. Residents said that they were pleased with the home. They each had a single, lockable bedroom, personalised with their own items to reflect their individual interests and preferences. Since the last inspection, some of the bedroom furniture had been replaced. Residents had exclusive use of their own lounge and lockable bathroom. The dining room and gardens were shared with the owner and her family. All areas were comfortably furnished. Gardens were well kept. Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 17 The home was warm, clean, and fresh. Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 The owner and her daughter provide residents with the support they need. EVIDENCE: Standard 35 was assessed in April 2005. Given the family nature of this home, standard 34 is not applicable at present. Greenbank is a small, family run home. The owner lives on the premises. She is assisted for 16 hours per week by one of her daughters. Discussions with the owner and her daughter indicated that they were knowledgeable about residents’ needs. From observations, it was clear that there was a good rapport between them and the residents, who did not hesitate to approach them if they needed to speak to them. The owner’s daughter had enrolled for NVQ level 2 in care. During the inspection she received a visit from her NVQ assessor. This standard will be looked at again next time. Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39 Although the owner has no formal qualifications, this family home provides a well-run, supportive environment for residents. The owner has methods for checking out the quality of the home but she needs to extend these to include anonymous comment sheets, and produce a written plan that will show residents and others how their views are being used to improve the service. EVIDENCE: Standards 37, 39 and 42 were assessed in April 2005. It was clear, from observations and discussions with the residents, that they were being provided with a homely, supportive, family environment. The owner has had approximately 15 years experience of running the care home. Although she had no formal qualifications, this in no way detracted from the service provided, and the outcome for residents was the provision of a wellrun, caring environment. Nevertheless, she is still advised to investigate options for training to level 4 NVQ in care and management. Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 20 The small homely environment meant that residents were able to freely discuss things with the owner at any time, and she could act upon any comments or suggestions as they arose. Residents could also record comments or concerns in the complaints book. There was also a visitors’ book in which visitors were invited to write down any comments that they had about the quality of the service. The owner was asked to devise some anonymous comment sheets to supplement these other ways of seeking opinions. There is a need to briefly report on the comments received (at least annually) and to look at whether there are areas that need improving. Residents, and others, need to know that their opinions have been listened to and, where applicable, acted upon. Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 X N/A X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Greenbank Care Home Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score 2 X 2 X X X X DS0000008433.V258290.R01.S.doc Version 5.0 Page 22 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 YA6 Regulation 14,15 Timescale for action The registered person needs to 30/11/05 ensure that risk management plans are up to date and that they contain details of the action needed to keep risks to a minimum. Quality monitoring needs to 31/01/06 include the use of anonymous comment sheets. The owner needs to report on the outcomes of surveys so that people will know that their views have been noted and, where applicable, acted upon. (Timescale of 1/9/05 not met) Requirement 4. YA39 24 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 YA32 YA37 Good Practice Recommendations The owner’s daughter needs to complete her NVQ level 2 in care. The proprietor is advised to investigate options for training to level 4 NVQ in care and management. DS0000008433.V258290.R01.S.doc Version 5.0 Page 23 Greenbank Care Home Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Greenbank Care Home DS0000008433.V258290.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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