Inspection on 24/02/09 for Greenbank Care Home

This inspection was carried out on 24th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Greenbank Care Home 07/03/07

Greenbank Care Home 18/10/05

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Greenbank Care Home 485 Bolton Road Bury Lancs BL8 2DJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lucy Burgess     Date: 2 4 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Greenbank Care Home 485 Bolton Road Bury Lancs BL8 2DJ 01617647925 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): bernardbasham@sky.com Mrs Margaret Elizabeth Basham Name of registered manager (if applicable) Mrs Margaret Elizabeth Basham Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The Home is registered for a maximum of 3 service users to include:- up to 3 service users in the category of MD (Mental Disorder under 65 years of age) The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection Brief description of the care home 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. 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. Care Homes for Adults (18-65 years) Page 4 of 28 care home 3 Over 65 0 3 Brief description of the care home Bedrooms are single and residents have exclusive use of a lounge and bathroom. The dining room and gardens are shared with the family. The Local Authority funds placements made at the home. The charge is 364.95 pounds. Items such as dry cleaning, newspapers and clothing are not included in the fees. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was unannounced and took place over half a day. Time was spent talking with the Owner/manager as well as chatting with residents. The inspector also looked round the home, examined some key records such as care plans, medication, finances and health and safety. The home is registered to provide accommodation for 3 people. The current residents have lived at Greenbank since it opened. As part of the inspection process the manager was asked to complete an Annual Quality Assurance Assessment (AQAA). This was completed and returned to us prior to our visit. Care Homes for Adults (18-65 years) Page 6 of 28 We also sent out feedback surveys to people living at the home. All three residents completed and returned them. Their comments have been added to the report. All the key standards were looked at during this visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A detailed assessment process was carried out, which included the prospective resident, ensuring the suitability of the placement prior to them moving in. Evidence: Placements at the home remain unchanged with the current residents having lived at the home between 13 and 18 years. As part of their resettlement process assessment, information was provided by the relevant health and social care professionals, which identified their individual needs. Reviews continue to be held with the social worker and health professionals such as the Consultant, ensuring information is up to date and reflects the current needs of people. It was evident speaking with the owner/manager that she has a good understanding of their individual needs and would act promptly if she had any concerns ensuring this did not affect their health and well being. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: All three residents confirmed on the surveys that they had been asked if they wanted to move into the home and had been given sufficient information about the service so that they could make an informed decision. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are encourgaed and supported in making decisions about their lives enabling them to maintain their independence. Evidence: Individual files are in place for each of the residents. Information includes assessment information, care plan, diary sheets, correspondence in relation to health care appointments and brief back ground history. As the residents have each lived at the home for a long period of time a lot of information has been archived as this is no longer relevant. The care plans had recently been updated and provided very general information which is specific to the residents current routine and activities. As residents have remained stable for sometime there were no specific risk identified. Each of the residents are aware that records are held and those wishing to, had signed to evidence that they were involved and agreed with the information. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: The residents and owner/manager were observed to have a good rapport with each other. As previously identified the owner/manager clearly knows each resident very well, and described how she supported residents with both their practical needs and their specific mental health needs. Where necessary additional support and advice is sought ensuring residents are cared for properly. In relation to personal finances, the owner/manager is appointee for each of the residents. Whilst two residents manage their own personal money each week one person is supported with a budget plan. Records are maintained to show what transactions take place and residents sign to evidence the money they have received. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents follow a lifestyle of their choosing which promotes and enables them to develop their independent living skills. Evidence: Each of the residents follow a lifestyle of their own choosing. Whilst they appeared to enjoy each others company within the home, they generally choose to follow separate activities with their own family and friends. Residents do not have a front door key as the owner/manager is always available, however this does not deter residents from being able to come and go freely. Each of the residents access community facilities using public transport. Regular visits are made to the local town centre, market, library and cafes. Residents are also members of a local centre called, Choice, however have yet to attend. One resident Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: explained that they did not like for formality of the centre and preferred a more relaxed environment to meet up with friends. The owner/manager explained that one resident enjoys going out with her for a meal at a local restaurant. A birthday party had also been arranged for the weekend following our visit for another resident who was celebrating a birthday. Over the summer period opportunities will be explored with regards to day trips and a holiday. One resident had enjoyed a break in Scotland visiting family whilst another resident regularly stays with family over the weekend period. Whilst at home, residents enjoy relaxing in the lounge watching television, listening to music or reading. Daily records included details of the activities undertaken. Residents also spend time in the privacy of their own rooms, which is respected. Locks are fitted to bedroom and bathroom doors. In relation to meals these continue to be flexible and are generally prepared and cooked by the owner/manager however residents are encouraged to wash their pots. Individual preferences are consider and residents are asked what they would like. The main meal is provided in the evening and may include roast dinners, stir fries, fish etc. Drinks and snacks are also available throughout the day. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of residents continues to be met ensuring their well-being is maintained. Evidence: The health and social care needs of residents continue to be monitored with periodic reviews taking place with their consultants and social worker. Support is provided by the owner/manager to any appointments. Records are held on file of all reviews and health appointments attended. Other health care checks are also carried out when needed. Each of the residents is registered with a local GP and dentist. Details of all contacts with health professionals were recorded. Residents are able to address their own personal care needs however prompts and offers of encouragement are given where necessary. Residents are able to move around freely and do not require any physical support therefore no aids and adaptations have been provided. Routines remain flexible with residents rising and Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: retiring as they choose. In relation to medication this is administered by the owner/manager. All items are dispensed by the supplying pharmacist in the blister packs and held securely. Administration records are completed when medication is provided. Through discussion with the owner/manager we were advised that on occasion items are taken from the blisters and held separately prior to being administered. This should not be done. All medication should be administered directly from the packs in which they were dispensed to ensure that no errors are made and residents receive the correct medication. The health and social care needs of residents continue to be monitored with periodic reviews taking place with their consultants and social worker. Support is provided by the owner/manager to attend appointments. Records are held on file of all reviews and health appointments attended. Other health care checks are also carried out when needed. Each of the residents is registered with a local GP and dentist. Details of all contacts with health professionals were recorded. Residents are able to address their own personal care needs however prompts and offers of encouragement are given where necessary. Residents are able to move around freely and do not require any physical support therefore no aids and adaptations have been provided. Routines remain flexible with residents rising and retiring as they choose. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to ensure that people are listened to and any issues are acted upon to ensure their safety. Evidence: Residents confirmed when spoken with and in the feedback surveys that they were aware of how to complaint and who to speak with if they had any concerns. One person stated, I always talk to the her (the owner/manager) if theres anything. A procedure is available within the home which residents have access to. The owner/manager confirmed that no issues have been raised with her since our last visit. No issues have been raised directly with us. In relation to adult protection the home has a copy of the local authority procedure and the supporting documents should a referral need to be made. However training in this area has not been completed. The owner/manager was advised of the course available through the Adult Training Partnership Group. Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home which is maintained to a good standard providing them with safe comformtable accomodation. Evidence: Greenbank is a small domestic dwelling which provides accommodation for 3 residents. The property is of a good standard and is located on a main road in a residential area of Bury approximately a mile and a half from the town centre. There is easy access to public transport as well as local shops, and pubs. It is in keeping with other houses in the neighbourhood. The home is shared with the owner and her husband. Accommodation for residents comprises of 3 single bedrooms, bathroom, lounge and shared dining kitchen. No aids and adaptation have been provided as the residents do not at present have any physical support needs. There is also private living space for the owner. The bedrooms and bathroom are fitted with door locks to offer privacy. The property also has well maintained gardens to the front and rear. Some of the rooms have recently been redecorated and provides comfortable furnishings. The owner/manager also takes responsibility for most of the domestic Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: tasks throughout the home with some support offered by residents. Residents commented in the surveys that the home was always fresh and clean. One person said that they would clean their own room. Due to the size of the home arrangements with regards to safety are the same as they would be in any domestic property, for example smoke detectors and domestic fire safety equipment have been installed. Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are confident that they are supported by people who are able to meet their needs however this could be enhanced with further training. Evidence: As already stated the owner/manager lives on the premises and provides the majority of the support, with additional cover being provided by the owners daughter when needed. Support is flexible as each of the residents are able and do spend time away from the home independently following activities and routines of their own choosing. Due to the staffing arrangement no recruitment has taken place. Relevant checks have been carried out for those people who offer support to the residents. Discussion was held with the owner/manager about training. No recent training has been undertaken. Consideration must be given to completing refresher courses so that the owner is up to date with current good practice guidance. The owner/manager was advised of the Adult Training Partnership Group in the areas which provides relevant training. As previously identified the owner/manager does not hold any formal qualification Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: however has had many years of experience supporting this client group and in particular the three current residents, therefore fully understands their support needs. The owners daughter however has completed the NVQ level 2. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed ensuring the service is ran in the best interests of those who live there. Evidence: The management of the service remains very stable. The owner has many years of experience supporting people with mental health needs. She has supported the current residents between 13 and 18 years and therefore has a good understanding of their needs. She is clear about her role and responsibilities ensuring that the health and well-being of residents are met and will seek the relevant advice and support should this be needed. In relation to monitoring the quality of the service provided, monthly reports are not completed as the owner/manager provides the care and lives on site. Discussion with residents is on a more informal basis, which they prefer. Each of them confirmed that could speak with her about issues or ideas and enjoyed her company. Other discussions about the service provided would be through the formal review meetings Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: with health and social care professionals. We also looked at some of the checks carried out with regards to health and safety. As the home is a domestic dwelling they have been advised what safety equipment should be in place. This has been provided. Periodic checks are carried out to ensure that the detectors are in good working order. Other checks had been carried out with regards to gas safety and electric. There was also an up to date insurance certificate. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 12 The provider must ensure that medication is administered from the blister pack from which it was dispensed This will ensure that mistakes do not occur and medication is administered safely. 30/05/2009 2 35 18 Up to date training in areas relevant to the needs of people living at the home must be provided so that staff are up to date with the relevant legislation and good pratice is followed ensuring residents are supported safely. 30/07/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 28 1 23 Training should be undertaken with regards to safeguarding adults so that the manager is aware of the procedure to follow should an issues arise ensuring peoples safety. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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