Inspection on 26/04/05 for Greenbank Care Home

This inspection was carried out on 26th April 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 but made no statutory requirements on the home.

Other inspections for this house

Greenbank Care Home 24/02/09

Greenbank Care Home 07/03/07

Greenbank Care Home 18/10/05

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 Announced 26 April 2005 th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Greenbank Care Home Address 485 Bolton Road, Bury, Lancs, BL8 2DJ 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) 0161 764 7925 Mrs Margaret Basham Mrs Margaret Basham CRH - Care Home Only 3 Category(ies) of MD Mental Disorder - 3 registration, with number of places GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15th September 2004 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 F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took place over 6 hours. Most of the day 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, looked at how medication was given, and ate lunch with the residents. Written comments were also received from 2 of the residents. Prior to this inspection, the Pharmacy Inspector had visited Greenbank, on 15th February 2005, to look closely at the home’s medication procedures. The requirements that she made were followed up at this inspection. 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 produced some written information covering key areas such as handling medication, gifts, and keeping residents’ personal information private. She has also tried to encourage regular visitors to the home to give their opinions GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 6 about the quality of the home to help her to look at anything that might need improving. 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 F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 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 standard(s) 2, 3 and 5 Residents’ inclusion in the assessment process enables all parties to reach a decision as to whether the home will be suitable in meeting a person’s needs. This means that residents have a say about what they would like to do and what they feel they need help with. The provision of written terms and conditions gives residents key information about what the home can, and cannot, provide so that they know what to expect from the home. EVIDENCE: There had been no admissions to the home for approximately 9 years. However, records showed that care management assessments had been updated, in consultation with residents, during the past 3 years. All three residents said that Greenbank had been a good choice of home. They said that, most of the time, they got on well with each other. They spoke highly about the support given to them by the owner and her family. The family nature of this small home means that the same people have supported the residents for many years and know them well. The owner and her daughter demonstrated an understanding and awareness of the individual needs and wishes of the residents. The information that they gave about residents’ needs matched that contained in written records. Records also showed that the home worked closely with specialist practitioners such as the Community Psychiatric Nurse (CPN) and the Consultant. GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 9 Each resident had signed a written contract covering the terms and conditions of residence. GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 10 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 standard(s) 6, 7, and10 Residents know that they can access their individual care plans, and that these are regularly updated to reflect any changes in their needs. They are able to make decisions about their lifestyles, with support and guidance from the owner if needed, enabling them to exercise their right to autonomy and individuality. Residents had seen the home’s written information about privacy of information, and they knew that their personal records were kept locked away. EVIDENCE: Care plans gave brief details of individual support needs, and guidance on how the support should be given. 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 see them whenever they wanted. Residents gave examples of some of the things they needed support with, and these matched with information recorded. The owner and her daughter clearly knew each service user very well, and they described how they supported residents with both their practical needs and their specific mental health needs. GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 11 Residents were seen coming and going from the home, independently, throughout the inspection. They said that they could choose how, where, and with whom, they spent their time. The owner offered support and guidance if needed to encourage people make appropriate choices, for example when considering leisure or employment opportunities. Residents managed their personal finances with varying degrees of assistance. Residents knew that their personal information was stored securely, and they had seen the written information covering privacy of information. The owner was 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. GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 12 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 standard(s) 12, 13, 14, 16 and 17 Residents choose how they spend their time, taking part in activities that they enjoy doing. They participate fully in the community, enabling them to lead valued lifestyles. Practices in the home respect residents’ rights to privacy, dignity and choice. The meals are good, offering choice and variety, and provide residents with a healthy diet. EVIDENCE: Residents followed their own daily routines, coming and going from the home independently. They said that they pursued their own preferred activities both outside and inside the home, and were 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 said that he liked to keep fit by taking daily walks in the locality. Another had links with a local Church. All three residents had received polling cards to enable them, if they wished, to vote in the forthcoming General Election. GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 13 At home, residents enjoyed pastimes such as watching television, listening to music or reading. One resident said that the owner regularly set time aside to play backgammon, trivial pursuit or scrabble with him. Residents said that the owner always arranged a party for them on their birthdays. Daily records included details of the activities undertaken. Residents said that their privacy was respected, for example nobody entered their bedrooms without permission. They said that they could either use communal areas of the home, or have undisturbed time in their rooms. Locks were fitted to bedroom and bathroom doors. Residents said that mail was left for them to open themselves. It was observed that residents and the owner spoke with each other in a natural, friendly manner. Residents said that the owner and her family treated them well. They said that they were happy with the home. One person said, “They are very kind.” The inspector enjoyed a pleasant relaxed lunch with the residents. The meal was tasty and there was enough to eat. Residents said that they enjoyed the meals. They gave examples of some of the dishes provided. They said that the owner knew about their likes and dislikes and that they sometimes made suggestions or requests for specific meals. GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 14 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 standard(s) 19 and 20 The owner’s in-depth knowledge of the residents means that any changes in health care needs are picked up and dealt with promptly, in liaison with the appropriate specialist health services. Medication storage and procedures promote good health and safety but there is a need for accredited training for those who administer medicines. EVIDENCE: Residents used community healthcare services such as opticians, Community Psychiatric Nurses, and GPs. Details of all contacts with health professionals were recorded. Records showed that health needs were monitored, and that any concerns were dealt with appropriately. Specialist services were obtained if necessary. The owner spoke knowledgeably about the physical and emotional health needs of the residents, demonstrating that she had the skills and experience to understand and respond to any problems. One resident said that he had taken up walking, and was following a healthy diet, in order to keep his weight at the right level. The owner and her daughter had encouraged and assisted him to achieve this. The pharmacy inspector had visited the home on 15th February 2005 to look at medication procedures. Since then the owner had devised a basic medication policy, suitable for this family run home. Medication was securely stored. GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 15 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 looked after their own medication. Residents had signed a “Consent to Medication” form. There was only one outstanding requirement from the Pharmacy Inspector’s visit. This was in respect of medication training. However, the timescale of 31st May 2005 had not yet been reached. The owner was waiting for a date for this training. The timescale was therefore extended by 2 months. GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 16 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 standard(s) 22 and 23 The systems in place for making complaints, and the approachability and accessibility of the owner, mean that residents feel comfortable about airing their views, and confident that they will be listened to. The protection procedures that are in place mean that the service has the means to respond properly to any suspicion or allegation of abuse. EVIDENCE: 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 the book. All three residents said that they would speak to the owner if they were unhappy with anything. They said she was almost always there to speak with them and they were confident that she would listen to them. 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 also provided written information about gifts, so that people were clear about what was, and was not, acceptable. The owner was asked to add a statement about borrowing and lending. The owner’s daughter was aware of these policies. Records showed that residents had signed for receipt of their personal allowances. All family members had undertaken CRB (Criminal Records Bureau) checks. GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 17 GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 18 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 standard(s) 24, 26, 27, 28 and 30 Greenbank provides its residents with a safe, clean, comfortable and homely environment, suited to their needs. EVIDENCE: Greenbank is a homely, 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. 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. They had exclusive use of a lounge and lockable bathroom. The dining room and gardens were shared with the owner and her family. All areas were comfortably furnished. The home was warm, clean, and fresh. GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 19 There were written procedures covering infection control topics. Residents were expected to use their own individual towel and soap, and not to share with others. Safety measures were the same as they would be in any domestic property, for example smoke detectors and domestic fire safety equipment were installed. GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 20 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The training topics that the family had completed, or were planning to undertake, were considered to be adequate for this type of service. Residents’ needs were being appropriately met in this family run home. EVIDENCE: It was evident, from discussions, observations, and written records that residents’ needs were being met in this family run home. Training certificates showed that the owner, and her husband and daughter, had undertaken training in topics such as food hygiene and first aid. The owner’s daughter had done part of the NVQ Level 2 course but not completed it. She said that she had made enquiries about re-starting the course and was awaiting a date from the college. This will be looked at again at the next inspection. As already stated in this report, the owner had made enquiries about medication training and was awaiting a date. GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 21 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42 Although the owner has no formal qualifications, this family home provides a well-run, caring environment for residents. The owner has methods for checking out the quality of the home, such as seeking comments from residents and visitors, but she needs to extend these to include anonymous comment sheets. Safety checking in key areas promotes the health and safety of the people who live there. EVIDENCE: It was clear, from observations and discussions with the residents, that they were being provided with a homely, caring, family environment. The owner had 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 well-run, caring environment. 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 knew that, if they wanted GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 22 to, they could also record comments or concerns in the complaints book. Since the last inspection, the owner had introduced a visitors’ book, and encouraged visitors to record any comments that they had about the quality of the service. There were some very positive comments from the Community Psychiatric Nurse. The owner was advised to extend these quality monitoring methods to include anonymous comment sheets, and to regularly report on the feedback received so that people know that their views have been noted and, where applicable, acted upon. Records showed that the owner took steps to promote the health and safety of the people living there. Valid certificates were seen for the electrical installation and gas safety checks. The home had up to date insurance. Accident records showed that, since the last inspection, one resident had needed to attend Accident & Emergency. The details should have been reported in writing to the CSCI. GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 23 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 3 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score x x x x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 GREENBANK CARE HOME Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 x 2 x x 2 x F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 24 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 10 Regulation 12(4) Requirement The confidentiality guidelines need to include a statement to explain that, in exceptional circumstances, information might need to be shared with others, for example if someone were at risk. Those responsible for administering medication need to undertake certificated training in safe medication procedures. (Previous timescale of 31 May 2005 not yet reached) The guidelines covering gifts need to include a statement about borrowing and lending. Quality monitoring needs to include the use of anonymous comment sheets. The proprietor needs to report on the outcomes of surveys so that people will know that their views have been noted and, where applicable, acted upon. The proprietor needs to provide the CSCI with written details about the circumstances that resulted in a resident needing to attend Accident & Emergency. Timescale for action 30 June 2005 2. 20, 35 13(2) 31 July 2005 3. 4. 23 39 12(1)(a) 24 30 June 2005 01 September 2005 5. 42 37 13 May 2005 GREENBANK CARE HOME F56 F06 S8433 Greenbank V210790 260405 Stage 4.doc Version 1.30 Page 25 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 37 Good Practice Recommendations The proprietor is advised to investigate options for training to level 4 NVQ in care and management. 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