Inspection on 07/03/07 for Greenbank Care Home

This inspection was carried out on 7th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Greenbank Care Home 24/02/09

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 08/07/2008.

CARE HOME ADULTS 18-65 Greenbank Care Home 485 Bolton Road Bury Lancs BL8 2DJ Lead Inspector Lucy Burgess Unannounced Inspection 7th March 2007 09:30 Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 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.V297352.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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.V297352.R01.S.doc Version 5.2 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.V297352.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th October 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. 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. The Local Authority funds placements made at the home. The charge is £339.00. Items such as dry cleaning, newspapers and clothing are not included in the fees. Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over half a day. Time was spent talking with the Owner and chatting with residents. The inspector also looked round the home, examined some key records around 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. Although the inspection was unannounced the completion of a pre-inspection questionnaire was requested. Feedback surveys were also sent to residents and health and social care professionals. The inspector received one survey from a GP, no issues or comments were made. All the key standards were looked at during this visit. What the service does well: What has improved since the last inspection? The home continues to provide a stable comfortable environment for the residents, which has contributed to their continued stable health. The Managers daughter has now completed her NVQ training and information has been passed to the assessor for marking. Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 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.V297352.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The process of gathering information includes the involvement of residents so their needs and wishes are clearly identified and met. EVIDENCE: There have been no changes within the home since the last inspection, with the current residents having lived at the home since it opened. Information evidenced on file showed that community care assessments had been completed identifying the needs of individuals. This had been shared with the owner and residents and continues to be reviewed along with relevant health professionals such as the Community Psychiatric Nurse (CPN) and the Consultant, ensuring information is up to date and reflects the support needs of individuals. As the home is very small with support being provided by the family, the needs and routines of residents are well known. Whilst chatting with the owner it was clear that she is knowledgeable about the support that the residents need, recognises change and responds to it. Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are involved in the development and reviewing of care plans, which promote their independence and well-being. Information is held safely and only shared with relevant parties. EVIDENCE: Records were in place for each of the residents. Information included personal details, relevant contacts, background history, care plan, records of daily activities, and a record of appointments, review notes and financial information. Care plans provided basic information in relation to the individual support needs, and guidance on how the support should be given. They were adequate for this type of family home. Care plans had been updated. A lot of information was also recorded within daily reports, these included details about peoples’ lifestyles, their physical and emotional health and appointments etc. Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 Page 10 All three residents are aware that records are held and had signed the plans to evidence that they were involved and agreed with the information. The owner clearly knew each resident very well, and described how she supported residents with both their practical needs and their specific mental health needs. The owner continues to offer support and guidance if needed to encourage the residents to make appropriate choices, for example when considering leisure or employment opportunities. With regards to personal finances, the owner holds individual records with regards to weekly allowances. These are managed by the residents and signed for to acknowledge full receipt of the money. Two of the residents also have individual savings accounts, which they manage independently. One resident is assisted by the owner. Residents are aware that their personal information is stored securely, and that they have previously seen written information covering privacy of information. Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. Meals offer choice and variety, and provide residents with a healthy diet. EVIDENCE: Routines are very much dependant on each of the residents. They are able to come and go freely following interests of their own choosing both in and away form the home. The relationship between the owner and residents was relaxed and friendly. Residents access community facilities using public transport. Regular visits are made to the local town centre, market and cafes. One resident had been regularly attending a local drop-in centre however due to changes at the centre was exploring other alternatives where he could meet with others and spend Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 Page 12 time relaxing. Another resident has a small job cleaning. The third resident enjoys going for walks and spending time with family. He had recently been to the cinema and out for tea, which he had enjoyed. Opportunities are also made available for residents to attend day trips with a local support group. Days out have included a trip on the River Mersey, Blackpool and Wales. A further trip has been planned for Easter weekend. 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 were fitted to bedroom and bathroom doors. Residents also maintain family contact, which is encouraged and supported by the owner. One resident visits family each weekend as they live locally. Another is planning to go away for a few days to visit his relatives. In relation to meals these are generally prepared and cooked by the owner, residents are however encouraged to wash their pots. Meals were said to vary. Residents are served with home cooked meals and preferences are taken into consideration. A menu was provided with the pre-inspection information which stated that breakfast consisted of cereal, eggs or a cooked breakfast, a light meal at lunch such a sandwiches or beans on toast with a full meal and desert in the evening. Items were also available for snacks and suppers. The owner also stated that when residents attend trips she will prepare a packed lunch. The owner also caters for birthday parties, which family and friends are invited to. Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owner is clearly aware of the needs of residents and is able to respond to any changes in health care needs promptly, in liaison with the appropriate specialist health services. Medication storage and procedures promote good health and safety. EVIDENCE: Residents continue to access community healthcare services such as opticians, Community Psychiatric Nurses, dentists and GPs. Details of all contacts with health professionals were recorded. The emotional and mental health needs of residents continue to be monitored and reviewed by the owner with additional support from appropriate mental health professionals. Regular reviews are also held to ensure that individuals’ well-being is maintained and medication is reviewed. Records are held on file of all reviews and health appointments. It was evident through discussion with the owner that she has a clear understanding of the individual needs of residents demonstrating that she had the skills and experience to respond to any problems. Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 Page 14 Rising and retiring times are very flexible, this was noted during the visit. Residents are able to manage 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. The owner, who is responsible for the administration of medication, has undertaken medication training. The inspector was informed that this had been completed with Boots pharmacy in 2006 however no certificate has been received. The storage of medication and records were also examined. The home has the MDS system, which is provided by Boots. Items are held securely and MAR sheets are completed. Clear records are made of medication being booked into the home as well as when residents are away from the home visiting family. Two residents regularly attend clinic for additional medication needs. Regular visits are also made to the home by the CPN. Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitable arrangements are in place with regards to the recording of complaints. Residents have an open relationship with the owner and feel they are 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: There have been no changes within this area since the last inspection. A complaints book, together with the complaints procedure, is kept in the residents’ lounge. The procedure includes the address and telephone number of the CSCI. Residents are aware of the procedure, and where the book was kept. Residents said that they had ‘no complaints’. No complaints had been made either to the home or to the CSCI during the past year. The home also has a written procedure covering adult protection and how to respond to any suspicion or allegation of abuse. Further information is in place with regards to protecting the residents. This includes a policy on finances and gifts, which includes a statement about borrowing and lending. Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Greenbank provides a homely environment. The property is clean, comfortable and well maintained ensuring the safety of those who live there. EVIDENCE: Greenbank is a domestic property providing a good standard of accommodation for the people living there. 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 is shared with the owner and her husband. Accommodation for residents comprises of 3 single bedrooms, bathroom, lounge and shared dining kitchen. 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. Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 Page 17 All areas of the home were comfortably furnished. On-going redecoration and refurbishment take place ensuring the property is maintained to a good standard. The owner carries out all domestic tasks with some support offered by residents. There were written procedures covering infection control topics. Residents were expected to use their own individual towels and soap, and not to share with others. Items were kept within individual’s own rooms. Safety measures were the same as they would be in any domestic property, for example smoke detectors and domestic fire safety equipment have been installed. Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitable arrangements are in place to meet the support needs of residents ensuring their safety and well-being. The owner may wish to consider refresher training to up date her on current good practice. EVIDENCE: As the home only accommodates 3 residents who require no physical support the Owner provides the majority of support. The owner’s daughter also provides additional support hours. The owner lives on the premises and is therefore available at all times should this be required. As the owner and family staff the home, no formal external recruitment has taken place however the owner is aware that should further recruitment take place then rigorous recruitment procedures would be required to ensure the safety of the residents. Information is held with regards to criminal record checks, which have been completed on the owner, her husband and two daughters. The owner has undertaken previous training covering first aid, food hygiene, health and safety and medication. Consideration needs to be given to Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 Page 19 completing refresher courses so that the owner is up to date with current good practice guidance. Although the owner does not hold formal qualification she has had many years of experience supporting this client group and in particular the three current residents, therefore fully understands their support needs. The owner’s daughter however has now completed the NVQ level 2 course and has submitted her portfolio to the assessors. Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This is well run home providing a stable environment for the residents. Systems in relation to quality assurance could be expanded providing a written plan that will show residents and others how their views are being used, where necessary, to improve the service. EVIDENCE: The home Owner has worked within the care field for many years, having previous own a care home before establishing Greenbank. As previously stated the owner does not hold a formal qualification in relation to NVQ however has considerable experience in this field and particularly with the residents having supported one for the last 16 years and the other two for 11/12 years. She is clear in relation to her role and responsibilities ensuring that the health and well-being of residents are met. Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 Page 21 In relation to quality assurance previous discussion has been held with the owner about how this area can be expanded upon. Residents are able to record comments or concerns in the complaints book. A visitors’ book is also in place where visitors are invited to write down any comments that they may have about the quality of the service. Opportunity is also available for residents to freely discuss things with the owner at any time enabling her to act upon any comments or suggestions as they arose. The owner was asked to devise some anonymous comment sheets to supplement these other ways of seeking opinions. There is also 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. Checks are carried out in relation to health and safety. As the home is a domestic dwelling the owner has been informed by the Fire Officer that it does not meet their criteria for inspection however has advised about what safety equipment should be in place. This includes a fire blanket and extinguisher within the kitchen and smoke alarms in the hallway and in each of the bedrooms. This has been done and checks are made on a weekly basis to ensure they are in working order. Other checks have been completed with regards to gas safety and electric checks. Adequate insurance was also in place. Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 YA35 Good Practice Recommendations The owner needs to consideration undertaking refresher training courses so that she is up to date with current good practice guidance. Quality monitoring needs to 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. 2. YA39 Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 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: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Greenbank Care Home DS0000008433.V297352.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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