Inspection on 08/05/07 for Greenbanks

This inspection was carried out on 8th May 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

Greenbanks 15/05/06

Greenbanks 08/02/06

Greenbanks 16/08/05

Greenbanks 01/02/05

Greenbanks 05/08/04

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

CARE HOMES FOR OLDER PEOPLE Greenbanks Greenbanks Road Watford Hertfordshire WD17 4JP Lead Inspector Robert Kittle Unannounced Inspection 8th May 2007 10:00 X10015.doc Version 1.40 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 Greenbanks DS0000019414.V338799.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenbanks Address Greenbanks Road Watford Hertfordshire WD17 4JP 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) 01923 255 160 01923 255 170 www.runwoodhomecare.com Runwood Homes Plc Manager post vacant Care Home 66 Category(ies) of Dementia (66), Old age, not falling within any registration, with number other category (66), Physical disability over 65 of places years of age (66) Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th September 2006 Brief Description of the Service: Greenbanks is a care home providing personal care and accommodation for 66 older people, who may also have a physical disability or dementia. It has been owned and operated by Runwood Homes plc, since 1999 (and was previously operated by Hertfordshire County Council. The home consists of a purpose built two-storey building that is divided into four units, each with its own name and identity. It is situated in a residential area on the outskirts of Watford. There is a parade of shops relatively close by, the town centre with shops, library and access to public transport, is about a mile away. It is next to a day centre that is also owned by Runwood Homes. All the homes bedrooms are single and have en-suite facilities. There is a passenger lift. The home has attractive grounds that are fully accessible for the service users and provide pleasant outlooks from the home and a stimulating and safe outside environment. The fee range for the home is between £400-559 per week. Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector was present for this unannounced inspection of all the key National Minimum standards. Information in this report is based on a review of information received by the Commission since the last inspection and during two visits to the service. Time was spent meeting in private with service users. Members of staff were also asked for their views during face-to-face discussions. Some of the policies and procedures and case files were inspected to ensure they were relevant and up to date. Observations of the daily activities were made during a tour of the premises. There was considerable movement of residents throughout the home during this visit and a resident from Cassiobury Unit summed up the atmosphere when she said, “There is always a happy atmosphere here”. This was generally a positive inspection and the outcome for the residents is good. What the service does well: What has improved since the last inspection? Since her appointment, the manager she has made a positive impact on the home and there is a clear sense of teamwork now. All the requirements made at the last inspection have been met. Staff awareness of healthcare needs has improved since the last inspection took place and there was verbal and documentary evidence of attention to pressure area care, oral care and psychological care. There were no longer noticeable odours, in fact a good standards of cleanliness was being maintained. Greenbanks DS0000019414.V338799.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. Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5. Standard 6 does not apply to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users can make a fully informed choice about whether or not Greenbanks can meet their needs. EVIDENCE: The service user guide is actively promoted by the home and there is a copy prominently on display in the outer reception area. In addition, a copy is placed in each new service user’s bedroom. This is a comprehensive document and the fact that the statement of purpose is currently under review does not therefore detract from the judgement of this outcome group. There was written evidence that senior staff undertake appropriate pre-admission assessments and, when time permits, trial visits can be offered. Staff have, or are developing, a full range of skills that will ensure that service users needs can be fully met at all times. The service user guide is currently being reviewed. Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have received sufficient training to enable service users to be assured that their health needs and personal care will be delivered to an appropriate standard. EVIDENCE: Care plans were generally kept to a good standard and contained sufficient information to ensure continuity of care. However, although there was a need for some minor updating of information, this was being picked up by senior staff. Appropriate and current risk assessments were seen in the care plans. Residents have access to healthcare professionals as needed. Staff awareness of healthcare needs has improved since the last inspection took place and there was verbal and documentary evidence of attention to pressure area care, oral care and psychological care. Staff were aware of the importance of nutrition and attention was being paid to weight and weight loss. Residents were positive about the standards of the meals provided, but some expressed surprise, as the menu appeared to have Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 10 changed. (The popular cook had broken his arm whilst on holiday, so a care team manager had stepped into the breach). Medication storage was good and the central storage room is air-conditioned. Temperatures are recorded to ensure consistency. Medication administration sheets were checked and were satisfactory. The administration of medication was observed in one Unit and this too was satisfactory. No residents currently self-administer. Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users enjoy stimulation through leisure and recreational activities, but there is a need for more attention to detail to ensure that all service users enjoy maximum benefit. EVIDENCE: The home has a large, central lounge as well as lounges in each unit. This provides residents with additional opportunities to socialise. On this occasion, the central lounge was being used as a waiting room for the visiting hairdresser. However, it is also used for communal activities such as quizzes, discussion groups and bingo. One resident said, “We have a discussion group and a residents’ meeting, so we know what is going on”. The home has an exceptionally talented Activity Coordinator who has received a National Civil Award in recognition of her work. Her latest project is ‘memory boxes’ and examples are beginning to appear throughout the home. Had the same attention to detail been observed throughout the home, the judgement for this outcome group would have been excellent. The home respects each resident’s religious persuasion and supports those who wish to observe their religion. Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 12 As described in the preceding section, there is a choice of meals and the mealtime routine observed in one unit appeared to be unhurried with staff providing appropriate assistance where necessary. Visitors appear to be unrestricted and can access the home at any socially acceptable hour. Residents also have outside contacts through the ‘Friends of Greenbanks’. Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service providers are fully committed to upholding the fundamental principals of safeguarding which means that service users can be assured that they will be listened to, protected and respected. EVIDENCE: There have been two complaint investigations concluded by the provider since the last inspection report was published. The outcome of the earlier investigation provided a demonstration of how ruthless the providers are prepared to be to assure service users of their protection from harm. There is a straightforward complaint procedure freely available and all staff who were asked were had considered how they would act to safeguard a resident who approached them with a complaint. Residents who were asked felt that it was unlikely that they would wish to complain, but said that they were confident that the staff on their particular unit would support them in need be. Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users live in a building that matches their requirements although there is a need for the service providers to review the overall decorative standards. EVIDENCE: There is a constant movement within the home and service users do not appear to feel confined to their individual residential units. Resident’s bedrooms generally contained personal effects that created a personal haven for the individual resident. Each unit had a housekeeper cleaning it with the result that there were no longer noticeable odours, in fact a good standards of cleanliness was being maintained. Overall, the premises are suitable for their purpose. However, much of the carpeting in communal areas was stained and should be replaced. The condition of the wall covering in communal areas added to a feeling of ‘dullness’. The manager stated that the home had been measured for new carpets and that the laminate flooring in the dining areas were also to Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 15 be repaired. There were decorators in Hazlemere unit who were painting over the wallpaper. There are also proposals for further redecoration to be undertaken. None of the staff that were asked were aware of why bolts were fitted on the outsides of dining room doors and these should therefore be removed. Staff had appropriate equipment available for them to support residents. There was documentary evidence of attention to safety (and portable electrical appliances were being tested whilst this inspection took place). Outside areas appeared to have been well maintained and safe. These are clearly valuable assets in clement weather. Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users may be assured that staff are suitably recruited and trained. They are deployed in sufficient numbers to ensure that care is delivered in an appropriate manner and that a safe environment is maintained. EVIDENCE: The inspecting officer was informed that there are now a number of staff from overseas employed at the home. However, all staff seen during this inspection had a good command of English. They were cheerful and interacted well with residents. A service user confirmed that, “Staff are good. If you ask them they’ll try to do it for you”. Good recruitment practices were being followed and the staff files studied revealed that all required documentation had been obtained prior to a staff member being offered employment at the home. Staff were keen to confirm the amount of training they have undertaken. Records supported this and there was a training matrix maintained to ensure that nobody is missed. During this inspection, a number of staff were taking an examination to mark the end of their dementia training. Five domestic staff have NVQ 2, two 2 care have NVQ 3 and 3 have NVQ 2. A number of other care staff are undertaking NVQ 2. Rotas indicated an adequate number of staff on duty by day and night and the manager confirmed this. Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate, (although it should be noted that the judgement would have been ‘good’ had the manager been registered). This judgement has been made using available evidence including a visit to this service. The management of this service has taken a positive turn over the past twelve months and users of the service may now benefit from a transparent and inclusive management style that should deliver a consistent standard of care for all service users. EVIDENCE: The service experience managerial problems and was without a registered manager for a period of about nine months before the present manager applied for registration (her application is being processed by the Commission). There is a clear sense of purpose in the home and staff are responding positively to the open management style. The manager accepts Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 18 that there are still changes to be made to drive up care standards even more. However, she is contemporary in her outlook and has acknowledged the need to address equal opportunities issues as well as any ethnic or religious matters that may arise from time to time. Runwood homes have introduced quality monitoring systems and the clear and accurate Regulation 26 reports contribute to this process. There is also a ‘comments box’ available. Policies and procedures are regularly reviewed and record keeping was to a good standard. Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 X 3 3 Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 20 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. 1 Standard OP19 Regulation 16 (2) (c) Requirement Floor coverings in communal areas must be brought up to a good standard of appearance or replaced. Walls in communal areas must be cleaned of decorated. Bolts fitted to dining room doors must be removed as they present the opportunity for restraint and compromise the fire precautions. Timescale for action 31/10/07 2 3 OP19 OP19 23 (2) (d) 13(7) 31/10/07 31/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Greenbanks DS0000019414.V338799.R01.S.doc Version 5.2 Page 22 - 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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