Inspection on 20/06/06 for Greenford Care Home

This inspection was carried out on 20th June 2006.

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 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

Greenford Care Home 07/10/08

Greenford Care Home 18/06/08

Greenford Care Home 30/11/07

Greenford Care Home 26/07/07

Greenford Care Home 07/03/06

Greenford Care Home 07/07/05

Greenford Care Home 29/12/04

Greenford Care Home 12/07/04

Greenford Care Home 22/12/03

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

CARE HOMES FOR OLDER PEOPLE Greenford 260-262 Nelson Road Gillingham Kent ME7 4NA Lead Inspector Graham Cummings Unannounced Inspection 20th June 2006 09:45 20/06/06 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 Greenford DS0000029057.V300924.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. Greenford DS0000029057.V300924.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenford Address 260-262 Nelson Road Gillingham Kent ME7 4NA 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) 01634 580711 Mr Cemal Osman Post Vacant Care Home 18 Category(ies) of Dementia - over 65 years of age (18) registration, with number of places Greenford DS0000029057.V300924.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th March 2006 Brief Description of the Service: Greenford is home to 17 service users with dementia. The home itself is situated in Gillingham adjacent to Gillingham Park, which can be accessed via the back courtyard. The home has mainly single rooms, two having en-suite facilities, day areas have a homely feel even though it is open plan in design. The main town of Gillingham offers High Street shopping and a mainline railway station. The home itself is on a bus route. There is limited parking to the rear of the home. The cost of the service ranges from £385:00p to £500:00p per week. Greenford DS0000029057.V300924.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the last inspection the ‘ Acting Manager’ has worked extremely hard to continue the improvements required to the environment. The company appear to have supported her in this by the purchasing of new furniture and redecoration of some bedrooms. There is still some work to be completed, most importantly the problems with the water flow to the kitchen and Service Users bedroom when the laundry is in use. An Environmental Health Officer visited the home on the 19/06/06 and has advised that the homes fridge, freezer and cooker are ‘suitable for use’. The ‘Acting Manager is presently completing the application form to become the Registered Manager and is hopeful that this will be completed and with the commission by mid July 2006. During the site visit the Acting Manager came across as being competent and confident in their role. A Deputy has been appointed and is working through their probation period, the appointment was external and appears to have brought further strengths to the management team. The Acting Manager and Deputy are looking to consolidate on the progress made and continue with making further improvements to the outcomes for Service Users, documentation and professionalism of the home. What the service does well: What has improved since the last inspection? A lot of improvements have taken place since the last inspection, mainly in the environment area with the decoration of a number of bedrooms, the purchase of new bedroom furniture and bedding. The lounge seating has been refurbished and the worn carpet removed from the stairs to the laundry. Greenford DS0000029057.V300924.R01.S.doc Version 5.2 Page 6 A deputy has been appointed and the home is now fully staffed. The Acting Manager is looking to have her completed Registered Managers Application form into the Commission by mid July 2006. 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. Greenford DS0000029057.V300924.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 Greenford DS0000029057.V300924.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5 The quality of the service provided is good Prospective Service Users have the information required to make an informed choice. Service Users have the benefit of updated contracts and terms and conditions. Service Users are assessed prior to a move to the home and are able to visit with family or relatives. EVIDENCE: The Inspector looked at 3 Service User files and found the contracts had been updated to include the purchaser and cost of the service provided. Since the last inspection the home has had 4 admissions. The Manager informed the Inspector that they had given out appropriate information to the individuals, on a file seen of a new admission, the home had carried out an assessment of need and visits to the home had been arranged prior to the placement being finalised. Greenford DS0000029057.V300924.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 The quality of the service provided is good. Service Users can be confident that their changing needs will set out in an individual plan and their health needs will be fully met. Service Users can be confident that they will treated with respect. Service Users can be confident that their wishes regarding illness and death are recorded and will be respected. EVIDENCE: The Inspector looked at 3 Service User care plans and found that the information contained was clear and informative. The plans were evaluated and risk assessments were in place. Statutory yearly reviews need to be arranged with the funding authority. All of the Service Users are registered with a local Doctor, Optician and Dentist and have their healthcare needs met. None of the Service Users living at the home presently self medicate, however, the home does have policies and procedures in place to cover this area should it ever be required. A new Greenford DS0000029057.V300924.R01.S.doc Version 5.2 Page 10 medication trolley has been purchased and Medication Administration Records were checked and found to be complete. The office is extremely small and often meetings take place in the dining area, this would compromise the Service Users confidentiality. Following a discussion with the Acting Manager and Deputy a solution may be to move the office entrance wall back to where the lift entrance is sited. The Inspector noted that on the Service User files seen all had their individual wishes regarding death had been recorded. Greenford DS0000029057.V300924.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The quality of the service is good. Service Users are enabled to maintain contact with their families and relatives. Service Users are helped to exercise choice and control over their lives. Service Users benefit from receiving a nutritious and healthy diet. EVIDENCE: Service Users are involved in choosing what clothes to wear, the activities they wish to participate in and the menu planning. This is done through Service User meetings, the Manager and Deputy speaking to Service Users daily to ensure they are happy and satisfied with the care they are receiving. Each Service User also has a key-worker and they meet monthly to discuss any issues around their care and lifestyle. The Inspector was informed that family and friends are able to visit at any reasonable time of day or evening. Service Users receive a wholesome and nutritious diet, however the dining tables have not yet been repaired or replaced and are still unstable. The cook has almost completed her NVQ Level 2 in cooking and told the Inspector that it was very enjoyable and had added to the variety of dishes on the menu. Greenford DS0000029057.V300924.R01.S.doc Version 5.2 Page 12 At the last inspection the Manager said that a Belly dancer had been booked to visit the home, this happened and was very successful and Service Users thoroughly enjoyed it. The home has purchased an exercise DVD which Service Users enjoy. The manager has applied to the council for permission to hold a summer fete on land just behind the home and is awaiting the outcome, if it is refused they are considering amalgamating with another local company home to use their grounds. Other activities include music and movement, art therapist, colouring and bingo. Greenford DS0000029057.V300924.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality of the service is good. Service Users can be confident that their complaints will be listened to, though the home needs to ensure that service users’ families and relatives are aware of the home’s complaints procedures. Service Users are protected from abuse by the home’s policies and practices in the area of finances. EVIDENCE: Neither the home nor the Commission have received any complaints since the last inspection. The Inspector looked through the finance procedures with the Manager. Service Users money is kept in the safe, any money taken out is signed for, when a purchase is made the amount is recorded on the individuals finance sheet and any change returned to the individuals cash wallet with the receipt. The Manager is the only person with access to Service Users finances at present though this is likely to change in the near future when the Deputy has completed their probation period. Greenford DS0000029057.V300924.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,24,25,26 The quality of the service is adequate. Whilst Service Users live in a safe environment with comfortable indoor facilities and surroundings improvements to their environment is ongoing and has yet to be completed. Service users do have access to sufficient lavatories and washing facilities. Service Users’ rooms suit their needs and the rooms are comfortable and furnished with personal possessions. Service users benefit from living in a home that is clean and pleasant. EVIDENCE: The home has improved the environment and is still working on the outstanding issues raised at the last inspection in March 2006. Greenford DS0000029057.V300924.R01.S.doc Version 5.2 Page 15 The day before the inspection an Environmental Health Officer had visited at the request of the Manager following the last inspection. The Inspector was given a copy of the report that stated that the size of the cooker and fridge were ‘suitable for the task it just required a degree of control to be put in place’ it also said that ‘As food is cooked & served, the home has a 2 hour exemption for service and display’. The EHO also informed the Manager that the height and depth of the sink was adequate. The home is to purchase a Hot plate for ‘hot holding’ of food. The Manager is hoping to rearrange the layout of the kitchen to give a greater working surface. The tiles along the back of the sink are still in need of being secured and grouted. The frayed carpet has been removed from the stairs leading down to the basement laundry but the problem with the water has not yet been addressed. The Inspector was informed that the laundry is in use throughout the day and night and does still affect the kitchen and Service Users bedroom wash hand basin. The toilet roll holder has been replaced but the grab rail is in need of being replaced. The dining tables are still unsteady and require repair or replacement, these have been ordered and are due for delivery in early August, the communal area needs to be redecorated. The lounge chairs have been replaced or recovered. The broken wardrobe has been removed and some new beds and bedroom furniture have been purchased. A number of bedrooms have been redecorated and the Manager has brought new bedding. The Inspector was assured that all of the bedrooms will be redecorated and furnished to a good quality and standard. Greenford DS0000029057.V300924.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The quality of the service provided is good. Service Users can be confident their care needs will be met by the staff team. Service Users are in safe hands and protected by the home’s recruitment policy and practices. The care offered to Service Users is enhanced by staff who are trained and competent to do their jobs. EVIDENCE: A new Deputy is in post and they are completing their NVQ level 3. The Manager is aware that the home does not meet the requirements regarding the percentage of staff and 4 staff have just started their NVQ level 2’s, the Manager is looking to start more staff on the NVQ in the near future to rectify this. The home is now almost fully staffed and a good training program is in place to ensure that staff have the knowledge and understanding to provide a quality care service. The training covers Adult Protection, Moving and Handling, First Aid, Care Planning, Environmental Health, Dementia and Medication. The Inspector looked at 3 staff files and found that 2 of the files were complete but lacked some signatures, the 3rd file was for a new member of staff who was on an induction program, the Manager was aware that the member of staff Greenford DS0000029057.V300924.R01.S.doc Version 5.2 Page 17 should not carry out any personal care until a clear CRB check had been returned. The Manager has changed the rota slightly so that it allows for individual staff to have breaks and ensure that Service Users care continued uninterrupted. Greenford DS0000029057.V300924.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,34,35,36,37,38 The quality of the service provided is adequate. The care of Service Users may be compromised because they live in a home that does not have a Registered Manager. The home is run in the best interests of the Service users and their financial interests are safeguarded. The Staff and Acting Manager have begun to receive regular supervision which should contribute positively to the overall care of Service Users. The home’s record keeping safeguards Service Users’ rights and best interests. The health, safety and welfare of the Service Users is partially compromised by the poor environment. Greenford DS0000029057.V300924.R01.S.doc Version 5.2 Page 19 EVIDENCE: The Acting Manager is in the process of applying to become the Registered Manager with the backing of the company and is hoping to have the application completed by mid July 2006. The Inspector noted that the Manager had grown in confidence and was a lot more assured and competent. The Inspector looked at the Service Users finances and found that the process of recording and accessing the individuals’ money safeguarded them from abuse. The home is run in the best interest of the Service Users and they are involved in making choices regarding their daily lifestyle through individual and Service User meetings. Service Users health, safety and welfare is partially compromised by the outstanding requirements from the last inspection. The home’s paperwork is much improved and further work is continuing in this area. The Manager and staff must ensure that all documentation is appropriately signed and dated. The Manager and Deputy have started a program of staff supervision and are attending a supervision training course this month. The Manager assured the Inspector that documentation will be signed by both parties involved. Supervision records will be kept in the individual staff files. Greenford DS0000029057.V300924.R01.S.doc Version 5.2 Page 20 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 2 3 X 3 3 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 2 17 X 18 3 1 2 3 X 3 2 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 3 3 2 2 2 Greenford DS0000029057.V300924.R01.S.doc Version 5.2 Page 21 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 OP19 Regulation 23(1)a23( 2)b d23(5) Requirement Timescale for action 30/09/06 2. OP31 9(2)(b)(i) That the Registered person shall having regard to the number and needs of the Service Users ensure that: the premises are suitable for the purpose of achieving the aims and objectives set out in the Statement of Purpose; and that all parts of the care home are kept clean and reasonably decorated. Issues to be addressed are: 1)The effect on the kitchen and bedroom water outlets when the washing machine is filling; 3)Dining tables are unsteady and dangerous; on order, delivery early August. 4)Some bedrooms and the communal area need redecorating; 5)Some bedroom furniture needs to be replaced or repaired. 6)Tiles need fixing and grouting in the kitchen. A person is not fit to manage a 30/09/06 care home unless - he has the qualifications, skills and experience necessary for managing the care home DS0000029057.V300924.R01.S.doc Version 5.2 Greenford Page 22 3. OP38 13(4)a c The Registered person shall ensure that - all parts of the home to which Service Users have access are so far as reasonably practical free from hazards to their safety; and unnecessary risks to health or safety of Service Users are identified and so far as possible eliminated. 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP2 OP10 OP16 Good Practice Recommendations That the Service Users Terms and Conditions include the Purchaser and cost of the service. The Home/Company look at increasing the office size to accommodate for small meetings and visitors so that confidentiality is kept. That Service Users family and friends are given a copy of the complaints procedure or that the copy on display is pointed out to them. The Manager needs to increase the number of staff working at the home with an NVQ to ensure they meet the standard. That the staff and acting Manager receive regular formal supervision. The Manager needs to make sure that all documentation is appropriately dated and signed. 4. 5. 6. OP30 OP36 OP37 Greenford DS0000029057.V300924.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Greenford DS0000029057.V300924.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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