Inspection on 07/10/08 for Greenford Care Home

This inspection was carried out on 7th October 2008.

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

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 18/06/08

Greenford Care Home 30/11/07

Greenford Care Home 26/07/07

Greenford Care Home 20/06/06

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 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Greenford Care Home 260-262 Nelson Road Gillingham Kent ME7 4NA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sue McGrath     Date: 0 7 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Greenford Care Home 260-262 Nelson Road Gillingham Kent ME7 4NA 01634580711 Telephone number: Fax number: Email address: Provider web address: donna.h@charinghealthcare.co.uk Name of registered provider(s): Name of registered manager (if applicable) Purelake (Greenford) Ltd Type of registration: Number of places registered: care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 18. The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE). Date of last inspection Brief description of the care home Greenford is home to 18 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 495.00 pounds to 520:00 pounds per week. 18 Over 65 0 Care Homes for Older People Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a Key Unannounced inspection that took place in accordance with Inspecting for Better Lives (IBL) process. Key inspections are aimed at making sure that the individual services are meeting the standards and that the outcomes are promoting the interests of the people living in the home. The IBL process for a key Inspection involves a pre-assessment of service information obtained from a variety of sources including an annual self assessment. It is now a legal requirement for services to complete and return an Annual Quality Assurance Assessment (AQAA). This assessment is aimed at looking at how the services are performing and achieving outcomes for people. Care Homes for Older People Page 5 of 26 Judgements have been made with regards to each outcome area in this report, based on records viewed, observations and verbal responses given by those people who were spoken with. These judgments have been made using the Key Lines of Regulatory Assessment (KLORA), which are the guidelines that enable The Commission for Social Care Inspection (CSCI) to be able to make an informed decision about each outcome area. The actual site visit to the service was carried out on the 7th October 2008. The main focus of the visit was to review any improvements made since the last inspection and the well being of the service users. Time was spent touring the building, talking to people who live in the home, talking to staff and reviewing a selection of assessments, service user plans, medication records, menus, staff files and other relevant documents. At all times the manager and staff were helpful and demonstrated a pro-active approach to ensuring that service users were being supported to the best of their abilities and resources. This report contains evidence and judgements made from observations, conversations and records. The requirements made at the last inspection had been complied with. Overall this was a positive inspection with good outcomes for service users. The inspector on leaving the home was satisfied that residents were both safe and well cared for and wishes to thank the manager and her staff for their assistance and hospitality. Due to the nature of the service provided it is difficult to reliably incorporate accurate reflections of the residents views in the report and therefore greater emphasis had been given to relatives/ representatives views of the service provided. Responses received from relatives spoken with on the day indicated that people were generally very satisfied with the standards of care provided. The owner has appointed a person to run the home on a day to day basis in the position of manager. They are not yet registered with the commission, but will be referred to as the manager within this report. What the care home does well: What has improved since the last inspection? The service has improved a lot of aspect of care since the last inspection. The care plans have been completely updated and now reflect actual needs and give clear guidance to staff. The inspector is now more confident the care plans are reviewed on regular basis and that any changes are recorded and acted upon. Staff have undergone a considerable amount of training recently and now have covered nearly all of the mandatory training plus other in depth specialist trainings. The remaining mandatory trainings have already been booked for staff to attend. The organisation has a commitment to National Vocational Qualifications with well above the fifty per cent Care Homes for Older People Page 7 of 26 required. The health safety and welfare of staff and residents has been improved by the fitting of radiator covers and all pipework had now been guarded. The laundry room has undergone a major refurbishment and when the flooring has been replaced will meet with the requirements of good infection control. Large fans have also been installed to ensure the temperature remains constant. The lounge and dining room have been repainted and this work is nearly complete. Several bedrooms have been decorated and some new bedroom furniture and a couple of beds have been purchased. There are plans in place to decorate the main hallway very soon. The new manager and her staff have worked extremely hard to ensure all the requirements made at the last inspection have been complied with. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents and their families are provided with the information they need to make an informed choice about moving into the home. People who live in the home benefit from a comprehensive assessment of their needs prior to admission to ensure their assessed needs can be met. People also have the opportunity to visit the home to assess the quality, facilities and suitability of the service. Evidence: The home had reviewed its statement of purpose and updated the information it contained. This document now complied with National Minimum Standard 1. The document was more available than previously. Training levels at the home had improved since the last inspection and this indicated that staff can now meet the needs of the people who live in the home. Care Homes for Older People Page 10 of 26 Evidence: Several visitors were spoken with on the day of the inspection and they confirmed they could visit their relatives whenever they liked. One relative said that often some of their families visits were at odd hours but the staff always made them very welcomed. Other visitors confirmed they were always offered tea and if the visit was over a meal time they had been offered a meal. Relatives also confirmed they had a written contract with the home. The manager confirmed that as part of the admission process a trial period was always offered to ensure the residents were happy to remain and that the home could met their needs. The manager confirmed the home does not provide Intermediate Care. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home benefit from clear and in depth care plans that identify needs and give clear guidance to staff. Care plans are regularly updated to ensure changes are recorded and acted upon. Health needs are met and residents benefit from having full access to all professional health care service as required. People who live in the home are protected by the homes policies and procedures for dealing with medicines. Evidence: Four care plans were reviewed and contained all of the information required to enable staff to deliver a good standard of care. These had been rewritten since the last inspection and were much improved. It was evident that families as well as residents had been involved when they were rewritten and all had been signed to say they approved the plans. Visiting relatives confirmed they had been involved with the new care plans. Records maintained in the plans were also much improved and actions could be traced and confirmed throughout the plans. Risk assessments were in place Care Homes for Older People Page 12 of 26 Evidence: to ensure residents remained as safe as possible. Evidence was also seen that regular reviews were undertaken by senior staff and that any changes were recorded and acted upon. The manager was confident the reviews were an actual reflection on the residents current condition and were completed on an individual basis. Staff appeared to have taken ownership of the care plans and this had improved their understanding of the process. The management of medication met with the guidelines from the Royal Pharmaceutical Society of Great Britain. The medication room was clean and tidy and well organised. Staff were observed administering the medication during the day and this was completed in a professional and controlled manner. All of the MAR sheets viewed were completed without any errors. All personal medication records were complete and up to date. During the inspection staff were seen to be very kind to the people who lived in the home and were considerate and helpful. All of the residents spoken with confirmed the staff looked after them very well. Visitors all said the staff were good and went the extra mile. One visitor said the staff were very kind to their relative and that she felt involved with the home. She had been invited to several social events in the home, which she had enjoyed. Another said she felt very happy to leave her Mum in the home which was a great relief for her. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home have their social and recreational interests and needs provided for with a wide range of organised activities. People who live in the home are supoprted to maintain contact with families and friends, which ensures they continue to receive stimulation and emotional suopport. People who live in the home receive a wholesome, appealing and balanced diet. Evidence: The home had employed a member of staff specifically to arrange activities in the afternoons. This was enjoyed by all the people who lived in the home. A wide range of activities were arranged from flower arranging, gardening clubs, where bulbs were planted, to art and craft work. One resident had made a bracelet for his daughter who commented how much she had appreciated receiving it. All of the activities undertaken were well recorded. Plans were in place to take the residents out for a fish and chip supper and a visit to a Pantomime at Christmas The local church comes in monthly to hold a service for those who want it. Care Homes for Older People Page 14 of 26 Evidence: All of the relative spoken with confirmed they could visit at any time and were always made very welcomed. Residents were encouraged to maintain contact with their relatives and friends and several still go out with their relatives. With the levels of dementia within the home it was not always easy to ensure full choices were given at all times, however staff were seen to offer choices where possible and where not possible, gave full support and consideration. From observations made during the inspection it was apparent that the people who live in the home were encouraged to personalise their own rooms where possible. The menus had recently been rewritten and now indicated that a range of foods were offered throughout the day. Supper had been added to the daily menus and the people who live in the home appeared to really enjoy this extra meal. Snacks and drinks were also available throughout the day. The cook was aware of who was on a diabetic diet and could offer other specialist diets if needed. Residents and their families all said the food was good and there was always a choice if the main meal was not liked. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are protected by a robust complaints system and residents and relatives feel their views are listened to and acted upon. The homes Adult Protection procedures and understanding now protect the people who live in the home. Evidence: The home did have a complaints procedure displayed in the home and families spoken with said they knew how to complain but none of those spoken with had ever had the need to use it. The manager confirmed they had received no complaints since the last inspection. The Commission can also confirm it has not received any complaints since the last inspection. The recent Safe Guarding Vulnerable Adults (SVA) alert has now been concluded and the management team said they had learned a lot from the experience. The management had produced a new guidance for staff to ensure they follow the updated procedure on how to deal with accidents. All the staff had signed to say they had read and understood the new procedures. The home fully co-operated at all times with the investigation and complied fully with the outcomes. All staff had been retraining in adult protection procedures and first aid. Care Homes for Older People Page 16 of 26 Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home benefit from a homely and comfortable environment which is clean and fresh. Evidence: Since the recent SVA alert the home has ensured that all hot water pipes were properly lagged and covered. No uncovered pipes were seen during the inspection. All of the homes radiator have also been covered to reduce the risk of burning. The handy man continued to monitor the water temperatures in the bedrooms and bathrooms. The lounge and the dining room had been decorated since the last inspection and the work was nearly complete. A few areas remained for example some of the handrails and woodwork needed to be painted and a small area of the ceiling by the door needed repair work done. Another area of improvement was the laundry in the basement. This has been completely redecorated and the walls have been clad with specialist laundry plastic sheeting to enable regular cleaning to take place. Two large fans have been installed to ensure the room temperature does not become excessively hot. Railing for clothing had been supplied. The next phase was to complete the work on the floor to ensure it was impermeable and easy to clean. A secure lock had been fitted to the top of the laundry stairs to reduce the possibility of any resident falling down the steep stairs. Care Homes for Older People Page 18 of 26 Evidence: Some new moving and handling equipment had been purchased including new slings and slide sheets. The manager confirmed the one hoist in the home could be used upstairs and downstairs as it fitted in the lift. New none slip flooring had been fitted to the bathrooms and toilets. Some new bedroom furniture had been purchased and the manager was hopeful that given time all of the bedroom furniture would be replaced. Two new beds had also been purchased. All of the beds had new valences fitted and at least three bedrooms had been decorated. The manager was planning to start the redecoration of the hallway and stairs in the very near future. All of the carpets had been steamed cleaned but several needed to be replaced. Again the manager confirmed that the plan was for the majority of the carpets and furniture to be replaced as soon as possible. On the day of the inspection the home was clean and fresh. The majority of the visitors confirmed this was always the case. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home now benefit from staff that are well trained and competent to do their job. Robust procedures are in place to ensure people who live in the home are in safe hands. Evidence: Staff had undertaken a high level of training since the last inspection and now had covered the mandatory trainings required. All staff had been trained in first aid. The level of the training was discussed and it will be recommended that at least one member of staff from each shift has undertaken a first aid training that has been approved by the Health and Safety Executive. This is normally First Aid at Work and covers approximately four days and is far more in depth than the one day appointed persons course. Further guidance is available on the Commissions website. The home had introduced a new induction programme which met with the Common Induction Standards from Skills for Care. One new staff member stated she was currently working through the programme and had found the course very thorough. Because the course was new to the home all staff were being asked to complete the course. Care Homes for Older People Page 20 of 26 Evidence: The rotas viewed on the day confirmed there were sufficient staff on duty to ensure the safety and well being of the people who lived in the home. Following a requirement being made at the last inspection all of the staff files had been audited and were now fully compliant with the requirements of Schedule two of the Care Standards Act 2001 Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home benefit from having manager who is supported well by senior staff in providing clear leadership throughout the home and by staff who demonstrate an understanding of their roles and responsibilities. People who live in the home benefit from having staff that are regularly supervised. The health safety and welfare of residents and staff are promoted and protected. Evidence: The manager was currently undertaking her Leadership in Management course, this was previously known as the Registered Managers Award (RAM) and hoped to complete the award within the next year. She was also in the process of registering with the Commission. All of the requirements made at the last inspection had been complied with and will now be removed. The management and staff have worked extremely hard and diligently to ensure all of the necessary work had been Care Homes for Older People Page 22 of 26 Evidence: undertaken. The manager had been supported by the providers and this was evidenced in the monthly regulation 26 reports that had been carried out. The manager also confirmed the providers had supported the home to improve. Staff stated the manager had moved things on since the last inspection and that generally the feeling was the home was now working more efficiently and as a team. The staff structure of the home had been reorganised and the appointment of a deputy manager had improved they way the home was managed. All staff appeared more confident of their individual roles and responsibilities. Evidence was seen in staff files that regular supervision was now happening. This was also confirmed by staff. The manager and deputy had undertaken specific training in supervision skills. The home manages small amounts of service users monies to enable then to purchase small items such as hairdressing newspapers chiropody and personal toiletries. The system used was robust and ensured the security of the residents personal monies. The manager was continuing to update all of the homes policies and procedures to ensure they all fully comply with regulation. As required from the last inspection all staff now undertake regular fire drills and are familiar with the current fire procedures in the home. As required from the last inspection the electrical wiring in the home had been tested as safe. The AQAA confirmed all of the necessary Health and Safety checks were being carried out and recorded. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 38 It is recomended that senior staff undertake a first aid course that is approved by the Health and Safety Executive such as the First Aid at Work Course. It is also recommended that at all times ther is one member of staff on duty who holds this qualifications. See further guidance om CSCI website. Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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