Inspection on 18/01/06 for Greengarth

This inspection was carried out on 18th January 2006.

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

Greengarth 09/06/08

Greengarth 23/05/07

Greengarth 11/10/06

Greengarth 29/06/05

Greengarth 03/11/04

Greengarth 23/06/04

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

CARE HOMES FOR OLDER PEOPLE Greengarth Bridge Lane Penrith Cumbria CA11 8HY Lead Inspector Jane Strawbridge Unannounced Inspection 18 and 27 January 2006 3:00 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 Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 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. Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Greengarth Address Bridge Lane Penrith Cumbria CA11 8HY 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) 01768 242040 www.cumbriacare.org.uk Cumbria Care Mrs Susan Jane Tweddle Care Home 40 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (40) of places Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The service must at all times employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. A maximum of forty older people (OP40) may be accommodated. Ten of whom may have dementia (DE(E)10). The matters detailed in the attached schedule of requirements must be completed in the specified timescales. The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults by 1st April 2004. When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users and when existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. The statement of purpose and service user guide must specify what the care home provides paying particular attention to the environmental standards. 29th June 2005 6. Date of last inspection Brief Description of the Service: Greengarth provides accommodation and care for up to 39 older people, of whom 10 have dementia. The home is operated by Cumbria Care which is an internal business unit of Cumbria County Council. The home is situated close to the centre of Penrith and is on a bus route. The accommodation for the residents is provided in four separate living units, each with a lounge/dining room with kitchen area, bathroom and toilets. Bedrooms are close by. There is also a communal large lounge that is used for special events, and a conservatory situated near to the unit which accommodates people with dementia. Residents who smoke can do so in a designated smoking and games room. There is also a small day centre in the home which operates Monday - Friday for people who live locally, but this is managed separately and therefore was not included in this inspection. There is a passenger lift and a range of equipment to assist people in their daily lives. Outside there are garden areas and two pleasant easily accessible internal courtyards for residents to sit out in good weather, and also a small car park for staff and visitors. Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home that took place during an afternoon and early evening and a follow-up session during a morning the following week. The manager was present for part of the afternoon inspection and for the whole of the morning inspection. The inspector spent time talking with the residents either in small groups or individually and with the manager and staff on duty. Records to do with the care of the residents and the day to day running of the home were looked at and the inspector visited all parts of the home. What the service does well: What has improved since the last inspection? What they could do better: Although significant progress has been made with the staff development files there is still work to be done to complete the task. Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 Page 6 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. Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 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 Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 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, 4 On enquiry, potential residents are given sufficient information about the home and the financial costs to enable them to make an informed decision about taking their application further. EVIDENCE: The home has produced a combined service user guide and statement of purpose that provides a comprehensive range of information including the facilities and available services, the staffing structure and the complaints procedure. Residents said that they had been reassured by reading the brochure and it had helped them to feel confident that the home would be able to meet their needs and this had been confirmed when they eventually visited the home. Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 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): 11 Practices within this home mean that residents and their representatives are confident that their wishes will be respected. EVIDENCE: This home has detailed personal files that contained a wide range of information about health and personal care needs, daily routines and preferences, to enable staff working in the home to provide a consistently high level of service. Residents were encouraged to talk about their expectations and wishes after their death and these were recorded. Staff had been given training on how to work sensitively with residents who were in their final stages of their life and to provide support for relatives. Community based health care workers were able to assist the staff to ensure that residents who wanted to do so were able to remain in the home until their death. Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 Page 10 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 The activities programme provides a range of interesting and stimulating social activities. EVIDENCE: Since the previous inspection there has been a significant extension in the in the range of activities offered in the home. Games afternoons, exercise sessions and musical mornings have been built into the programme and occasionally staff have had the opportunity to organise impromptu bingo sessions for all residents. Residents said they enjoyed going to the big communal lounge for games sessions and concerts where they met people from other parts of the home and hoped these sessions would continue. There had been lots of activities leading up to Christmas and the staff had become more involved with the League of Friends who have a role in fundraising to provide additional social activities for the residents. Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 Page 11 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): 17 The home has a satisfactory procedure in place to ensure that the legal rights of residents are protected. EVIDENCE: The manager and senior staff recognise the right of each resident to make their wishes known and if necessary to use an advocate to speak on their behalf. They were aware of the local advocacy service that could be used by residents who were unable to speak for themselves or who did not have a family member or friend who could take on the role. At the time of the inspection nobody was using this service. Assistance was provided if necessary to keep the electoral roll up to date. On previous occasions some residents had preferred to register for a postal vote and some residents preferred to go to the local polling station to vote at election time. At the last election the political candidates had visited the home to generate interest and to offer transport for anyone wishing to vote locally. Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 Page 12 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): 22, 25, 26 The continuation of the refurbishment programme has improved the environment for people living and working in this home. EVIDENCE: Since the previous inspection more bedrooms and communal areas have been redecorated and new carpets fitted. Residents and staff said how much better they felt about living and working in conditions that were bright, pleasant and homely. Further refurbishment work is planned for the next financial year commencing April 2006. All rooms throughout were clean and tidy which was commendable considering that the home continues to run with a vacancy for a domestic worker and it has been necessary to use agency staff for housekeeping duties. Fortunately this arrangement was working well because the agency had been able to provide the same member of staff to give some continuity and maintain standards. The home has developed a close working relationship with community based occupational therapists and physiotherapists who, when necessary assess the physical needs of residents and advise on the adaptations and equipment Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 Page 13 required to enable an independent lifestyle. Specialist equipment including a ceiling hoist and specialist bed had been installed recently and have proved invaluable for the residents and for staff. Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 Page 14 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): 28, 29 Senior staff members in this home follow the necessary selection and training procedures to ensure that residents are protected from abuse. EVIDENCE: The home continues to follow a rigorous recruitment policy that included a number of safeguards to protect the residents from harm. Since the previous inspection an additional four posts for support workers had been filled so that there were now more staff on duty at the busiest times of the day. All staff had begun their employment only after the required checks had been successfully completed. All new members of staff are required to complete their induction training that covers a range of essential topics concerning the health and safety of people living and working in the home. Although significant progress has been made with the staff development files there is still work to be done to complete the task. The manager plans to work on these during the near future. The files will be looked at during the next inspection. Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 Page 15 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): 33, 34, 35, 38 There is an open style of management in this home where residents’ views are aired, respected and acted upon. EVIDENCE: The residents and their families and / or their representatives are encouraged to comment on the quality of the service they receive. There is an annual satisfaction survey and the results are published and feedback given to residents and staff. Residents said how they knew who to speak to if they had a concern and if necessary they were confident that they would be given a prompt response to tell them what would happen to put things right. Examples of comments from the annual surveys together with the complaints procedure are printed in the service user guide. Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 Page 16 Staff employed in the home follow the rigorous procedures designed to protect the financial interests of the residents. The central finance department undertake regular financial audits of records and money kept in the home. Since November 2005 Cumbria Care had implemented a policy that required a second member of staff to check that the medication had been administered correctly. Additional staff hours had been granted to reduce the impact on support workers on duty during the times that medication was given to residents and staff had been appointed to cover this role. However during the evening medication round, staff on the appropriate unit were seen to be taken away from their work with residents to fulfil the role of the second person required to check the administration of medication. On this particular evening it was evident that this practice was causing some tensions and some support staff on duty at the time raised their concerns. Because the manager had not been able to stay for the duration of the inspection the inspector returned to the home the following week to check that this practice was not happening regularly. On investigation it was found that this was not regular practice and had happened on this occasion due to a staff shortage. All records relating to the administration of medication and the fire log had been completed correctly. Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 Page 17 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 X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 X X X X 3 X 3 3 X STAFFING Standard No Score 27 X 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 3 3 X X 3 Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 Page 18 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. Refer to Standard Good Practice Recommendations Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Greengarth DS0000036484.V271319.R01.S.doc Version 5.1 Page 20 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!