Inspection on 29/06/05 for Greengarth

This inspection was carried out on 29th June 2005.

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 18/01/06

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 29 June 2005 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 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 F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Greengarth Address Bridge Lane Penrith Cumbria CA11 8HY 01768 242040 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Cumbria Care Susan Jane Tweddle Care Home 40 Category(ies) of OP - Old Age registration, with number DE(E) - Dementia, over 65 of places Greengarth F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service must at all times employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. 2. A maximum of forty older people (OP40) may be accommodated. Ten of whom may have dementia (DE(E)10). 3. The matters detailed in the attached schedule of requirements must be completed in the specified timescales. 4. The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults by 1st April 2004. 5. 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. 6. The statement of purpose and service user guide must specify what the care home provides paying particular attention to the environmental standards. Date of last inspection 03 November 2004 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, 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 two designated areas.and there are plans to convert a small bedroom into a games / smoking 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 day to day 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 F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 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 over one day. The manager was on a study day and the supervisor was in charge during the manager’s absence. However the manager returned to the home part way through the 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: The care plans were comprehensive and easy to read although some had vital pieces of information missing. Greengarth F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 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 F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Greengarth F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 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 standard(s) 3, 5 There is a comprehensive range of information about the home to help prospective residents to make an informed decision whether the home would be able to meet their needs. EVIDENCE: There was a clear admissions procedure to the home that included a full assessment of need being carried out. All residents were issued with an individual contract and terms and conditions. The contracts clearly stated the terms of residency that included trial periods. Each service user had a care plan based on the assessment of need. Residents said that they had been given an opportunity to visit the home prior to moving in and some had taken up this opportunity and found it helpful and reassuring. Greengarth F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 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 standard(s) 7, 8, 9, 10 This home used a clear and consistent care planning system which ensured that the residents’ health and social care needs were met in a dignified way EVIDENCE: The home used their initial assessment of the needs and capabilities of new residents as the basis for their individual ongoing plan of care. The care plans provided staff with the necessary information to ensure that they were able to meet the needs of each resident. Reviews had been held on time and the residents or their representative had signed them to confirm that they had been involved. Records of visits by GPs and other health care appointments had been kept. Residents confirmed that the staff assisted them to keep hospital out patient appointments and to see the chiropodist, dentist and optician. Medication procedures were followed and were regularly audited by the local pharmacist to ensure the safety and well being of the residents. None of the residents was administering their own medication. Residents said that staff “were smashing” and spoke to them in a courteous manner, respecting their right to privacy. They said their personal care was handled in a way that preserved their dignity. Greengarth F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 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 standard(s) 12, 13, 14, 15 The residents’ wellbeing is encouraged and promoted by continued social contact with families and friends. The range of activities does not always satisfy the interests and aspirations of the residents. The meals in this home are good offering a varied range of food that meets the service users tastes and choices. EVIDENCE: The majority of the residents who spoke to the inspector were very positive about their experiences of living in Greengarth. They said that they enjoyed living in this home because they had been able to maintain their long standing friendships as staff had encouraged them to invite friends and family members into the home. Two residents said that they had recently started to go out to a nearby social club for a drink and to meet their friends which was “a nice change.” They enjoyed this very much and looked forward to it each week. However there was a small group who said “often there was nothing for them to do during the day apart from sitting together for a chat and a smoke.” They identified a range of things that they would like to do together and asked the inspector to report this to the manager. She informed the inspector that there had recently been a residents’ meeting when their views had been noted and plans were in hand to respond to their suggestions. A small bedroom is currently being converted into a designated smoking and games room. A good practice recommendation has been made to cover this shortfall. Greengarth F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 Page 11 The home had an “open door” policy regarding their visitors who were welcome at reasonable times of the day. Service users said that their visitors were always made to feel welcome by the staff on duty when they visited. Some visitors saw their relative and friends in the communal rooms and others in the privacy of the bedrooms. Most meals are taken in the dining room in each residential unit although residents said it was possible for them to be served in their own rooms if they preferred. Three full meals a day were served, always with a choice of menu. Care staff provided assistance to service users at meal times as required. Residents said “ the food is good here” and they enjoyed their meals. There was always a further choice if there was something on the menu that they did not like or want. Greengarth F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 Page 12 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 standard(s) 16, 18 This home has a satisfactory complaints procedure in place and staff members have a sound knowledge and understanding of the home’s policies and procedures to protect the residents from risk of harm or abuse. EVIDENCE: The home had a complaints procedure, and a copy of this document was given to all residents and their families on admission to the home. Residents said that they knew who to speak to if they were unhappy about something and they were confident that they would be listened to. Others said that they would ask someone else to speak on their behalf if necessary. Staff had been given training on the protection of vulnerable adults and how to recognise abuse. The home has a whistle blowing policy and the staff have been given training on how to use it. Through discussion they were able to demonstrate their understanding and knowledge and competency to deal with these matters. Greengarth F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 Page 13 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 standard(s) 19, 20, 21, 24, 25, 26 This home has benefited from recent investment for refurbishment and redecoration to improve its appearance, and provide a more homely and comfortable environment for people to live and work in. EVIDENCE: Some of the rooms identified at the previous inspection as requiring attention have been redecorated and have new furniture and carpets as part of a rolling programme, with the planned work due to be completed by June 2006. The home was clean and tidy on the day of the inspection and residents and visitors confirmed that this was normal. The private bedrooms all had a hand washbasin and were furnished and decorated in a homely fashion. Residents had been encouraged to bring their treasured small items of furniture, photographs, pictures and other ornaments to make their rooms individually personal. All communal areas in the home are easily accessed with ramps and handrails to help residents move around easily indoors and outdoors. Residents who use wheelchairs said that they were able to use the lift independently or with the minimum of assistance, although they sometimes needed help to Greengarth F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 Page 14 move through doorways if the doors were closed. The bathrooms were nicely decorated to make them as homely as possible and equipment and bathing aids had been installed to help residents to bath in safety and as independently as possible. The staff members had been given training in infection control and safe food handling to minimise the risks of infection within the home. Greengarth F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 After a period of instability in the staff group due to long-term sickness, the manager has been granted permission from her line managers to recruit and develop a competent staff team to offer consistency of care throughout the home. EVIDENCE: On the day of the inspection there were sufficient members of staff members and a supervisor on duty to meet the needs of residents. During the morning a supervisor was in charge until the manager returned at lunchtime from a Study half day. Staff members were seen to respond to the requests from residents in a prompt and efficient manner. The home was clean and lunch was served on time. At the previous inspection the inspector noted there were not enough staff on duty at busy times of the day to adequately meet the needs of the residents. A requirement was made that an additional member of staff must be recruited to cover this shortfall. Since then the manager had been successful in gaining additional staffing hours and had advertised for three support workers and a domestic. As an interim measure agency staff were employed to maintain adequate staffing levels until permanent staff could be appointed. The home operated a recruitment policy that had been designed to protect residents. The procedures were thorough and contributed towards the protection of service users. All staff had been required to attend courses on the Greengarth F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 Page 16 protection of vulnerable adults and the safe administration of medication. Staff are encouraged to work towards the NVQ level 2 in Care and they are able to take one day per month as paid study leave to help them to achieve the award. Fifty per cent of the care staff group should have achieved NVQ level 2 by the end of the year. Each member of staff had been given a file to record their Continuing Professional Development. Greengarth F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, 38 The manager has a clear development plan for the home and is well supported by senior staff in providing leadership to motivate all staff groups working in this home. EVIDENCE: The manager has a range of experience that she has used effectively to improve standards within the home for the benefit of residents and staff. She has achieved the NVQ level 4 in Management is currently working towards the Registered Managers’ Award. All staff members had been given an annual appraisal where achievements and training needs had been identified. The programme for formal staff supervision was currently being implemented and will be looked at in detail at the next inspection. The records showed that the home’s staff group are committed about ensuring the health and safety and wellbeing of the service users, themselves and colleagues. Greengarth F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 x x 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 2 x 3 Greengarth F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 Page 19 No 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP12 Good Practice Recommendations The manager should ensure that residents are offered a range of recreational activities to suit their needs and preferences. Greengarth F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 Page 20 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 F58 F10 s36484 greengarth v225824 290605 ui stage 4.doc Version 1.30 Page 21 - 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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