Inspection on 11/11/05 for Greenheys Lodge

This inspection was carried out on 11th November 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

Greenheys Lodge 22/06/07

Greenheys Lodge 26/01/06

Greenheys Lodge 05/01/05

Greenheys Lodge 20/07/04

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

CARE HOMES FOR OLDER PEOPLE Greenheys Lodge Sefton Park Road Toxteth Liverpool Merseyside L8 3SL Lead Inspector Natalie Charnley Unannounced Inspection 11th November 2005 08:45a 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 Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 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. Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Greenheys Lodge Address Sefton Park Road Toxteth Liverpool Merseyside L8 3SL 0151 291 7822 0151 291 7821 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) European Wellcare Homes Ltd Ms Evonne Robinson Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One named person under 65 years old may be accommodated The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 5th January 2005 Date of last inspection Brief Description of the Service: Greenheys Lodge is a purpose built home in the Toxteth area of Liverpool. The home is near the city centre and close to local shops, bus, rail and road links. The home can accommodate up to 33 residents and does not provide nursing care. It is located within a ‘care village’ owned by a large private organisation, European Wellcare homes LTD. The care village consists of other similar homes that are all connected via a corridor. All homes share the same kitchen and laundry facilities, which are located within Greenheys Lodge. The home is on two floors and has a selection of dining and lounge areas. Two lounges are designated smoking areas. Gardens are located around the care village and can be used by residents and visitors. A large car park is also available. Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over a period of one day The inspector arrived at the home at 08:45 and left at 15.00 .The inspector spoke with 9 staff, the home manager and 10 residents. No visitors were available at the time of the inspection. The inspector completed the inspection by looking at the homes records, a tour of the building, formal and informal interviews and information from previous inspection reports. The inspector followed an inspection plan written before the start of the inspection to ensure that all areas that needed covering were done so. Feedback was given to the manager during and at the end of the inspection. What the service does well: What has improved since the last inspection? 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. Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 6 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 Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 7 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): 3 The home carries out a full assessment before a resident moves to the home to ensure they can meet their individual needs. EVIDENCE: All residents who move into the home have an assessment completed by staff from Greenheys Lodge. This is usually by the manager or senior care assistant who are experienced in carrying out assessments and completed before a resident moves into the home. The care files looked at during the inspection showed that this process was detailed and thorough. Residents and their families are involved in this assessment and are free to ask questions about how the home will care for them. The home also uses social services assessments in this process if they are appropriate. The pre admission assessment then forms the basis of how a residents care plan is drawn up. Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 8 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 and 9 Care planning at the home is based on the individual and details how care is to be given. Residents health care needs are well managed and promote quality of life Staff need to ensure that they are familiar with the home medication policy to ensure that medications are given out safely to protect residents. EVIDENCE: A selection of care plans were sampled during the inspection. These showed that the home are beginning to involve residents in planning their individual care, residents are being asked to sign care plans to say that they agree with what has been written. When a resident is unable to do this, family or next of kin are involved. Plans detail how care is to be given and details short and long term goals. Plans are clear and detailed and are updated on a monthly basis. Residents have access to a wide range of health professionals such as chiropodists, dentists and opticians who assist the home in providing care. These visits are recorded by the home in the daily records. As the home does Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 9 not provide nursing care, district nurses visit when residents need them. They keep separate records, which staff can access. Staff stated that they had a good relationship with the visiting nurses and felt that they could always ask for advise. Residents have clear risk assessments in place, which cover pressure sores, nutrition, falls, moving and handling and smoking. Any other risks that are taken by residents have separate assessments in place. Residents are weighed every couple of months at present. Staff stated that they had to book scales as the equipment is shared by all the homes on site and locating them can be hard. On the day of the inspection staff from another home were searching the home, as they couldn’t locate the scales. The inspector has recommended that the home have a set of scales specifically for their unit. The home had one resident living there that was awaiting a dementia placement. The home showed that they had dealt well with the assessment of his deteriorating mental health well and involved a variety of other professionals. The care plans and risk assessments that were in place showed that the resident was safe until he could move to a more suitable home. All aspects of medication were checked during the inspection. The medicine room was clean and tidy and staff were signing for all medications that came in and out of the home. Medication administration records (MAR’s) had some hand written entries that were not double signed or dated. On the whole, other records were well recorded, with only a small number of gaps in MAR’s. Staff were not sure of which medication policy was in use at the home and the home did not have a copy of the Royal pharmaceutical society guidelines on medication administration in care homes. Two policies were found at the home, one of which was old and clearly not in use. The second referred to ‘nurses’ administering medication and did not have information regarding how to dispose of medication. The home must ensure all staff are aware of which policy is in operation and that it is appropriate for a care home. Residents who self medicate did not have risk assessments in place. This must be addressed. Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 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 and 15 Activities at the home are varied to suit the needs of individual residents. Dietary needs of residents are well catered for with a balanced selection of food that meets the tastes of residents. EVIDENCE: Residents at the home spoke highly of the activities that the home provided. One resident stated, “ I went on a day out that was a real adventure” another said, “We had a Halloween party recently that was good fun”. Many activities at the home are planned and structured for example, Mondays is ‘moving to music’ and Wednesday the hairdresser visits. Some activities are ‘ad hoc’ and are based on the wishes of residents at a particular time. The home had a recent autumn fair where they raised £347.00, which is going towards taking residents to the Pantomime in January. Residents spoke of recent trips out to Southport and of a cheese and wine party. Reminiscence therapy is also used to help residents with their memory. The home has access to a mini bus and have a variety of plans for the Christmas period including a party and an entertainer. The home has 12 hours of staff time specifically for activities per week. This has meant that 1:1 sessions for residents have begun, to develop social Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 11 assessments and pen pictures, detailing a residents history and preferences for activities. This is an example of good practice. Residents at the home can have up to four cooked meal per day, including a cooked breakfast. The menus rotate on a monthly basis and residents are asked for their input when new menus are started. A hospital dietician assisted with the development of the current menus to ensure they were nutritionally balanced. The home was able to demonstrate how they cater for the residents who need special diets during the inspection. Residents are asked daily of what they would like to eat and alternatives are always offered. The home has recently completed a ‘drinks preference questionnaire’ to look at how the home were providing drinks and what changes residents wanted. The home has a licensed bar for residents to enjoy, offering as small choice of drinks at a cheap price. Lunchtime was observed during the inspection and found to be a relaxed and unhurried, social occasion and comments such as ‘delicious’, ‘nice’ and ‘excellent’ were used by residents to describe food and meals at the home. Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18 The home has a satisfactory complaints procedure, which is easy for residents or families to use. Staff have a good knowledge of adult protection procedures which protects residents from abuse. EVIDENCE: All staff working at the home undergoes Police checks before they start work. Staff spoken with had taken part in abuse awareness training and were aware of local policies and home policies that cover this area. The manager stated that more training was to be given to staff in this area in the near future. The home has central policies and procedures in place relating to abuse and related topics. The home has a clear and easy to use complaints procedure. Details of this are on display around the home. Residents spoken to stated they knew how and who to make a complaint to. No complaints had been recorded since the last inspection. Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 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 the following standard(s): 19 and 26 The layout, facilities and location of the home are suitable for the residents who live there. The home is safe and clean, however some minor areas of maintenance need addressing EVIDENCE: A full tour of the home was undertaken. Residents have access to a hydrotherapy pool and snoozelam a sensory room) which are located within the home but are shared facilities with the whole site. The laundry area was found to have a washing machine that was not working and from discussion with laundry staff, it was thought that the home needed an additional tumble dryer as a backlog of drying often occurs especially when all the homes bedding is changed. The ‘dumb waiter’ that takes washing directly from the home to the laundry was also broken. External gardens and grounds are neat and tidy and the home is easily accessible. A maintenance person is available to assist the home with daily maintenance problems. A plan for redecoration of the home was discussed with the home manager. A selection of bedrooms were checked and all communal Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 14 areas. These were found to be clean, tidy and in good decorative condition. Residents stated that ‘staff keep this place spotless’ and ‘cleaners are here daily’ when asked about the cleanliness of the home. Staff spoken to were aware of the home infection control policies and had received some training in this area. Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 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 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 and 30 Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their quality of life. Staff have the necessary skills and training to care for residents appropriately. EVIDENCE: Staff interviews and discussion with residents demonstrated a committed and enthusiastic staff group. Many members of staff have worked at the home for a long time and know other staff and residents very well. Only one area of staffing was causing concern. This was in regard to finding staff that would work a ‘sleepover shift’. The manager stated that staff currently undertaking this role, including herself were often working long hours and had become demotivated. The home had advertised for staff to cover this shift but the vacancy still remains. A small discussion took place around ways to resolve this problem and the manager was advised to discuss this further with the company and speak further with the inspector. Along side the care staff, a team of ancillary staff are employed. This includes 2 domestics, a team of kitchen assistants, 2 chefs and 3 laundry staff (kitchen and laundry staff cover the whole care village). Residents spoke highly of the staff that care for them. One lady said, “Staff are so kind to us” another stated “there are plenty of staff around to look after me, even at night”. Rotas checked also showed that staffing levels were satisfactory. Staff spoken to confirmed that the home had interviewed them and taken up references and Police checks. They also stated that they had job descriptions, Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 16 conditions of employment and were having appraisals and supervision. They listed some training courses that they had attended such as medication management and oral health and felt that the home was supportive in developing their skills. 15/20 care staff at the home are NVQ (national vocational qualification) qualified. The home has a training matrix which shows the training that is planned. Topics such as oxygen therapy, Parkinson’s disease, death and dying and infection control are planned in the near future. A separate record of staff training is also held by the manager. Staff are paid for training that they undertake. All staff were aware that the home has an equal opportunity policy. Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33 and 38 The manager leads by example and provides a positive, supportive role model for staff. The home seeks the needs of staff, relatives and residents. These views are then acted upon swiftly. The home maintains the health and safety of staff and residents at all times, protecting them from harm. EVIDENCE: The home manager has several years experience in the care setting and is currently in the middle of a NVQ management qualification. Staff spoke highly of the managers commitment to develop the home and to listen to their ideas. Staff felt that she is approachable and open in her style of management. From discussions with the manager, it was clear she is aware of the current needs of the residents and staff and displayed knowledge of how to care for the elderly. Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 18 Residents at the home are included in how the home is run. They have regular residents meetings which are recorded and residents are given regular questionnaires to complete and asked for ideas and what they want from the home. A quality office is also employed on site that carries out regular checks and staff also meet regularly to give ideas and suggestions. The manager audits a variety of practices at the home on a regular basis. All certificates and health and safety checks were in place at the home. Accidents are recorded well and were last audited in May 2005. The night before the inspection the home experienced with their nurse call bells not working. An engineer was called and staff demonstrated that they maintained the safety of the residents by keeping a 15 head check. The home has been advised that they will need a new system in the near future. The system was working correctly on the day of the inspection. Health and safety policies and procedures were available for staff in the main office. Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement Timescale for action 01/01/06 2 OP19 23(2)(c) The registered person must ensure that staff are aware of the correct medication policy and that it reflects the status of the home. Handwritten entries must be double signed and dated. The registered person must 01/01/06 ensure the dumb waiter and washing machine are repaired or replaced 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 Refer to Standard OP8 OP19 Good Practice Recommendations The inspector recommends that the company provide individual homes on site with weighing equipment The inspector recommends that the home consider purchasing another tumble dryer. Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Greenheys Lodge DS0000059312.V267008.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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