Inspection on 12/06/07 for Greenhill

This inspection was carried out on 12th June 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Greenhill 06/06/08

Greenhill 16/06/06

Greenhill 12/12/05

Greenhill 27/06/05

Greenhill 08/03/05

Greenhill 10/12/04

Greenhill 26/01/04

Greenhill 16/09/02

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOMES FOR OLDER PEOPLE Greenhill Wagon Road Potters Bar Hertfordshire EN4 0PH Lead Inspector Mrs Alison Butler Unannounced Inspection 12th June 2007 10:00 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 Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenhill Address Wagon Road Potters Bar Hertfordshire EN4 0PH 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) 0208 449 8849 0208 449 6343 B & M Investments Limited (Trading as B & M Care) Caroline Ann Inch Care Home 67 Category(ies) of Dementia - over 65 years of age (26), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (67), Physical disability over 65 years of age (3) Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th June 2006 Brief Description of the Service: Greenhill is a care home providing personal care and accommodation for 67 people aged over 65 years and who may have a physical disability and/or dementia. No other categories apply and, therefore, the home cannot provide nursing care or a service to people who have mental health problems other than dementia. Fees for the services are £650.00- £695.00 per week. Additional charges are made for newspapers, toiletries etc. (this was correct as at 12/06/07). For up to date information contact the home direct. Set in extensive, and well-kept grounds, Greenhill is a very attractive old detached manor-house style property, which has had various extensions and an annexe has been added. The property has been sensitively adapted, whilst maintaining its numerous and attractive features, including a bar and large hall with seating for several people. There is a passenger lift. The majority of the homes rooms provide single occupancy, two offer shared accommodation. Most of the rooms have an en-suite facility. There are four communal bathrooms in use. The upper rooms and gardens provide wonderful views as far a-field as Canary Wharf, and are easily accessible. There is ample parking space within the grounds and Potters Bar Town Centre is a short car journey of approximately two miles. Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this unannounced inspection; time was spent talking with those who use the service, staff and visitors to the home. Care records were examined as part of the inspection process. Where information remains the same, it has been brought forward from previous inspection reports. What the service does well: What has improved since the last inspection? Risk assessments give guidance to staff on the action required to minimise or eliminate the identified risk as far as is practicable. Medication procedures have been improved and a check showed that all medication storage and records were well kept. All but one bathroom has been fitted with locks to provide privacy to all users; they are accessible in an emergency. All areas of the home were clean and fresh and no malodours were detected. Staff records showed that all the required information was available prior to new staff commencing employment. Care plans have improved and more detailed information is provided to ensure staff are clear how to meet the needs of the individuals. Another activities co-ordinator has been employed, thus creating more choice in leisure activities. Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 Standard 6 is not applicable to Greenhill. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service have their needs assessed prior to admission and are provided with the information to make an informed choice. EVIDENCE: Examination of the records of two people who were newly admitted to the service showed that assessments had been carried out prior to admission to ensure that the home was able to meet their assessed needs. This assessments and any further information that had been obtained was used to compile the care plan Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans are in place setting out the action required by staff. Staff should be reminded that the people who use the service are treated with dignity and respect at all times. EVIDENCE: Examination of four care plans showed that a new format is being introduced which provides information in a better and easy to read way. In addition, the information provided was more detailed than the last time they were examined by the Commission. Risk assessments are also more detailed in providing detail on how the risk can be minimised. This information should be carried forward into the new format. Staff should sign and date all individual sheets when information is being added; this also demonstrates reviewing is taking place. Time was spent talking and observing people who use the service. Some of those spoken to were very happy with the care they received and said “they are lovely girls and are always smiling”. One individual stated they would like to spend some more time in their own room but was unable to get there alone. The information was passed to the manager who said that she would look into Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 Page 10 this and arrange for assistance to be given to enable them to return to their room when they wanted. Observation took place in Cedar’s Unit where it was noted that individuals were spoken to appropriately and were encouraged to be as independent as possible. However, some staff members were seen to enter a bathroom without knocking and some poor moving and handling practise took place (where an underarm procedure was carried out whilst supporting an individual to transfer from a wheelchair to a lounge chair). This practise must stop as it can cause injury to individuals. On another occasion the hoist was taken to a higher level than necessary. This could be quite frightening for the individual. Staff must consider peoples privacy and dignity when using the hoist with ladies who wear dresses and consider using a small knee rug to cover up their knees when carry out the procedure. When staff enter the lounge with an individual they make no conversation with others sat in the lounge, they need to remember that they are entering peoples home and as such should make conversation whenever they enter rooms. A particularly good piece of practice was seen when a member of staff put on some music and one individuals face lit up and a big smile appeared and they said to me “I like that”. The resident then proceeded to sway and hum along to the music. A check on the medication was carried out and it was pointed out that staff should sign and date any changes on the record sheet as no entries had been signed and dated. The temperature of the refrigerator is taken and recorded. A check showed that some eye drops were ready for disposal as they had been open for over 28 days. The deputy manager dealt with this during the inspection. All other records were in good order. Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recreational activities are offered in consultation with those who use the service. Family and friends are made to feel welcome whenever they visit the home. EVIDENCE: The inspector observed the meal on Cedars Unit. Staff were seated whilst offering individuals support and encouragement. The tables were laid with linen tablecloths and a choice of juice was available. The individuals were offered extra drinks and food; some took up the offer others declined. They have two activity co-ordinators who cover 47 hours over 7 days. There was a craft session in place where residents were preparing items to sell at the forthcoming fete and barbeque. A further session was held in the afternoon on Cedars Unit. On entering the unit, the residents were greeted by a smile and asked if they were ready to take part and take some exercise. Music was put on and then a soft ball was thrown to individuals who were encouraged to throw it back. Whilst they were encouraged to take part, if they chose not to, they could chose to sit and watch. Staff on the unit joined in the exercise. Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A complaints procedure is in place and relatives and those using the service are confident that their views are listened to and acted upon. Those using the service are protected from abuse. EVIDENCE: An examination of the complaint record showed that complaints received had been dealt with and actions and outcomes were recorded appropriately. Those spoken to during the inspection felt that they know whom they need to speak to and feel they are listened to and action is taken to deal with the issues raised. Training for staff is carried out to ensure that all those who use the service are safeguarded from abuse as far as is reasonably practicable. Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Greenhill is clean, safe and well maintained. EVIDENCE: A tour of the building revealed no malodours and that the home was clean on the day of the inspection. All but one bathroom had been fitted with locks following the requirement made at the last inspection. There were no bars of soap found and soft disposable towels were available to aid in the prevention of the spread of infection. Systems are in place for redecoration and a handyperson is available to deal with minor repairs as they happen, as they are employed for 25.5 hours a week. The main corridor has been decorated since the last inspection. Exterior work was being carried out to the front of the building as a number of rooms had signs of damp. Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 Page 14 The service has received money from a grant to build a log cabin in the garden. This will provide extra space when the weather is not good enough for residents to sit in the garden. There is also a hope they will run a gardening club from the cabin for those who wish to take part. Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place for the recruitment of staff and numbers are usually adequate to meet the needs of those who use the service. EVIDENCE: Whilst the manager has increased overall staffing numbers within the home, deployment of those on duty should be reviewed to ensure staff breaks are covered after the lunchtime period. As whilst in Cedar Unit, only two staff were available when a member of staff took their lunch break. This put those using the service at risk as the majority of residents on the unit required two staff to meet their needs. This leaves no one with the others residents. This was discussed with the manager who said that it would be dealt with to ensure that three staff were on the unit at all time during the waking day to ensure those who use the service are supported at all times. A training matrix is in place, which provides the manager information to ensure that all staff have the required skills to complete their roles. A number of staff are undertaking the diploma in dementia care. By 1 July 2007, training will be provided to all staff to ensure that they are fully conversant with the new care plan format. Examination of the files for three new staff showed that all the required information had been received prior to them commencing employment, thus meeting a previous requirement. Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Greenhill is well managed and policies and procedures are in place. Robust policies and procedures are in place to safeguard the financial interests of those using the service. EVIDENCE: The company have just purchased new policies and procedures and the manager will be looking at them to ensure they meet the needs of the service. She will then sign and adopt them for Greenhill. The staff felt supported and an open door policy is in place. A fire service visit took place and a number of issues were raised. A following visit showed some matters arising had been addressed and an extension of time was provided. The manager stated that these items have now been dealt Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 Page 17 with and the Fire & Rescue Service has completed a further follow up visit. Fire records were seen to be up to date with regular fire drills taking place. Polices and procedures are in place to safeguard the financial interests of those using the service and there have been no issues arising from this area and therefore it was not examined on this occasion. The manager will address the issues around privacy and dignity with staff and ensure that the staff level remain at a minimum of three on the Cedar Unit. Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 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 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 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 Page 19 Yes 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 OP10 OP30 Regulation 12 (4)(a) Requirement Staff must be provided with appropriate training to ensure that they provide the residents with dignity, choice and respect at all times. Staff must receive appropriate training in the safe moving and handling of residents Timescale for action 30/06/07 2 OP30 12 (4), 13(5) & 18 (1) 31/07/07 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 Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: 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 © 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 Greenhill DS0000019415.V343211.R01.S.doc Version 5.2 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. 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