Inspection on 19/07/05 for Greenhill Park

This inspection was carried out on 19th July 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

Greenhill Park 31/05/07

Greenhill Park 29/12/05

Greenhill Park 01/03/05

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

CARE HOMES FOR OLDER PEOPLE Greenhill Park 24 Greenhill Park Road Evesham Worcestershire WR11 4NL Lead Inspector Mandy Burton Unannounced 19 July 2005 8:50 am 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. Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Greenhill Park Address 24 Greenhill Park Road, Evesham, Worcestershire WR11 4NL 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) 01386 40836 Mrs Maria Bayliss Mr Michael FrancisCole Mrs Maria Bayliss Care Home 24 Category(ies) of DE(E) Dementia over 65 (10) registration, with number OP Old age (24) of places PD(E) Physical disability over 65 (24) Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 1 March 2005 Brief Description of the Service: Greenhill Park is a residential care home situated in a quiet residential area of Evesham close to the town centre and provides care and accommodation for maximum of 24 older people. There is an area of landscaped gardens with two attractive patio areas for the service users to enjoy and there are extensive views over the Vale of Evesham and the Cotswold Hills. Accomodation is provided over two floors and comprises of 18 single rooms, 12 of which are ensuite and 3 shared rooms. A passenger lift provides access to first floor rooms . Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 08.50am. It took place over a period of six hours. A partial tour of the home was undertaken and a selection of care records were examined. Five residents and six staff were spoken to during the course of this visit. What the service does well: What has improved since the last inspection? What they could do better: The maintenance of daily records in relation to each resident will ensure greater continuity of care. Providing residents with details of menu alternatives at lunchtime will enable them to make an informed decision at all mealtimes. Documenting two signatures for all financial transactions with respect to the management of residents’ monies will provide protection from financial abuse. Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 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. Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 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 Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 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 and 4 Resident’s individual needs are fully assessed prior to moving into the home, which enables staff to provide the appropriate care and support when they move into the home. EVIDENCE: All residents are assessed fully by staff from the home prior to their admission. The quality of assessment records seen was good and demonstrated that as part of the assessment process staff had accessed any relevant information relating to the care of the resident from appropriate professionals. During this visit staff were overheard talking with residents and their visitors. Relationships between all staff and residents were very relaxed and friendly. Staff spoken to had a very good understanding of each resident and their individual needs. Staff were observed offering residents assistance in a very caring and sensitive manner. Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 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 and 11 The health care needs of residents are well met. Care plans are in place for each resident, which record their individual needs and contain appropriate information for staff to ensure these needs are met. Personal support is offered to residents in a way that ensures their privacy and dignity is respected and independence promoted whenever possible. Systems for the administration of medication are good and ensure residents’ medication needs are met. EVIDENCE: Individual records and care plans are kept for each resident. Records seen were very informative, focusing on the individual needs and preferences of each resident and the care to be provided by staff to meet those needs. The manager reported that the system of care planning is to be reviewed in the near future. Discussion took place about opportunities to enhance the current system further and the need to ensure daily notes are maintained in relation to the care of each resident, as under the current system typically only significant events are recorded. Care staff reported that resident’s care plans are always readily available to them and they are encouraged to contribute to them. Staff in the home are Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 Page 10 kept informed of any changes in the health and well being of residents during the handover report at the commencement of each shift Health care screening is carried out on all residents and any changes, which may be apparent, are investigated and referred to the doctor or specialist health professionals as necessary. Since the last inspection systems have been introduced which ensure all residents are regularly assessed for the risk of developing pressure sores. It was recommended that further work take place to develop protocols/prompts for staff, which direct the action to be taken by staff dependant on the level of risk identified. From discussions with staff and management it was evident that staff are sensitive to the needs of residents who may be terminally ill providing a high standard of care and support to the resident and their family members. Medication administration records were examined. The standard of record keeping was noted to be good and appropriate arrangements were in place for the storage of medication. Up to date information about specific medicines is readily available to staff for reference purposes if required. Medication training has been made available to all staff responsible for the administration of medication. Observations made indicated that residents in the home were treated with respect and their dignity maintained. Residents spoken to said staff treated them well. Staff in the home try wherever possible to promote independence. Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Residents in this home are encouraged to be as independent as able and make choices and decisions about how they wish to spend their time. The dietary needs of residents are well catered for, with a varied selection of food readily available, which meets their individual preferences. EVIDENCE: Residents spoken to were able to confirm that they are able to make choices in respect of daily living. When asked about making choices one resident replied by saying ‘definitely’ and spoke about choosing when to go to bed or get up and where they wish to take meals. Residents are offered three meals a day and snacks are readily available outside meal times. It was reported by catering staff that since the homes’ last inspection there has been some changes to the menu, which have provided residents with a wider ranger of menu options which reflect their preferences. Details of the meals to be served each day are displayed on a notice board in the main reception area. The menu seen recorded several options for breakfast and the evening meal, and a set meal was recorded for lunchtime. The menu did however state that ‘alternatives’ are always available. Details of the alternatives were not however displayed. Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 Page 12 On the day of this visit several residents mentioned that they did not like the main meal offered and had asked for an alternative. From further discussion with these residents it was evident they were not always made aware in advance what the alternative would be. Meals served to residents were in ample portions and were well presented and any special diets were appropriately catered for. All residents spoken to were complimentary of the quality and selection of food served to them. The kitchen was noted to be very clean and well organised. All catering staff have received food hygiene training. In addition to this a certificate is on display in the home, which has been presented by the local authority for high standards of food hygiene. All staff in the home are actively encouraged to make time available to spend with residents and provide social and recreational opportunities. A recent success at the home was a ‘Strawberry Cream Tea’, which was reportedly attended by residents, staff and a significant number of visitors. Other opportunities made available to residents include, attendance at local religious meetings, visits by ‘pets as therapy’, and in house bingo sessions. In addition to this visitors are always welcome in the home at any time. Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 Page 13 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 and 18 The complaints process is this home is good. Residents feel that staff are approachable and are confident to discuss any concerns knowing that they will be taken seriously. Management ensure all staff have the required knowledge and understanding of adult protection issues, ensuring a safe environment for residents. EVIDENCE: The management and staff have created an open atmosphere within the home where anyone who has any concerns about the care provided in the home can raise concerns at any time without fear of repercussions. Written policies and procedures in relation to making a complaint, whistle blowing and incidents which may constitute abuse are displayed in the main reception area of the home. All residents spoken to were happy with the care they received and said that if they had any concerns they would know who to talk to and would feel confident to do so. Staff spoken to demonstrated a good awareness of issues of abuse and the action to be taken should a case of abuse be suspected. All staff spoken to made reference to the fact that the home owners were very open and approachable and that they were confident that if they raised any concerns at all, they would be taken seriously. Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 Page 14 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, 25 and 26 The standard of the environment within this home is very good and provides residents with an attractive, homely and safe place to live. EVIDENCE: During this visit a partial tour of the home took place. The home was noted to be well-maintained and homely in character. The extensive gardens were very well maintained and attractive, providing a number of different areas, which could be easily accessed by residents. Residents have access to two lounges and a dining room. All communal areas were furnished to a good standard, were homely in appearance and were being well utilised by residents. Since the last inspection maintenance work has taken place as requested to guard a radiator and pipe work in one bedroom. Appropriate infection control measures were in place. A recent improvement has been the installation of liquid soap dispenser in communal hand washing facilities. Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 Page 15 Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 Page 16 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,and 30 Adequate numbers of staff are on duty, which ensures residents’ individual needs can be met and they are kept safe. Appropriate training is made available to all staff, which ensures they have the necessary skills and knowledge to care for residents . EVIDENCE: On the day of this inspection 20 residents were living in the home and the home was adequately staffed to meet the needs of those residents. The atmosphere within the home was very relaxed and staff were observed carrying out their duties in a very unhurried manner. Residents spoken to said they felt there was enough staff on duty to meet their needs and call bells were answered promptly. Staff spoken to felt staffing levels in the home were appropriate and were confident that if the needs of residents increased they could approach management for additional support. The owners of the home have a strong commitment to ensuring all staff are appropriately supported and receive training relevant for the duties they have to perform. As a result of this a variety of training opportunities have been made available to staff which include training on: moving and handling, first aid, dementia care, medication, continence and optical awareness. In addition to this care staff are also being supported to undertake NVQ training. Staff spoken to during this visit welcomed the opportunity to participate in the range of training opportunities that have been made available to them. Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 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, 35, 36 ,37 and 38 This home is well managed and staff are provided with the support and guidance to care for the individual needs of residents and ensure their safety. Existing methods for recording any residents’ monies taken for safekeeping need improving to ensure that residents are safeguarded from any potential risk of financial abuse. EVIDENCE: The home is well managed. It was evident that the new owners have quickly created an environment where staff feel valued and suitably empowered to influence service delivery. Staff were highly complimentary of the manager and emphasised the relaxed atmosphere within the home and the ongoing support they receive. A ‘suggestion box’ was introduced following the initial change of ownership. The box continues to be in place and provides an opportunity for everyone to influence service delivery. All staff spoken to were very happy with the working environment and commented positively on the support they receive. Since the new ownership Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 Page 18 four staff meetings have reportedly taken place, all of which were described as positive experiences for staff. Staff spoke positively about the fact that following consultation with the owners they now have new uniforms. One member of staff described the home as ‘a lovely place to work’ and referred to a positive aspect as being able to spend time to laugh and joke with residents. At the time of this visit arrangements were being made to create a ground floor office for the manager in order to make them more accessible to residents and staff. Arrangements for the safe keeping of resident’s monies were assessed. Any monies held for safekeeping are typically only accessible when either the manager or her deputy are on site. Discussions took place about the need to ensure two signatures are recorded for each transaction and that wherever possible one should be the respective resident or their representative. Procedures are in place for all staff to receive regular supervision. Records are kept of all supervision that takes place. The overall standard of record keeping was good. Discussion took place about ensuring all care documentation is stored securely and appropriate security methods discussed. Positive health and safety practices are promoted. The manager reported that all staff were due to undertake first aid training in the near future. Fire safety training for all staff is ongoing. Risk assessments are being completed in relation to all areas of the home both internally and externally. The quality of assessments seen was good and gave clear detail of action to be taken to reduce/eliminate any risk identified. In addition to this any risks identified on a day-to-day basis are assessed and dealt with immediately. All accidents that occur are recorded. Discussion took place about initiating regular accident audits to enable any patterns or trends to be identified and identifying any potential for changes in practice. Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x x x 3 3 STAFFING Standard No Score 27 3 28 x 29 x 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 x 3 x x 2 3 3 3 Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 Page 20 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. 2. Standard 7, 8, 37 35 Regulation 12(1) 13 17(2) Requirement Daily records to be maintained in respect of each resident . Two signatures must be documented for all financial transactions/deposits , one of which should be the resident or their representative whenever possible. All care documentation must be stored securely in the home. Timescale for action Immediate and ongoing Immediate and ongoing 3. 37 17 Immediate 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. 3. Refer to Standard 8 15 38 Good Practice Recommendations Protocols/prompts to be developed in relation to action to be taken by staff when residents are identified at risk of developing pressure sores. A menu of alternative options should be displayed which would ensure residents can make an informed choice at mealtimes . Accident audits should be undertaken and documented regularly in order to establish any patterns or trends which may influence future care practice . Greenhill Park E52 S63333 Greenhill Park V238966 190705.doc Version 1.40 Page 21 Commission for Social Care Inspection The Coach House, John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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. 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