Inspection on 18/04/06 for Greensleeves Residential Care Home

This inspection was carried out on 18th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Greensleeves Residential Care... 16/09/08

Greensleeves Residential Care... 29/09/07

Greensleeves Residential Care... 06/12/05

Greensleeves Residential Care... 02/09/05

Greensleeves Residential Care... 22/03/05

Greensleeves Residential Care... 27/09/04

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

CARE HOMES FOR OLDER PEOPLE Greensleeves Residential Care Home 8 Westwood Road Portswood Southampton Hampshire SO17 1DN Lead Inspector Mr Richard Slimm Unannounced Inspection 18th April 2006 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 Greensleeves Residential Care Home DS0000059080.V287657.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. Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greensleeves Residential Care Home Address 8 Westwood Road Portswood Southampton Hampshire SO17 1DN 023 8031 5777 023 8049 0033 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) Greensleeves Residential Care Home Limited Mr Paul Robert Fellingham Care Home 21 Category(ies) of Dementia (21), Dementia - over 65 years of age registration, with number (21), Old age, not falling within any other of places category (21) Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. People in DE category must be 55 years and over Date of last inspection 6th December 2005 Brief Description of the Service: Greensleeves is a care home situated in Southampton and close to local facilities. The home is registered for twenty-one service users within the category of older persons and dementia care. The home provides accommodation in a range of single and double bedrooms, which mainly have en suite facilities. There are two shared bedrooms. The home has two communal lounge areas, and a dining area which are on the ground floor of the home and easily accessible to service users. All meals are provided, and due to the needs of service users access to the kitchen may be restricted. To the rear of the property is an enclosed garden that is accessible to service users wishing to use it. In 2005 the home was registered to new owners. In late 2005 the manager left. The CSCI has received an application to register a new manager, who is also one of the co-owners of Greensleeves RCH Ltd. Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit as part of the unannounced inspection took place over 6 hours. The homes’ new manager/owner and senior staff assisted the inspector, as well as input from residents throughout the visit. On entering the home there were three care staff on duty to meet the needs of 18 residents. The manager attended the home approximately 2 hours after the start of the inspection and assisted the inspector. The inspector undertook a tour of the premises and also met 16 of the residents. Three residents were case tracked with a focus on outcomes of the services provided for these people. The inspector assessed all the key standards, and followed up the requirements and recommendations from the last inspection report It is advised that any reader of this report reads the last inspection report dated 6/12/05. The inspector spent 30 of the inspection talking to service users and observing care practices. One relative was spoken to over the ‘phone, as visitors were not available at the time of the visit. This relative provided very positive feedback about the care services provided at the home to his mother who has quite specialist needs. In addition the inspector spoke to the former Community Psychiatric Nurse of this resident, who confirmed that the home had improved since the new manager has taken over, and that the home met the needs of her patient in a sensitive and professional manner. She was positive about the new management arrangements and how the new providers respond to any requests regarding service users. A current care manager was spoken to, once more over the ‘phone who also confirmed that she had confidence in the home and the staff, and has other clients who live at the home and who are funded by the City council. What the service does well: The new management appear to be a significant improvement on previous arrangements. The new manager was committed to improving the quality of service provided at Greensleeves Residential Care Home (RCH). This was also confirmed by three stakeholders who were spoken to over the ‘phone following the site visit. Fourteen of the sixteen residents’ spoken to were found to be very happy and contented living at the home, and happy with the services they received. There is a clear staffing structure, and staff levels had been improved since the last visit. Other improvements had been made in line with the last CSCI report, and there appeared to be a clear commitment by the Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 6 manager/owner to working constructively with stakeholders, including the CSCI in the ongoing development of the home to the primary benefit of residents. Staff members were found to promote dignity and respect with more vulnerable residents, and to practice safe manual handling and moving techniques. What has improved since the last inspection? What they could do better: The home could further develop systems and methods to consult and involve residents in day-to-day decisions about their individual care, lives and the running of their home. A more pro-active approach to listening to concerns is needed, and where necessary a formal investigation of issues undertaken to establish a resolution for one resident who raised concerns at the time of the visit. The home should review the care package for one resident who has very specialist needs, and is currently receiving additional input for support external to the home. This support is currently used in one block each week. There was evidence to support the view that these additional resources could be used more effectively if planned with the resident concerned, and spread across the week to support the resident to engage in activities of his choice safely, external to the home. Such an approach may assist this resident in achieving greater independence in the longer term. One resident spoken to stated her wish to move from a shared bedroom, as she did not wish to share with a stranger. At the time of the visit there were two single bedrooms available. The home needs to be more pro-active in seeking the views and wishes of residents in regard to all levels of service provided. (See standards 23.6 / 23.7). Action is needed to ensure that each residents care plan clearly identifies what their individual needs and wishes are and specify the action to be taken by staff to meet those needs and wishes. Where there are restrictions or limitations in place due to the needs of the resident, these need to be fully recorded and kept under constant review. The home may benefit from undertaking some dementia mapping, to establish ongoing aspects of the service that may need further development. Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 7 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. Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 8 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 Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 9 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 makes arrangements to assess the practical support and healthcare needs of residents prior to admission. Assessments currently fail to address other essential aspects of quality of daily life for residents that promote choice, control and independence. Quality in this outcome area is adequate. This judgement has been made using available evidence including a site visit to this service. EVIDENCE: Greensleeves does not provide intermediate care packages or rehabilitation; consequently standard 6 is not reviewed. The inspector carried out a series of case tracks to provide documentary evidence for quality of lifestyle planning. While assessments are carried out with residents prior to admission, much of the focus of the assessment is currently around practical daily support issues that the home appears to provide quite well. Residents spoken to who needed support in such areas as personal care were found to be quite contented with how and who provided this support. The home needs to extend assessment to ensure residents are enabled to continue to reach their full potential as individuals. Assessment formats need to consider issues around mental health Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 10 and emotional and psychological support needs. More detail of what residents did in their lives would be helpful to determine their individual histories and interests, and consequently enable the home staff to begin to plan relevant activities that really are meaningful to the individuals involved. Residents with high support needs external to the home need to be offered opportunities to get out more, especially now the weather is improving, this could be achieved by encouraging families or friends to become more involved. Where residents are receiving special support to access the local community, this needs to be negotiated with the resident concerned as to how the resources for support are used. The residents should be encouraged and enabled to take as much control over their care and support packages as possible. Due to the needs and wishes of one resident the support he receives would be better provided throughout the week as opposed to all in one day. Assessments that focussed on such aspects of quality of life and choice would potentially improve the outcomes for residents significantly. Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 11 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): 7-8-9-10 The home provides care-planning systems that quality assure arrangements to meet residents health and personal care needs. Care plans do not sufficiently promote individuality or address other essential aspects of resident wellbeing including emotional and psychological needs and wishes. Care plans do not provide specific detail for staff to guide them in their daily interventions with residents. Arrangements for the administration, recording, storage and handling of medications were safe. Resident independence is not always fully promoted. Staff members treat residents with respect and promote their privacy. Quality in this outcome area is adequate. This judgement has been made using available evidence including a site visit to this service. EVIDENCE: There was evidence that residents’ health and personal care needs are identified via assessment and a plan of care put in place. Residents in receipt of intimate and personal care were found to be happy with how this is provided by staff members. Staff were observed treating residents with dignity and respect, and there appeared to be a genuine warmth in the home, especially toward more vulnerable residents, with age relate mental health problems. The Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 12 degree to which care plans specify each individual’s personal wishes and choices appeared to be limited, with aspects of care plans repeated from one service user to another in such areas as personal care, feeding, toileting etc. Care plans did not appear to promote individuality, choice and control to the highest possible level based on the abilities of each individual. Assessments and care plans did not fully take account of other essential aspects of promoting positive outcomes for residents in such areas, as emotional and psychological support needs. Plans failed to specify in detail the actions needed by staff on a daily basis to meet the needs and wishes of each resident, focusing on practical issues as opposed to quality of life outcomes. However, in discussion with the new manager the previous manager had not addressed many of these issues, and it is the intention of the new manager to make any improvements needed to make Greensleeves a better place to live. The manager stated that she and her partner wish to work with the CSCI and any other stakeholders in making the home the best in the area. Arrangements for the administration of drugs and medicines appeared to be safe. Staff members confirmed that they had received training in this area, and residents spoken to said they were happy with the arrangements provided at the home in regard to their medications and health care. One resident currently subject to guardianship was not entirely happy with his current living arrangements, and he was advised of his rights under the mental health tribunal by the inspector at the time of the visit. Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 13 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): 12-13-14-15 The home needs to be increasingly pro-active in promoting positive resident lifestyles both within and outside of the home. The home needs to adopt a more positive approach to how the residents are consulted and involved in decisions about their home, lifestyle and lives. Residents, especially those people who are more confused need to be supported and encouraged to make choices and take more control over their lives. The quality of the service could be improved if residents were consulted and empowered more. There was evidence of a commitment by the new manager/owners to improving the quality of service provided at the home. Residents are happy with the quality, choice and variety of food provided at the home. Quality in this outcome area is adequate. This judgement has been made using available evidence including a site visit to this service. EVIDENCE: The inspector was given the structure for residents’ activities for each week in the home and this outlined that on Monday – Movement and Music; Tuesday – Nails, hand-massage and facials; Wednesday – Skittles; Thursday – Reminiscence Therapy; Friday – Beanbags; Saturday - Bingo/board-games; Sunday – Movies. Residents spoken to indicated that activities had increased recently, however, there were still long periods of boredom and a lack of opportunity to get out. The type and nature of activity did not appear to be Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 14 based on any assessment of needs or wishes, as this was not documented, there was also no evidence recorded that residents had been consulted about the type of activities provided. Some residents spoken to confirmed that they had not been consulted as to activities, but that they enjoyed them when they happened. There was little recorded evidence of the outcome of activities being provided within care plans, so it will be difficult to monitor the success/relevance or otherwise of such initiatives, it will also be difficult to determine when activities need to be changed from those described above, in order to ensure they continue to accurately reflect the needs and wishes of residents. Residents’ said there were no restrictions to when they saw visitors, and that the home’s staff always made their visitors welcomed. There is a visiting policy and a visitors book, however, how accurately this book was being maintained could be questioned? The visitors book is an important document, not just from the perspective of fire safety, but the book, if accurately maintained, enables visiting to be monitored, and for residents who receive less visitors to be prioritised for support with this area of their lives, and provided with other forms of opportunity such as outings etc. The degree to which residents are enabled to take part in their local community is limited. Residents said they rarely go out from the home, unless taken by a relative. Once more this pointed to some degree of weakness in assessment in determining if residents were religiously active prior to admission, in order that the home could then pro-actively support residents to maintain these links with their communities outside of the home. One resident stated that he wished to go out to his local pub to have a pint, play dominoes and read his paper as he used to before being placed at the home under guardianship. The degree to which residents are actively encouraged and supported to exercise choice and control over their lives could be increased by the improvement of key working systems that enabled staff members to get to know residents more closely, and to establish appropriate relationships that would encourage staff to advocate for those people in their care. There was evidence that the home needs to adopt a more pro-active approach to how residents are consulted and listened to, both formally and informally in their home. The home may benefit from undertaking some dementia mapping exercises to assess quality outcomes and areas of the service that need to be further improved and developed with residents. The new manager was very interested in how she might improve the home and this bodes well for the future of the service. Residents and staff spoken to were all positive about the new management arrangements and said the home was a much happier place since the new manager took over. Residents’ feedback about the food varied from “it is adequate” to “the food is very good”. Consequently the provider may wish to consult residents about menus and food quality, and may wish to refer to the latest CSCI publication “Highlight of the day?” which can be downloaded from the CSCI website free of charge. Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 15 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): 16-18 The service needs to be more pro-active in it’s approach to listening to residents’ concerns. The home needs to develop a complaints procedure that is easily understood by residents, and that may be used by residents when they need to. The home needs to consider the use of advocates for more dependent and vulnerable residents to achieve a better quality of outcome in this area. The manager and staff are aware of the local adult protection procedures. The home undertakes checks on staff to promote the protection of residents. Quality in this outcome area is adequate. This judgement has been made using available evidence including a site visit to this service. EVIDENCE: Two residents spoken to were less than contented with the services being provided. One of these residents is subject to an order to stay at the home for their own protection, and is currently subject to guardianship. This said there is still a need to listen to the resident concerned as to how his care package is provided to him and for the home to support and encourage this resident to retain skills he had prior to admission. It was clear that this resident is becoming increasingly frustrated and there is a need to carefully monitor the ongoing matter of his placement by the commissioners and health care staff involved in his protection. At the time of the visit the inspector advised the resident of his rights under the mental health tribunal. Another resident shared her concerns about a staff member she felt she had a clash of personalities with. This resident was not fully aware of the complaints procedure, and said she had never had this explained to her. The manager felt she had been given a copy of the complaints procedure as well as the residents’ daughter. Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 16 Currently the home’s complaints procedure or guidance as to where this can be found, accessed or used is not prominently displayed at the home, and the only format is a written one, which may not be fully understood by an older person with age related mental health problems. The resident who wishes to appeal to the health tribunal will need to be seen by an approved social worker in order that some preparation work is undertaken to ensure his wishes are considered. It may also be necessary to provide an advocate to this resident given his specialist needs. This should be arranged by the local social services in consultation with all relevant others involved in this residents life currently. One other resident stated that she wished to move from a double bedroom to a single room. As there were 2 single bedrooms vacant at the time of the inspection the manager has agreed to arrange this with the resident and her family. Consequently there was some evidence that the culture of the home needs to change in the context of how residents wishes are considered and how residents are consulted in the running of their home and taking as much control as possible over their daily lives. There had been no formal complaints to the CSCI, however, the CSCI were aware that management arrangements needed to be improved. There was evidence of a clear commitment from the new owners to make the necessary changes to improve the management of the home, and to ensure the service becomes more pro-active in the area of complaints. Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 17 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): 19-23-26 The homes’ appearance was valuing and homely, for an establishment accommodating 21 people. The environment appeared reasonably maintained and safe. The home needs to ensure that people who have been fully consulted and chosen to share a room only share double rooms. The home was cleaned to a good professional standard throughout. Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to this service. EVIDENCE: The inspector undertook a tour of the premises. The home was cleaned to a good standard. A separate domestic worker is employed. The environment was reasonably maintained. Two bedroom door locks were not working. The inspector was advised these matters are being dealt with. A small window in the ground floor communal WC was broken. The manager advised this is being dealt with. Residents said they were quite happy with how the premises were presented and maintained. One resident said her room was drafty. One resident was accommodated in a double room with out having been given the Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 18 right to exercise informed choice. The manager agreed to provide this resident with the choice of a single bedroom. Given the size of the home the laundry area appeared to be very small. The manager advised this is not a problem. Residents said they were happy with the laundry services, and the cleanliness of their home. A number of residents were interviewed in the privacy of their own rooms and all residents appeared to have been encouraged and supported to personalise their rooms. Residents had personal possessions and photos of loved ones displayed. Many rooms have individual en suite facilities. Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 19 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): 27-28-29-30 The home provides a mix of skilled staff that meets the practical needs of residents. More specialist training could be provided in the area of dementia caused by alcohol abuse. Arrangements are in place to promote the safety of residents without infringing their rights. Selection and recruitment procedures are in place for staff employed, and all checks are carried out as part of a robust process to protect residents. NVQ and core training is in place. Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to this service. EVIDENCE: On entering the home there were three care staff and a cleaner on duty to meet the needs of 18 residents. Two hours after the start of the inspection the manager arrived on site. The senior carer was covering the cook on the day of the visit. Staff members were observed to treat residents with dignity and respect. Staff members were supporting more vulnerable residents’ in a sympathetic and kind manner. Residents generally spoke highly of the staff team. One resident said there was a clash of personalities between herself and one staff member. The manager will be investigating this with those people concerned, and explaining the rights of the residents to make her concerns known, and to have them dealt with. The home had a clear rota of staff hours that accurately reflected staffing arrangements. There was evidence of a clear commitment to the ongoing training and development of the staff team. Three staff members on duty were NVQ trained. Baseline training was found to be in date for manual handling and moving, fire, food hygiene and health and safety. Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 20 One staff member was interviewed and said the home was improving since the new owners took over and new management arrangements put I place. Staff confirmed that were able to provide more activities since staffing level had been increased. A sample of staff records provided evidence that all appropriate checks are carried out on staff prior to being offered employment working with vulnerable adults. The manager is to undertake the NVQ 4 and registered managers award. Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 21 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): 31-33-35-38 The manager needs to be registered. There was evidence that management arrangements are improving. The home needs to further develop and formalise quality assurance systems and place residents at the centre of the running of the home. The home needs to increase the frequency and type of consultation being undertaken with residents and other stakeholders. The home promotes the health and safety of residents and staff. Quality in this outcome area is adequate. This judgement has been made using available evidence including a site visit to this service. EVIDENCE: Staff and residents said that the home was better managed than before. One relative and two professionals who were interviewed by telephone also stated that they believed the home is now better managed. The commission were aware that there had been difficulties due to absence of the manager and alleged miss-management in the past, and a number of concerns had been Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 22 raised with the new owners in regard to this matter by the CSCI. These matters culminated in a meeting with the new provider, and it has been decided that one of the directors would become the registered manager. The CSCI has been advised that the owners have taken action with the former registered manager who had been absent from duty at the home without permission from the owners. An inspection visit to the home took place on the 6/12/06, following the meeting to discuss concerns above, and the report of this inspection is available on the CSCI website. The new manager demonstrated a commitment to the ongoing development and improvement of the home for the benefit of residents. The home needs to document how residents are consulted and formalise these arrangements to provide evidence that the home is being run in the best interests of the residents. There are a number of areas identified above that indicate there is still a lot of work to be done to promote resident involvement, control and interests. This will need to start with assessment, care planning and review; resident consultation forums and records; complaint procedures; the general culture of the home will need to become more pro-active in encouraging and supporting residents to take more control of their lives and how their home is run. The home needs to actively listen to residents and frequently seek their views, and residents in shared rooms must be consulted. Staff members were able to demonstrate an awareness of fire procedures. Residents said they felt safe living at the home, and confirmed that they could have access to their money when needed. Manual handling training had been updated and risk assessments had been put in place. The inspector was advised that there are sufficient staff members trained in first aid to provide 24 hour cover. Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 23 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 2 X X 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 2 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X 2 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 2 X 2 X 3 X X 3 Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP3 Good Practice Recommendations Assessments need to include the development of personal profiles of residents who are more confused to establish personal histories, interests, likes, dislikes. This work should be carried out as far as possible with the resident and/or a relative who knows them, to promote the involvment of residents in their care records. Such information should then be used to increase the emphasis within care plans of residents emotional and psycological needs, and of the actions needed to promote an improvement in quality outcomes for residents. There is a need for increased vigilance from staff and management to the upkeep of daily care records/chronologies. Care plans need to develop further to cover social aspects of the residents quality of life. Plans need to be more specific in the ACTION aspect that guides staff in their daily interventions with residents. DS0000059080.V287657.R01.S.doc Version 5.2 Page 25 2 OP7 Greensleeves Residential Care Home 3 OP18 OP33 It is recommended that some dementia mapping of indiduals at the home be carried out to determine the outcomes for residents with age related mental health needs. Residents should be consulted more often in such areas as the provision of activities, outings and entertainments; the day-today running of their home including food menus. A type of resident friendly notice board could be provided to increase and promote daily orientation for more confused residents. It is recommended to provide a notice board that can be written up daily in large clear letters, and provide such information as the day; year; weather; activities happening that day; food menu for the day; staff on duty, resident consultation meeting dates etc. A user friendly complaints procedure could also be displayed here. The resident in a double bedroom should be offered an informed choice/alternative room in line with her stated wishes and the NMS. 4 OP23 Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Greensleeves Residential Care Home DS0000059080.V287657.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!