Inspection on 11/09/08 for Greenways

This inspection was carried out on 11th September 2008.

CSCI found this care home to be providing an Good service.

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

Greenways 29/06/06

Greenways 27/01/06

Greenways 05/09/05

Greenways 07/02/05

Greenways 14/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Greenways 227 Hawthorne Road Bognor Regis West Sussex PO21 2UW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sheila Gawley     Date: 1 1 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Greenways 227 Hawthorne Road Bognor Regis West Sussex PO21 2UW 01243823732 Telephone number: Fax number: Email address: Provider web address: home.bog@mha.org.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Mavis Eileen Stevens Type of registration: Number of places registered: Methodist Homes for the Aged care home 41 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: No service users under 65 years of age may be admitted. Up to 41 male and/or female service users over 65 years of age may be accommodated. Date of last inspection Brief description of the care home Greenways is a Care Home situated near the town centre of Bognor Regis. It is a purpose built Care Home registered to accommodate up to forty-one Service Users in the category OP (old age, not falling into any other category). The home is divided into five wings with accommodation over three floors, accessed by a vertical lift. All rooms are for single occupancy and each has en-suite facilities. There is a large wellmaintained garden accessible to Service Users. The Registered Manager is Mavis Stevens. The home is owned by Methodist Homes. 0 Over 65 41 Care Homes for Older People Page 4 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This is a 2 star good service. This means the people who use this service experience good quality outcomes.This site visit as part of the inspection process was carried out on 11th September.Prior to the visit the service file was reviewed as were any comments or complaints received by the Commission for Social Care Inspection. The home had sent us their Annual Quality Assurance Assessment for the inspection, which gave us the information we needed on the home. People who use the service and staff were spoken to on the day. We were in receipt of comments on fifteen surveys we had sent to people who use the service, one from a professional and two from staff and one from a professional. Comments from people who use included The staff are amazing and work very hardWould recommend it to anyone good food-delightful saladCould not wish for betterFour people who use the service were case tracked Care Homes for Older People Page 5 of 23 during the inspection. Staff and people who use the service spoken to on the day stated that they were happy in the home.The premises were toured. The acting manager facilitated the inspection and any documents required on the day were made available. The atmosphere within the home was restful and relaxed and the staff carried out their duties in a respectful manner taking into account the dignity and privacy of residents. A fire drill was handled according to policy. All of the outcome groups assessed today were rated as good or excellent. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good quality in this outcome area because needs are assessed and information needed to make an informed choice is available. This judgement has been made using available evidence including a visit to this service. Evidence: Evidence of comprehensive pre admission assessment was seen in care plans. Two people who use the service who were spoken to confirmed that they had this assessment and received all help and support to move into the home. Standard 6 is not applicable. Care Homes for Older People Page 9 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good outcomes in this area. All needs are assessed and met, They are set out in a plan and people who use the service are treated with respect. Medicines are handled safely according to policy. This judgement has been made using available evidence including a visit to this service. Evidence: All residents had a plan of care. Four people who use the service were case tracked, their care plans were inspected and these contained information on health, personal, spiritual and social need. The care plans were person centered, people who use the service spoken to stated that they felt confident when entering the home that their need would be met.The plans were drawn up following an assessment of needs. This included mental, physical and social need, nutritional assessments, mobility, hygiene continence, and pressure areas, and risk assessments. The risk assessments covered, moving and handling, nutrition, pressure area risk and tissue viability. There were daily records and evidence of monthly review and weight is monitored. There is clear narrative on what each area of the plan addresses, for example the narrative in one Care Homes for Older People Page 10 of 23 Evidence: section states that there must be an awareness of healthy living initiatives, medical needs, activities, exercise, dietary need and the need to support a positive attitude to life. This ensures carers are clear about the support they are to offer. There is a monthly audit of care plan. There is a key worker in place and staff demonstrated what this implied to them, such as acting as a advocate for the people who use the service. Independence and individuality is encouraged. Two people who use the service commented on their surveys that they make and attend their own doctors appointments. They confirmed that medical consultations and all care is offered in the privacy of their room and all staff knock prior to entering. Access to specialist health support is available as required including general practitioner, district Nurse, dietitian and speech and language therapist. and chiropodist,.End of life wishes are recorded and the home allocate staff to sit with people at the end of their lives in line with relatives wishes. Medicines are received stored, administered and recorded correctly. All medicine administration charts were up to date. Controlled drugs were correctly stored. Those people who use the service risk assessed as being able to selfadminister do so. A lockable space is supplied in bedrooms for the safe storage of these medicines. There is training, policies and procedures in place to support the safe administration of medicines. The home was not overstocked with medicines. There is a one and a three monthly audit of medicines. Staff were observed offering care in a respectful and encouraging manner and people who use the service spoken to stated that they are treated with respect. People who use the service spoken to also stated that care is offered as assessed. One person who uses the service commented, “Carers patience is beyond belief and another stated The staff are amazing, they work very hard. There is a comprehensive training programme in place to ensure need are met by a suitably trained staff. Care Homes for Older People Page 11 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good quality in this outcome area because The lifestyle experienced in the home meets the needs of those who live there. This judgement has been made using available evidence including a visit to this service Evidence: All of the comments on surveys received on life in the home were very positive. The home has a very relaxed and calm atmosphere. A professional commented it is an excellent caring home and all of the questions on the survey were responded to as alwaysA person who uses the service commented I never knew there were such kind and helpful people The majority of people who use the service spoken to stated that they were happy with the activities in the home, although some said they did not join in due to disability. There are trips out in the minibus music and movement, concerts, crosswords, knitting, birthday parties and seasonal events. One person commented that the activities had reduced of late as the activity coordinators hours had been reduced. All people who use the service get a weekly timetable of activities planned. One person who uses the service. organises a classical music afternoon to which other people are invited to participate. There is a well-maintained garden with a Care Homes for Older People Page 12 of 23 Evidence: variety of vegetables growing which the people who use the service help to cultivate. There is a library in the home and the home has links with West Sussex libraries.Relatives are welcome in the home and are offered refreshment. Clergy visit the home and there are weekly services. People who use the service are also taken to church on Sundays if they wish.There is a nutritious menu in place, which offers choice. There is often a regional monthly themed food. The people who use the service mostly felt that the food was good but there were some criticisms. One commented the menus were not well thought out Another responded adequate, as you would expect, and another some days good all day, others not. The acting manager had been made aware of these criticisms by the people who use the service and active measures were being made to change the menus with input from people who use the service. The meal seen served on the day was well presented and enjoyed by people who use the service Care Homes for Older People Page 13 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service experience good quality in this area because a complaints system is in place and systems are in place to protect residents from abuse.This judgement has been made using available evidence including a visit to this service. Evidence: There is a clear complaints procedure which is on display and which is included in the Statement of Purpose and Service User Guide. People who use the service spoken to stated they were aware of the procedures. The procedure is on display and clearly identifies whom a complaint should be addressed to and the timescales in which a complaint will be dealt. It needs to be updated with the Commissions new contact details. People who use the service were clear as to whom they can raise concerns with.There was evidence that staff attend safeguarding adults training to ensure that people who use the service are protected. There were good administrative records of this training. Care Homes for Older People Page 14 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good quality in this outcome area because they live in a well-maintained homely and relaxed environment with pleasant grounds and garden areas. This judgement has been made using available evidence including a visit to this service. Evidence: The home externally and internally is decorated to a good standard. It is arranged in five units each with its own dining room. There is a large lounge and conservatory and further small seating areas about the home. It has comfortable homely furnishings. Radiators are covered. There is a well-maintained garden with a variety of vegetables growing which the people who use the service help to cultivate. The specialist equipment required to meet the needs of people who use the service is in place. There are sufficient wheelchairs, hoists and assisted baths and there are grab rails.Bedrooms are well decorated with comfortable good quality furnishings. The bedrooms are personalised according to the wishes of people who use the service. One married couple who choose to share have adjoining rooms, one serving as a sitting room and the other as a bedroom. this reflects the homes ability to address the diverse needs of people who use the service All have en suite toilet and shower. The home was neat, clean and free from offensive odours on this occasion. Doors have locks and temperatures are recorded weekly. There are suitable laundry facilities sited Care Homes for Older People Page 15 of 23 Evidence: away from food storage and preparation areas and which contains machines with all the requires temperature programmes. Care Homes for Older People Page 16 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience excellent quality in this outcome area because needs are met by suitably qualified staff.This judgement has been made using available evidence including a visit to this service. Evidence: Staff rota showed staffing levels were sufficient to meet the needs of residents. There is housekeeping, laundry and kitchen support. Staff were observed going about their duties in a relaxed and respectful manner. A fire drill was handled quietly and according to procedure. A call bell was responded to promptly. There are robust recruitment procedures in place and staff files inspected contained all the documentation required to ensure the protection of people who use the service. There was evidence of application forms with employment history. Criminal Records Bureau Clearance and POVA check, two references, identity documentation, and photograph were all in place. The comments received on staff surveys received were positive indicating that staff find the home to be a supportive place to work and this was confirmed by three staff spoken to on the day, they stated that training needs are met.People who use the service find the find the staff helpful. One person who uses the service spoken to stated “The staff are amazing, they work very hard, another commented carers patience is beyond belief.There is a staff-training programme in place which staff spoken to confirmed they attend. Training records were seen in staff Care Homes for Older People Page 17 of 23 Evidence: files. The training provided includes safeguarding adults, food hygiene, moving and handling, fire, infection control, first aid and health and safety.There is good administrative computerised documentation of this training, which flags up when a staff member is due for update. 60 of care staff have attained National Vocational Qualification Level 2 in Care. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good quality in this outcome area because the home is run in the best interests of the people who use the service. This judgement has been made using available evidence including a visit to this service. Evidence: The acting manager is in the process of applying to the Commission for registration, and is working towards RMA and has a NVQ4 in Care/Management and ILM 5 in Learning and management. She is supported by two assistant managers. There are monthly service managers meetings within the organisation to support and keep managers up to date with organisational policies and procedures. The AQAA provided was clear and comprehensive. It states that quality assurance systems are in place in the form of meetings for people who use the service, a 6 monthly internal audit involving residents and junior staff, annual resident satisfaction survey. this was evidenced on inspection. There is a monthly audit of care plans, a monthly audit of kitchen systems and a one month and a three monthly audit of medicines. There is an Care Homes for Older People Page 19 of 23 Evidence: annual self-assessment (Standards and Values Assessment) carried out be senior advisers in MHA . There was a recent food audit to address requests for change from people who use the service. Collated evidence from these quality assurance measures were available for inspection. There is strong support within the organisation and an internal management review includes a clear business plan. The style of management observed in the home was open and supportive. Staff spoken to stated that they felt supported in the home. People who use the service stated that the manager is approachable.The home does not manage any financial affairs for people who use the service and people have their own bank accounts. Allowances held for people who use the service are held securely and recorded and receipted.Staff supervision is in place, evidence of supervision was seen in staff files and staff spoken to confirmed that this occurs.The registered provided ensures the health, safety and welfare of people who use the service by the provision of mandatory training and has more that 50 of staff at National Vocational Qualification Level 2 in Care or above. The home meets the requirements of the local Fire Authority and Environmental Health Department.Substances hazardous to health are stored securely. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 22 of 23 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - 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!