Inspection on 29/09/08 for Greenways Nursing Home

This inspection was carried out on 29th 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

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 Nursing Home 171 Comptons Lane Horsham West Sussex RH13 6BW     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: 2 9 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 © (2009) 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 Nursing Home 171 Comptons Lane Horsham West Sussex RH13 6BW 01403259081 01403259086 ashtongrpgreen@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Kamta Prasad Fakun Type of registration: Number of places registered: Greenways Healthcare Sussex Ltd care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 31. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Date of last inspection Brief description of the care home 31 Over 65 0 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: The quality rating for this service is 2 stars. 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 29/09/08. This was the first visit to a new registration of an existing service. Prior to the visit the service file was reviewed as were any comments or complaints received by the Commission for Social Care Inspection. Four people who use the service were case tracked during the inspection. Care plans, wound care, personal care and nursing charts were examined as were medicine administration charts. Four relatives were spoken to on the day and they all expressed great satisfaction with the home, one stated that this home is better than all the other homes my husband has been in.The home had sent us their Annual Quality Assurance Assessment for the inspection, which gave us the information we needed on the home. Care Homes for Older People Page 5 of 23 Staff and relatives spoken to on the day stated that they were happy in the home. Activities were observed a quiz and some singing and the people who use the service appeared to enjoy this.The premises were toured. The registered manager facilitated the inspection and any documents required on the day were made available. The responsible individual was also available throughout the visit. 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: People who use the service have their needs assessed prior to admission to ensure the home will be able to meet needs. Evidence of this assessment was seen in care plans inspected and it was comprehensive including communication, mental wellbeing, medical need, personal need, vision, mobility, elimination and pressure area assessment. Residents spoken to could not express an opinion on information supplied to them prior to admission by the home however relatives spoken to stated that full assessment was carried out and that they were involved in the process. The responsible stated that the home is in the process of ensuring that all people who use Care Homes for Older People Page 9 of 23 Evidence: the service including those who are self funding have a contract. Care Homes for Older People Page 10 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 quality outcomes in this area because needs are assessed, reviewed and are met by staff in a respectful manner.This judgement has been made from evidence gathered both during and before the 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 they contained information on health, personal, nursing and social need. The care plans were drawn up following an assessment of these needs. This included mental, physical, personal and social need, nutritional assessments, mobility, hygiene, elimination, and pressure areas/ wound care, and risk assessments. The risk assessments covered, moving and handling, nutrition and pressure area risk. There were daily records and evidence of monthly review and weight is monitored. A key worker has been introduced and staff spoken to demonstrated what this means for them and for the people who use the service. They have knowledge of the people they are responsible for, they update care plans and Care Homes for Older People Page 11 of 23 Evidence: ensure all information on changing needs as passed on to nursing staff.Wound care records inspected evidenced that the home is working with the district nursing team in the care and treatment of wounds. Personal and nursing care records such as fluid charts and positioning charts were up to date. Access to specialist health support is available as required including general practitioner, district nurse and community mental health team. There is access to chiropody dentist and optician. Medicines are received, and stored, correctly. All Medicine Administration Charts for the people who use the service case tracked were up to date. Controlled drugs are appropriately stored and correctly accounted for. Policies and procedures are in place to support the safe administration of medicines. Registered Nurses administer the medicines. A drug audit has been introduced and the audit carried out in August was seen. Staff were observed offering care in a respectful and encouraging manner and relatives spoken to stated that their relatives are at all times treated with respect. One relative commented commented, “The care is excellent and communication is very good. Another commented the care is very good. Care Homes for Older People Page 12 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 outcomes in this area because the lifestyle experienced in the home meets their needs and expectations.This judgement has been made from evidence gathered both during and before the visit to this service. Evidence: An activities organiser is employed and attends for three half days a week. The activities includes music, quizzes, cards, art, poetry, aromatherapy, reminiscence. A pianist attends and two singers attend monthly. Last month The Council of Music for Hospitals gave a full concert. There are seasonal events such as summer barbecue and Christmas parties. A relative confirmed that she and all of her family attended the summer barbecue, which was said to be great fun with good food. The registered manager stated that all people who use the service receive a birthday cake and party as they wish. The people who use the service also receive an Easter Egg and a Christmas gift annually. There are twice monthly visits from the local clergy and one Hindu person who uses the service is taken home by family for festivals. Surveys are in place to consult people who use the service on leisure activities. Visitors are welcome at all times and are offered refreshment. The AQAA stated that daily routines Care Homes for Older People Page 13 of 23 Evidence: are flexible and that people are encouraged to exercise choice and control in their lives. The chef was spoken to and there is a rolling menu in place. There is a choice of food at all mealtimes . The choice of food for the meal on the day was displayed on a notice board. The meal seen being prepared and served on the day appeared nutritious and was well presented.Pureed foods were tastefully presented. A relative spoken to stated that every effort is made to meet requests and that Soya milk is provided for her husband. The chef and kitchen assistant have attended a food and hygiene course and the chef is to attend an update on October 9th. He is also to attend Advanced Cooking Level 4. The kitchen meets the requirements of a recent Environmental Health Department report. Care Homes for Older People Page 14 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: The AQAA stated that the home has a complaints procedure. This was seen on display in the hallway and it is also made available in the Statement of Purpose and Service User Guide. All concerns and complaints are recorded. There are also many cards and letters of gratitude to the home. Relatives spoken to stated that any concern would be addressed.There are safeguarding procedures in place and staff spoken to are aware of the processes to follow. Staff files contained evidence of safeguarding training. The home communicates well with the Commission and all incidents are notified according to the regulations. Care Homes for Older People Page 15 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 with pleasant grounds and garden areas. This judgement has been made using available evidence including a visit to this service. Evidence: The home was inspected and the environment internally and externally is well maintained and offers the people who use the the service a homely place in which to live in with comfortable furnishings. There is a programme of routine maintenance work and a handyman has been employed.The Home complies with the requirements from the local fire and environmental health authorities. Water temperatures are recorded. There are accessible well maintained grounds for people who use the service. there are suitable lifts, hoist and grab rails throughout. The home has suitable laundry facilities and was neat and clean and free from offensive odours. The responsible individual highlighted some hygiene issues which she wished to address such as the cleanliness of the floor attachment of the bathroom hoist. 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 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 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. 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. Staff spoken to on the day stated that the home is a supportive place to work and that training needs are met. they confirmed induction and a clear understanding of the key worker system and how it supports people who use the service, Relatives spoken to stated that the “The staff look after people very well . They work very hard. Another stated that this was the best home her husband had ever been in. There is a staff-training programme in place. Training records were seen in staff files. The training provided includes safeguarding adults, food hygiene, moving and handling, fire, infection control, first aid and health and safety. There is also training on communication skills, stoma care,epilepsy, dementia, challenging behavior, care Care Homes for Older People Page 17 of 23 Evidence: planning, risk assessment. Over 50 of care staff have attained National Vocational Qualification Level 2 in Care and two domestic staff are doing an NVQ in housekeeping 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 manager is registered with the commission as being fit to manage the home. He works in a supportive organisation and requests for new equipment are well received, such as the purchase of three new nursing beds. The AQAA provided was clear and comprehensive. It states that quality assurance systems are in place in the form of surveys for relatives which are soon to be extended to professionals. There are monthly staff meetings. Audit of medicines has been recently introduced. Collated evidence from these quality assurance measures were available for inspection. Recently 22 responses were received from 28 surveys sent out. The Home uses the ‘Blue Cross Mark of Excellence’ Quality Assurance system to Care Homes for Older People Page 19 of 23 Evidence: Audit its standards and practices. The home does not manage any financial affairs for people who use the service and they do not hold any allowances for people. Staff spoken to stated that they felt supported in the home. Relatives stated that the manager is approachable. 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 © (2009) 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!