Inspection on 24/05/06 for Greenways Residential Home

This inspection was carried out on 24th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Greenways Residential Home 14/10/09

Greenways Residential Home 23/09/08

Greenways Residential Home 18/10/05

Greenways Residential Home 02/06/05

Greenways Residential Home 09/12/04

Greenways Residential Home 28/05/04

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

CARE HOMES FOR OLDER PEOPLE Greenways Residential Home 6-8 Victoria Road Southwick West Sussex BN42 4DH Lead Inspector Mrs D Peel Unannounced Inspection 24th May 2006 10:30 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 Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 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. Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Greenways Residential Home Address 6-8 Victoria Road Southwick West Sussex BN42 4DH 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) 01273 591573 Mrs Brenda Clark Mrs Brenda Clark Care Home 15 Category(ies) of Past or present alcohol dependence (1), Old registration, with number age, not falling within any other category (14) of places Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 1 person in the category A (past or present alcohol dependence) to be accommodated at any one time 18th October 2005 Date of last inspection Brief Description of the Service: Greenways is a care home registered to provide personal care and accommodation for up to 15 older people. The property is detached and is situated in a residential area close to the centre of Southwick. Shops and other local community facilities are nearby. The majority of private accommodation is arranged on two floors. The upper floor can be accessed by a passenger lift, however four bedrooms on the middle mezzanine floor can only be accessed by steps. The majority of rooms are for single occupancy and have en suite facilities. Communal space consists of a lounge/dining room, a conservatory and there is a garden and patio to the rear of the house. Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by Mrs Diane Peel on the 24th May 2006. The intended outcomes for 33 standards were assessed; these included the key standards for care homes providing a service to older people. Prior to the visit to the home the inspector reviewed information provided by the manager in a pre inspection questionnaire completed at the request of the inspector some weeks prior to the visit and other information received from the provider since the last visit to the home on the 18th October 2005. A case tracking exercise for three residents was undertaken to look at how the assessed needs of this group of residents with diverse needs were being met. The inspector spoke with a group of residents in the conservatory and other residents individually whilst visiting them in their bedrooms. The majority of those residents spoken with were satisfied with the standard of care and praised the staff for their kindness. Five service user surveys were returned to the inspector during the visit all reporting satisfaction with the service at the home. The records of three staff were inspected and staff were spoken with informally during the visit to find out what it is like to work at the home and what training had been provided. Samples of other records required to be kept by the home were viewed during the visit to ensure that the provider is meeting their obligations with regard to the administration of the home. The current scale of fees being charged at the home is from £325 to £390 per week. What the service does well: Residents say that the staff are friendly and try to help them feel at home by being flexible with routines. The environment is homely and residents have taken the opportunity to make their own bedrooms reflect their own tastes. Care plans are informative and show that resident’s needs are assessed and regularly reviewed by staff at the home. Residents are encouraged to remain part of the community; those who are able can access local facilities. Residents say that their relatives and friends can visit the home whenever they want and they are made to feel welcome. Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5,6 Prospective residents and their families are provided with the information they need to make an informed choice about the home and are encouraged to visit the home before making a choice. Residents and their relatives/advocates have a contract so that they know the terms and conditions of living at the home are. Residents are assessed prior to moving into the home to make sure that the home can meet their needs. The outcomes for residents are good. EVIDENCE: Greenways have a Statement of Purpose and Service user Guide, called a Residents Guide. This document was observed to be available in each of the bedrooms visited during the visit and had been revised since the last visit to the home. Contracts were in place for those residents whose records were viewed but not all residents spoken with were aware if they had a contract or not even though at least one of these residents had signed the contract themself. Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 9 Two residents had moved into the home since the last visit. It was observed that both residents had their needs assessed before moving into the home. One resident spoken to who had moved into the home since the last visit commented that they had visited with a relative and liked it, and so moved in soon afterwards. They said, “ Its very comfortable and it feels like home. I can come and go out when I want”. Intermediate care is not provided by the home although respite care is sometimes offered. Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 10 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): 7,8,9,10,11 Systems for care planning give clear information to assist with all aspects of health, personal and social care needs. Records are in place to monitor the health care needs of residents and record intervention from medical professionals. The homes medication procedures ensure that medication is well managed. Dying and death are treated sensitively and with respect, with support and comfort being offered to families. Outcomes for residents are good EVIDENCE: Four care plans were examined at this visit to the home and a case tracking exercise was undertaken to find out if the assessed needs of residents had been developed into a care plan which staff were following to meet individual residents needs. Plans were informative, identified problems, had expected outcomes and explained what staff should do to care for that individual residents without taking away any independence which that resident might have. An example of this was that it was identified in one persons care plans that they wished to remain independent with personal care tasks for as long as Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 11 possible. Risk assessments had been carried out and together it had been agreed that assistance with bathing would be provided. Discussion with the resident confirmed that this person had a bath twice a week and has help from the care staff, which they had requested. Care records and daily care notes record any changes in the heath and welfare of each resident. They record any visits by medical professionals and outcomes to these visits. Medication reviews are also recorded. The home has a medication policy including a homely remedies policy, which were provided prior to the visit to the home. They had been revised this year. The inspector observed the secure storage and administration of medication during the visit to the home to see if the policy was being followed. Whilst examining cards and letters received, included in the homes quality assurance records it was noted that there were many thank you cards from relatives who commented on the support from staff during the death of their relative at the home or when they had to go into hospital prior to their death. Training records showed that at least one senior carer had attended a course on the physical and psychological care of the dying. The inspector observed that the home has a policy for dealing with death and dying and that a supply of “ What to do after death” leaflets were observed to be present to give to relatives and friends. Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 12 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 has flexible routines which allows those who are able, to exercise choice and some control over their lives. Activities are offered and residents who are able are encouraged to be part of the community. Residents are encouraged to maintain contact with their family and friends so that they so that they can satisfy their social and emotional needs. Home cooked food is provided to a good standard with choices of alternatives available. Outcomes for residents are good EVIDENCE: Some of the more able residents spoke with commented about the ability to maintain their independence. One person spoke about the convenience of the home being so close to shops and local facilities. This person commented that they were able to go out and come back when they wanted. There are some opportunities to take part in activities and events at the home but residents made it clear that they are able to choose if they take part or not. Resident meeting notes observed during the visit showed that residents have strong views. Activities such as art and crafts, movement to music and bingo Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 13 were popular and the suggestion of card games and memory boxes had a good response whilst attending a local tea dance was not so popular. Other matters discussed showed that residents are encouraged to exercise choice and control over their lives. One resident spoke about a recent birthday when twelve members of their family had visited and how the staff had made everyone feel welcome. Another person who had just moved to the home at the time of the last visit by the inspector said “ I really have settled in” they said “ I love to have lovely cooked meals everyday without having to worry about the washing up.” This resident confirmed that their family can visit whenever they want and the staff make them welcome. The home has a rotating menu which residents are consulted about at their meetings. Residents spoken with felt that there was plenty of choice and that if they didn’t like what was on the menu or “fancied” something different then they knew that they could ask for an alternative. Questionnaires returned to the inspector on the day of the visit reported a good standard of food. One questionnaire reported, “ The cooking is extremely good. I enjoy my food and have a good appetite. The butcher is the same as I used myself”. Another questionnaire reported, “Yes I like the food and there is plenty of it.” During the visit residents were heard to make complimentary remarks about the lunchtime meal, which was chicken with garlic potatoes and fresh, vegetables followed by ginger sponge and custard The records of food chosen and eaten by residents record what fresh vegetables are provided each day as the weekly menus state “ seasonal vegetables.” Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 14 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 complaints procedure is clear and enables those using the service to have the confidence that their complaint will be responded to within a maximum of 28 days. The registered person has arrangements in place to protect residents from being placed at risk of harm or abuse. Outcomes for residents are good. EVIDENCE: The complaints procedures are on display in the home and a leaflet was observed to be in each bedroom with the resident’s guide. There has been one complaint to the home since the last visit in October 2005. This complaint was raised as an adult protection alert but then dealt with through the homes own complaints procedure. It was felt that this complaint could not be substantiated. The complaints record book at the home could be improved to assure confidentiality. This matter was discussed with the manager who has agreed to introduce another format. Residents returning surveys to the inspector report that they know how to make a complaint. The home has an adult protection procedure, which was revised in March 2006. Staff have attended Adult protection training by an independent training provider and staff are aware of procedures to follow. Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 15 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): 19,20,21,22,23,24,25,26 Residents have a comfortable, homely environment to live in. Bedrooms are comfortable and meet the needs of the residents. Residents are encouraged to contribute to making their bedrooms their own by having their own personal possessions around them. Residents have a reasonably clean home to live in. Outcomes for residents are good. EVIDENCE: The inspector visited all areas of the home with the exception of two bedrooms. All areas viewed were clean although one bedroom carpet was beginning to look tired and stained. This matter was discussed with the manager who said that she is already looking at alternatives. The communal areas of the home feel homely and are used by residents. New curtains and some replacement chairs in the lounge and conservatory have made improvements to what already were comfortable areas. Most of the dining room furniture has been replaced since the last visit to the home. Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 16 Many bedrooms have in addition to en suite facilities a small washbasin in the corner of the room which are mostly unused. It was observed that one such hand basin was in need of de scaling. The manager explained that the resident users this basin to water plants which sit in water for a long time. The manager has agreed to clean the sink. The inspector observed environmental risk assessments covering radiators, which remain uncovered in the home. The temperatures of hot water running from three hot water outlets in resident’s rooms were recorded as running between 43 degrees centigrade and 48 degrees centigrade during the time of the visit. Action was taken to reduce the temperatures immediately but the inspector has recommended that regular monitoring of water temperatures in residents accommodation takes place and that records are kept. Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 17 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 Staffing levels at the home are meeting the needs of the residents living at the home. Recruitment procedures safeguard and protect residents at the home. Staff have taken part in training and Vocational Qualifications to maintain their skills and ensure that residents are safe. Outcomes for residents are good EVIDENCE: Rotas provided to the inspector before the visit and during the visit show that there is sufficient staff on duty with additional staff working at busy times of the day. Staff records and information provided before the visit show that 50 of the staff have an NVQ and have continued to develop their skills and knowledge by attending training since the last visit to the home. The records of four staff were examined during the visit to see if recruitment policies of the home were being followed and to ensure that those employed had Criminal Record Bureau Clearance and Protection of Vulnerable Adult Clearance. It was noted that one person being inducted was awaiting the return of the CRB and POVA clearance but the manager told the inspector that they are supervised when working with residents. Other required documentation was in place. Seven staff have recently attended a First Aid Course and the majority of staff have attended adult protection, responding to challenging behaviour training and understanding dementia training since the last visit to the home. In Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 18 addition some staff have completed a safe handling of medicines course in November 2005. Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 19 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): 31,33,35,37,38 Systems are in place to ensure the effective management of the home. The views of residents, their families and friends are sought to measure how successful the home is at meeting its aims and objectives and the statement of purpose of the home. The homes record keeping with regard to residents monies kept by the home is not always safeguarding service users rights and best interests Procedures are in place to ensure that the home is a reasonably safe environment to live in. Outcomes for residents are adequate. EVIDENCE: The manager has more than two years experience in a management position and has completed an NVQ Level 4 in Care Management. Customer consultation questionnaires show that residents and their families have been consulted about their views of the home. Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 20 There are residents and relatives meetings and minutes of these are available and staff meetings are held and staff opinions sought. A few residents have monies kept by the home on their behalf. The records of records of incoming and outgoing expenditures were observed. It was recommended that errors in these records should not be erased but scored through and initialled. Other records examined at this visit were up to date and well maintained. The temperatures of hot water running from three hot water outlets in resident’s rooms were recorded as running between 43 degrees centigrade and 48 degrees centigrade during the time of the visit. Action was taken to reduce the temperatures immediately but the inspector has recommended that regular monitoring of water temperatures in residents accommodation takes place and that records are kept. Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 21 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 3 3 3 3 3 1 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 3 X 3 X 2 X 2 1 Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 22 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. 1 Standard OP38 Regulation 13.4(a)(c) Requirement Water temperatures of hot water leaving hot water outlets should be regularly monitored and records kept to ensure that residents are not at risk from scalding Timescale for action 01/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 Refer to Standard OP16 OP37 Good Practice Recommendations It is recommended that the format being used to record complaints could be improved to promote confidentiality It is recommended that errors in any records should not be erased but scored through and initialled. Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Greenways Residential Home DS0000014543.V293205.R01.S.doc Version 5.1 Page 24 - 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. 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