Inspection on 15/11/05 for Greenwell House Nursing Home

This inspection was carried out on 15th November 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Greenwell House Nursing Home 01/05/07

Greenwell House Nursing Home 12/07/06

Greenwell House Nursing Home 13/04/05

Greenwell House Nursing Home 16/09/04

Greenwell House Nursing Home 08/04/04

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

CARE HOMES FOR OLDER PEOPLE Greenwell House Nursing Home Wycar Bedale North Yorkshire DL8 1ER Lead Inspector John McGarva Unannounced Inspection 15th November 2005 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 Greenwell House Nursing Home DS0000028028.V260507.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. Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenwell House Nursing Home Address Wycar Bedale North Yorkshire DL8 1ER 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) 01677 424012 F/P 01677 424012 The Fisher Partnership Mrs Liza Mufti Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 60 years plus Date of last inspection 13th April 2005. Brief Description of the Service: Greenwell House is a Care Home registered to care for up to 21 service users over 65 years of age who require nursing care. The service is provided in a detached stone built building on three floors; the upper floors are serviced by a vertical lift. There are 13 single rooms 7 of which have of en-suite facilities and 7 two-bedded rooms 3 of which have en-suite toilet facilities. The home is located near the centre of the market town of Bedale overlooking the local bowling green. Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection that took place on Tuesday 15th November 2005. The inspection lasted 3.5 hrs (10am to 1.30pm). There were 20 residents in the home, all requiring nursing care. The inspection focused a number of key standards and some areas of concern identified at the last inspection. An inspection of the premises took place, including a number of bedrooms, bathroom and lounge area. Residents spoken to were content with the quality of their care and the kindliness of the care staff. One resident was pleased with her care but expressed the wish to be in a room of her own. With four shared rooms, 38 of residents are sharing a room when the home is full, so this will be a recurring issue for some residents. What the service does well: The assessment documentation continues to be of good quality this helps ensure that all the residents’ health and social care needs are identified and met. The home provides a good standard of care, which is evident to see in the presentation of the residents as well as their comments. The staff are well motivated and several have been working in the home for some years. The manager has an open and inclusive style, which was evident to the inspector and in conversation with the staff and residents alike. Staff meetings have recently been convened and the staff spoken to appreciated this development. Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 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. Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 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 Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 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): 2 and 4 The resident’s are provided with appropriate information on admission and the home can demonstrate their ability to meet their needs. EVIDENCE: The resident’s contracts reflect the care and services that are provided in the home, including the rooms to be occupied. There is sufficient staff with relevant qualifications and experience to meet the needs of the registered categories for the home and access to other support such as community nursing and, medical and dental services is arranged as required. Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 10. There are systems in place to ensure that the health care needs of the residents are identified and met. EVIDENCE: Records of regular weighing are now routinely recorded, particularly where weight loss has been identified as an issue of concern. Residents spoken said that the staff are very good and kind and that their needs and wishes were addressed in a professional manner. The toilet doors throughout the home have now been identified and the sliding door for the toilet off the main lounge has been fitted with a privacy catch. A curtain pole with curtain has now been installed to provide a screen from the lounge and corridor where the toilet is immediately located. This now provides for more privacy from the main downstairs toilet. Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 Page 10 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 and 14. The resident’s wishes are respected in relation to activities and contact with relatives and friends is encouraged. EVIDENCE: The resident’s routines of daily living are tailored to their needs and choice within their physical capabilities. Many of the resident’s are too frail to benefit from actual diversionary therapy but the care staff endeavours to talk to them, providing appropriate conversation relating to their interests. Visitors can visit the home at any time they choose, day or night, with drinks being provided for them routinely. Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 Page 11 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): 18. There are appropriate complaints and adult protection policies in place to safeguard the residents from abuse. EVIDENCE: There are satisfactory Adult Protection and Whistle Blowing procedures available to protect the residents. The care staff are aware of what to do should any complaint or incident about a resident should take place. Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 Page 12 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): 19,21,22,24 and 26 There are a number of matters relating to the environment that require attention. EVIDENCE: Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 Page 13 The premises meet the standards for homes registered before 2002. Some issues identified at the last inspection have received attention: The general décor in places is tired, but the lounge, some rooms and corridor areas have been decorated. The toilets are now clearly identified. The outside windows have been painted. The toilet facility on the ground floor corridor leading to the lounge area now offers greater privacy with a door catch and a curtain screen from the lounge to the toilet corridor now provided. A number of matters are outstanding matters from the previous inspection include: • Some of the sash windows are in need of attention and two in the lounge are unable to be opened, causing heat gain problems in the warmer weather. There are no grab rails fitted round corridors, bathrooms or toilet facilities, although they have been purchased and await installation. There is a lack of storage facilities throughout the home with the consequent clutter of equipment located in corridors, stairwells, lounge and bathroom. Only 4 adjustable height beds are provided for service users who require nursing care, but two have been ordered. There are lockable facilities provided in only a few of the resident’s bedrooms for the storage of medications, money or valuables. Some rooms have a lockable drawer, but there are no keys. The sluicing facilities located on the first floor are not adequate to ensure safe practice. A single hot -water tap has been located on the wall for the cleaning staff to fill buckets etc, but no sink underneath. This can create problems with leakage and flooding. A slop hopper sink should be provided to help ensure safe practice. The location of the laundry facilities next to the lounge and kitchen constitutes a risk of infection and cross infection for residents. The provider has now rented a large adjacent building that was envisaged would accommodate the laundry and provide staff and storage DS0000028028.V260507.R01.S.doc Version 5.2 Page 14 • • • • • • Greenwell House Nursing Home accommodation. The old laundry space could then be redeployed for the provision of a shower room. However, the laundry has not been moved due to some contractual issues relating to the reliability of the machines. Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 Page 15 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 The residents receive a good standard of care from staff that is appropriately trained. More NVQ training is indicated for care staff that has not received it. EVIDENCE: There is only two of the care staff trained to NVQ Level 2 standard representing 15 of the care staff employed in the home. One member of staff has commenced this training and two have embarked upon the higher NVQ Level 3 training. When the four staff who have commenced their NVQ courses, complete, the home will meet the required 50 standard. The home provides sufficient foundation and mandatory training on a routine basis. There is enough staff at the present time to meet the needs of the residents and care staff indicated that more care staff from the Philippines were soon to start work at the home. Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 Page 16 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): 31,32,33.36. The home is well managed with staff that is kept informed and consulted on developments in the home. EVIDENCE: The Manager is a first level nurse with many years of experience in caring for the elderly and has worked in the home for several years. She has not yet decided whether to embark upon the NVQ Level 4 Management Award. The staff said that meetings with them had only recently been introduced and matters such as break-times, named carers and access to and writing in the residents care plans had been discussed. Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 Page 17 The care staff had not seen the last inspection report and there was no copy in the home to seen. There is no annual development plan for the home that staff are aware of. There is currently no quality assurance system in place, which would identify the wishes and opinions of the residents. This was a requirement from the last inspection. There is a training officer who oversees the training over the three homes in this group of homes and also organises the mandatory training in Moving & Handling, Health & Safety and Fire safety and First aid. There is no formal staff supervision in place at the present time and staff spoken to confirm that they could benefit from this. Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 Page 18 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 3 X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 1 X 3 2 1 2 X 1 STAFFING Standard No Score 27 3 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X X 1 X X Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 23(2)(a) (b)(d) Requirement The sash windows must be kept in working order. All parts of the home must be kept reasonably decorated. (Previous timescale of 1-5-05 not met) Lockable space and keys must be provided in each resident’s rooms so they can store money, medications or valuables. (Previous timescale of 1-9-05 not met) Plans to transfer the laundry to the adjacent building must be implemented.(Previous timescale of 1-9-05 not met) A slop hopper type sink must be provided in the sluice room. (Previous timescale of 1-9-05 not met) A quality assurance programme must be introduced. An annual development plan for the home should be produced and shared with the staff. (Previous timescale of 1-9-05 not met) Formal staff Supervision for the care staff must be introduced. DS0000028028.V260507.R01.S.doc Timescale for action 01/04/06 2. OP24 23(2)(m) 01/04/06 3. OP26 23(2)(k) 01/04/06 4. OP26 13(3) 01/04/06 5. OP33 24(1) 01/04/06 6. OP36 18 (1) 01/04/06 Greenwell House Nursing Home Version 5.2 Page 20 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 OP22 Good Practice Recommendations Suitably qualified persons including an occupational therapist should assess the premises. Grab rails should be provided in corridors, bathrooms, toilets and communal rooms. Additional adjustable height beds should be provided. The provider should endeaviour to have 50 of the care staff trained to NVQ Level 2 Standard. The manager should acquire NVQ Level in Management award The CSCI inspection reports should be made available to the residents and staff at the home. 2. 3. 4. 5. OP24 OP28 OP31 OP32 Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Greenwell House Nursing Home DS0000028028.V260507.R01.S.doc Version 5.2 Page 22 - 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!