Inspection on 18/09/06 for Greenwood House

This inspection was carried out on 18th September 2006.

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

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

Other inspections for this house

Greenwood House 29/07/09

Greenwood House 10/08/07

Greenwood House 16/11/05

Greenwood House 17/08/05

Greenwood House 16/02/05

Greenwood House 04/06/04

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

CARE HOMES FOR OLDER PEOPLE Greenwood House South Parade Peterborough PE3 6BG Lead Inspector Dragan Cvejic Unannounced Inspection 18th September 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Greenwood House DS0000035290.V312732.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. Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenwood House Address South Parade Peterborough PE3 6BG 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) 01733 569362 01733 568984 Peterborough City Council Susan Elizabeth Clayton Care Home 40 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (8), Old age, not falling within any other of places category (32), Physical disability (3) Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to three service users aged between 60 and 64 years may be accommodated at any one time These three services users will fall within categories PD and DE only Date of last inspection 16th November 2005 Brief Description of the Service: Within a few minutes walk of Peterborough city centre, Greenwood House is set in its own grounds at the end of a residential cul-de-sac. Service user accommodation is on two floors, and consists of 4 units. One unit is for 8 people with dementia care needs; the other units offer a number of respite places, and accept people who are admitted from hospital on an ‘interim care’ basis, as well as offering permanent care to frail elderly people. Each unit has its own lounge, dining-room, bathroom, toilet and kitchen facilities, and there is a laundry, main kitchen and staff facilities. The gardens are well kept and attractive, and one upstairs lounge opens onto a large balcony with garden furniture and an array of tubs and hanging baskets. The home is owned by Peterborough City Council: the management of the home transferred to Greater Peterborough Primary Care Partnership on 01 April 2004. Deadline for transferring staff to the NHS is coming in October 2006. There is a day centre which operates from a separate lounge in the building: the manager of the home is no longer responsible for the management of the day centre. Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out the during morning hours and lasted for 5 hours. The main methodology used was case tracking. Two service users were fully case tracked, but the comments about the home were collected from service users from all four units. The quality of service was measured and judged by the satisfaction that service users expressed. The judgement was supported by written evidence from documentation kept in the home. Two staff members, key workers of case tracked service users, were also consulted and their documentation checked. Observation of working practices also helped reach the judgements. Ownership had been transferred from Peterborough City Council to the Greater Peterborough Primary Care Partnership, as a result of the government programme Agenda for Change. What the service does well: What has improved since the last inspection? The home continuously was providing a good service and the shortfalls regarding medication identified on the previous inspection were appropriately dealt with and medication procedures were made safe. Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 Page 6 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. Greenwood House DS0000035290.V312732.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 Greenwood House DS0000035290.V312732.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): 1,3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home produced effective documents to help service users choose the best home for them. Initial assessments carried out in detail helped the home create a care plan that addressed all needs and how to meet them to the users’ full satisfaction. EVIDENCE: The home reviewed and had displayed in the entrance foyer their Statement of purpose and Service User’s Guide, making them available to all existing users, visitors and anyone interested in it. These documents helped users make an informed choice of home. Each file contained a detailed admission assessment form that addressed all main areas of service users’ lives. The form had a subsection where functional ability was assessed and recorded. Daily records and care plans were compared to establish if the needs were met. The practical work was observed, a staff member helping a user to transfer from her chair, two other staff helping two users to eat and a member Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 Page 9 of staff talking to a user affected by dementia. All working practices were appropriate, confirming that the home had the ability to meet users needs. The home did not provide intermediate care, but eight beds were allocated for respite care. Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were respected and helped in an agreed way that was recorded in details in their care plans. Their healthcare needs were met by appropriate engagement of external professionals. EVIDENCE: Three care plans were checked and scrutinised against a care plan check list included in inspection records. Service users comments and staff explanation of care plans confirmed that all users’ needs were assessed and appropriately addressed in a written form. Any change to care plans was recorded on reviews that were also signed by service users. In case of a service user having been unable to sign, the home recorded: “Unable to sign”. Care plans were reviewed regularly and changes were recorded. When a service user became unsafe to use a hot water bottle, this was also recorded on his care plan. Service users’ health care was ensured through organised and appropriate procedures. A service user’s records indicated pain and acid indigestion. The steps taken included a GP appointment and medication was prescribed. The Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 Page 11 same user’s likes and dislikes included whiskey in the evening as a preference. However, diabetes affected the staff’s action to monitor the amount and limit to one small glass a day. The service user was satisfied with the arrangement. Users’ files contained information about nail care, continence, oral care and even care of glasses and hearing aids for those that used them. There was an evidence of engagement of external health professionals necessary for full support and care to service users, such as a speech therapist, community psychiatric nurse and diabetic team. Medication was inspected for case tracked service users and included checks of controlled drugs. The procedure, administration, records and observed practice demonstrated full safety of service users and appropriate procedures. Service users commented that their privacy and dignity were respected. They were called by their preferred names, staff were observed knocking on the doors before entering users’ bedrooms and a service user stated that he did not mind being helped by female carers. A double room was used as a single. Service users wishes in case of death were recorded in their files, specifying arrangements for funerals. Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ dignity and autonomy were promoted and encouraged, making them stimulating and satisfied with services and provisions. EVIDENCE: The daily routine in the home was organised in the way that service users wanted. A service user stated: “ I never feel bored. There are plenty of activities and I can decide what I want to do.” Another service user was arranging a poster at the time of the site visit and stated: “I go to the day centre and I always find something to do.” The third user said, amongst other things while talking to staff: “We dress up for Halloween, don’t we.” A mealtime and lunch were observed. Two staff were helping two service users to eat, in a slow, unhurried and dignified way. Two service users commented on visits from their relatives, stating that the home was open and was welcoming visitors. Service users’ autonomy and choices were respected. They confirmed that they had a choice of food, but also could choose how to spend their time during the day. One user even commented that she “instructed” staff how to make her bed and they followed the instructions. Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 Page 13 Menus checked demonstrated that a well balanced and nutritious diet was chosen. Although the home was currently trying to recruit a new cook, the quality and quantity of food were not affected and 8 service users stated that food was excellent. The home also kept records if service users chose something different, outside the set menu and it was provided to them. Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home displayed their complaints procedure and allowed service users, visitors and staff to openly say any potential complaints or concerns and demonstrated determination to act appropriately and investigate and act to protect service users. EVIDENCE: Three service users spoken to stated that they knew how to complain and would complain if they had anything to say. The manager stated that the home did not receive any complaints and did no have allegations that would initiate Protection of Vulnerable Adults (POVA) procedure. The complaint procedure was in the User’s Guide and was also displayed in the hall. Among other displayed information, there was also a flyer “Responding to Abuse” and information for handling money for older people “Choice and Control”. Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was suitable for the needs and met the expectation of service users to live in a comfortable and pleasant environment. EVIDENCE: The manager invited the inspector for a tour of the premises. All communal areas and 3 service users’ bedrooms were checked. One bedroom lock was missing, taken for repair. A double bedroom was used as a single and did not have a screen as it was not necessary. Redecoration on the first floor was in progress and the maintenance man explained that he was doing this in phases to reduce any disruption to service users. The building was in a good state of repair, clean and bright. The maintenance records demonstrated that faults were dealt with on time and promptly. Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 Page 16 The home had an infection control programme in place. A heat wave procedure was displayed, instructing all how to minimise effects of excessively high daily temperature. Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 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 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. By properly vetting staff, the manager ensured service users were safe and in the good hands of trained, skilled and gentle support. EVIDENCE: The staff rota showed and service users spoken to confirmed that there were enough staff on duty per shift. A staff member spoken to considered that there were enough staff on duty to meet the needs of service users. A service user stated: “We get on very well with staff”. A staff member spoken to stated: “We are a good team. We support each other and get support from our meetings, too, as well as from very important handovers.” Staff knew about service users and explained that a user from a different ethnic background did not have any specific culturally coloured needs. She considered that the staff team was well balanced and that 3 people per unit per shift was an appropriate ratio that ensured the meeting of service users’ needs. She commented that: training was excellent and that the induction was very good. The change of ownership did not affect the main terms and conditions for the majority of staff and that staff were consulted if they wanted and would accept transfer to the primary care trust. Some staff documents were held in the head office, but records of new staff were complete. Unlike some older serving staff, all new staff members (one Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 Page 18 randomly chosen file checked) had received their CRB and POVA. The older file did not have two references but an email from the head office confirmed that the staff had their CRB and POVA and references. The home was in the process of recruiting a cook. Care staff were inducted as was seen in a newer staff’s file. Training was good in the view of service users and staff and the manager also presented dates for refresher courses planned for the near future. Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 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): 31,32,33,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensured the safety and welfare of service users through their working practices, good monitoring system and by regularly organised reviews of users’ satisfaction. EVIDENCE: The manager was skilled and experienced, and ran the home following set safe working procedures. She stated that the transfer to the new provider would not affect safe working practice and that the new arrangement was due to be completed on the 1st October. The manager and the staff spoken to confirmed that the change did not affect staff’s morale and enthusiasm and that the ethos in the home had not and would not change. Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 Page 20 All staff were fully aware of the homes directions and objectives and felt encouraged to express their initiative and creativity. Staff surveyed service users on a monthly basis ensuring that the quality assurance process was running all the time. The manager was analysing results and fed back to participants of the survey. One of the relatives consulted about quality assurance also commented on their card: “So much thanks for your constant support for our relative. Your kindness will be remembered.” The home did not deal with service users’ money. The information about resources that could help with finances was displayed on the notice board. Staff’s files and comments confirmed that staff felt well supported and were regularly supervised. The home had safe working practices in place. Regular training and refresher courses kept staff informed about many theoretical changes in community care principles. The forthcoming training event “Infection control” was already booked and 7 staff were listed to attend. The home ensured the safety and wellbeing of service users. Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 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 X 3 3 X 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 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Greenwood House DS0000035290.V312732.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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. 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