Inspection on 13/05/05 for Greswold House

This inspection was carried out on 13th May 2005.

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

Other inspections for this house

Greswold House 12/12/08

Greswold House 12/12/06

Greswold House 14/10/05

Greswold House 11/11/04

Greswold House 15/06/04

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

CARE HOMES FOR OLDER PEOPLE Greswold House 76 Middle Leaford Shard End Birmingham B43 6HA Lead Inspector Kath Strong Unannounced 13th May 2005 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 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. Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Greswold House Address 76 Middle Leaford Shard End Birmingham B34 6HA 0121 783 1816 0121 784 5194 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Yardley Great Trust Vacant Care Home 29 Category(ies) of Older People registration, with number of places Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 11th November 2004 Brief Description of the Service: Greswold House is a purpose built residential home for elderly people situated within a residential area of the Shard End suburb of Birmingham. The premises are within close prximity to private households, a sheltered housing scheme and a nursing home. The accommodation comprises of 27 long stay places and two respite rooms. All bedrooms are of single status, the long stay rooms have en-suite facilities consiting of toilet and wash hand basin and there are bathing facilities directly adjacent to the two respite rooms. The services are provided on three floors which are connected by stairs and two shaft lifts. There is a lounge/dining area/kitchenette and communal toilets and bathing facilities on each level. The main kitchen provides all meals to each floor, there are also dedicated laundry and hairdresssing facilities. There are pleasant grounds to the rear of the premises that are accessible to residents via the ground floor lounge. A seating area is also available at the front of the premises. There is sufficient off road parking at the front of the building to accommodtae seven vehicles. The home has its own mini bus. Security to the front of the building is mainatined by close circuit television, this does not intrude upon the privacy of the residents. Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of the visit was to conduct an unannounced inspection of the home, which lasted for a period of half a day. Each of the relatively few requirements made from the last inspection were reviewed in order to determine progress achieved. The outcome of this report is based upon examination of relevant documentation including the means of accepting admissions into the home. Samples of care plans were reviewed including tracking of the full care needs of one resident to ensure that all of the individual’s needs were being met. The programme of leisure activities was looked at. The complaints procedure, staffing levels and staff training were also explored. A partial tour of the premises was carried out. What the service does well: What has improved since the last inspection? A new manager has been appointed and is due to commence employment shortly. The home has introduced a new style of comprehensive care planning. New lounge and dining chairs have been purchased for the communal rooms. The deputy manager has successfully achieved the registered managers award. The home has recently succeeded in completing an accredited quality assurance system. Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 Page 6 Domestic style lighting has been installed in the lounge and corridor of the ground floor. 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. Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 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 standard(s) 2, 3, 4, 5 and 6 The home carries out extensive pre-admission assessments and consults with all relevant persons before a placement is offered. EVIDENCE: The home has individual assessment tools for day visits and permanent placements. Both were seen to be satisfactory with the long stay tool including dietary preferences, behavioural and sleep patterns. The format of both tools is based upon the activities of daily living. Prospective residents are invited to visit the home for a full day to look around, circulate with other residents and sample the meals provided. Family and friends are invited to the home and are encouraged to be involved in decisions regarding the home. Upon admission residents are supplied with a welcome pack that includes the service user guide and a contract of terms and conditions of residency. A trial period is offered prior to confirmation of a permanent placement. Ongoing reviews carried out indicated that the home demonstrated its ability to meet resident’s needs. There was also evidence that where necessary appropriate notice is given when the home can no longer meet the individuals needs. The home does not provide intermediate care. Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 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 standard(s) 7 and 8 Care plans are comprehensive; cover all aspects of care and how they will be met. Resident’s health care needs are fully met. EVIDENCE: Three care plans were examined and it was noted that the home had introduced a new style of records. The pre-admission assessment tool is used as the basis for a more in depth assessment; identification of specific needs and provide details regarding how care will be provided. The files included a life history, current abilities and decision making. Records indicate personal preferences and choices regarding how often residents wish to receive personal care. Weight and basic observations are recorded monthly. Relevant risk assessments had been carried out and regularly reviewed. Care plans include a dedicated section for the input of external professionals. The format used permits the rationale for the visit, treatment prescribed and follow-up details to be clearly recorded. The files indicated that a wide range of external professionals visited the home and that support was provided for residents to attend hospital appointments. Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 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 standard(s) 12, 13 and 14 The home provides a varied and interesting activities programme. Links with the community are good and enrich resident’s social and educational opportunities. Resident’s views are regularly sought and acted upon. EVIDENCE: Each floor has a residents and relatives notice board. A monthly programme of in-house activities was on display covering every weekday. The programme indicated that a wide range of leisure pursuits were included thus catering for a variety of preferences. The type of activities varied on each floor, residents were advised of which floor to visit depending on their preferences. Participation or refusal of each individual was clearly documented within the respective care plan. Relatives are invited to attend birthday celebrations and are encouraged to participate in other events. Forthcoming events include numerous outings with varying themes. The organisation will be holding a 650 year garden party and hope to amalgamate this with the birthday celebration of a resident aged 105 years. The home has a policy of open visiting at any reasonable time with the exception of meal times. The public telephone can be plugged in all bedrooms. Some residents choose to go on holiday. Minutes of the quarterly residents meetings were also on display. These provided evidence that residents are consulted regarding leisure preferences, outings and routines within the home. Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 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 standard(s) 16 and 17 The complaints process within the home is good fostering positive outcomes and relationships. Residents are encouraged and supported in maintaining their legal rights. EVIDENCE: The home has a comprehensive written complaints procedure and a means of dealing with, documenting, and monitoring the outcome of each complaint. The home historically receives very few complaints. During the recent general election one resident visited a polling station and others cast postal votes. Resident’s families arrange appointments for legal representatives to visit the home. Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 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 standard(s) 19, 20, 21, 23, 24 and 26 The standard of the environment within the home is good, providing residents with an attractive, warm and homely place to live. The toilet and bathing facilities are inadequate for some areas of the home. EVIDENCE: The three floors offer single en-suite bedrooms and communal areas. The three lounges/dining areas are pleasantly presented and with the exception of the ground floor have nearby communal toilets. A dedicated hairdressing area is incorporated within the reception area. Assisted bathing facilities are provided on each floor. The requirement to convert the bathing facilities to assisted bathing for the two respite room’s remains outstanding. The front garden houses an attractive water feature and seating and there is an enclosed rear garden, which residents can also frequent. Following the inspection CSCI received proposed plans regarding the homes intention to provide a suitably located toilet on the ground floor, a hospitality room and a smoking room. Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 Page 13 Bedrooms are limited in size but the layout serves to maximise the available space. Of those rooms visited they were well appointed and personalised to the extent of the occupants preference. There was evidence of many personal items and small items of furniture in some rooms. The home was found to be very tidy and hygienic. There was evidence of strong compliance with infection control measures. Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 The home fully meets staffing requirements. Staff training and morale is good resulting in an enthusiastic workforce that works positively with residents to improve their quality of life. EVIDENCE: The staffing rota revealed that the home was fully staffed. Information was provided that when gaps occur permanent members of staff cover them and that “agency staff are used as a last resort”. The home has the additional advantage of a deputy manger and further senior staff with each having specific roles as well as influencing day-to-day running of the home. There are also cooks, kitchen staff, housekeepers and laundry staff. The home has an ongoing programme of staff training, which more than complies with the National Minimum Standards. Quarterly staff meetings cover all aspects of day-to-day operations and inspections and minutes are circulated accordingly. Employment practices were determined to be satisfactory thus ensuring the protection of residents. Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 and 38 In the absence of a manager senior staff continued to provide clear leadership demonstrating an awareness of their roles and responsibilities. EVIDENCE: The deputy manager advised the inspector that a newly recruited manager would commence employment shortly. The deputy manager who possesses the experience, knowledge and skills was temporarily managing the home. During the visit she demonstrated her ability to delegate tasks in a professional manner. There was no evidence that the home was not being managed efficiently. There was a comprehensive quality assurance system in place that takes into account resident’s opinions. The home had recently successfully completed the Bettal Quality Assurance audit. Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 Page 16 The home had carried out the work required from a fire inspection of the premises. No further issues were noted regarding health and safety. Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 x COMPLAINTS AND PROTECTION 2 3 2 x 3 3 x 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 Standard No 16 17 18 Score 3 3 x 2 x 3 x x x x 3 Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 Page 18 YES 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. 1. Standard OP19 Regulation 23(2)p Requirement The registered person must replace flourescent lighting with domestic style lighting. Work had commenced regarding this outstanding requirement. The registered person must ensure that there are sufficient communal toilets available to residents on the ground floor. The registered person must covert the respite bathroom to provide assisted bathing facilities. Timescale for action 31st August 2005 2. OP21 23(2)j 31st Octoiber 2005 31st October 2005 3. OP21 23(2)j 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 Good Practice Recommendations Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Greswold House E54 S16906 Greswold House V227755 130505 Stage 4.doc Version 1.30 Page 20 - 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. 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