Inspection on 14/10/05 for Greswold House

This inspection was carried out on 14th October 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 13/05/05

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 West Midlands B34 6HA Lead Inspector Kath Strong Unannounced Inspection 14th October 2005 10:05 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 Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 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. Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Greswold House Address 76 Middle Leaford Shard End Birmingham West Midlands B34 6HA 0121 783 1816 0121 784 5194 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) Yardley Great Trust Mrs Rita Wells Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13/05/05 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 proximity 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 consisting 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 hairdressing 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 accommodate seven vehicles. The home has its own mini bus. Security to the front of the building is maintained by close circuit television, this does not intrude upon the privacy of the residents. Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of the visit was to carry out an unannounced inspection; which two inspectors conducted over a period of five hours. The outcome was determined by various means. In depth discussions were held with the recently appointed manager, a senior member of staff was formally interviewed and four residents were spoken with individually. Relevant documentation was examined including four care plans. The medications system was reviewed and a tour of the premises carried out. At the conclusion verbal and written feedback was provided to the manager. The inspection focussed upon the few outstanding requirements, key standards not examined at the last inspection and other issues deemed necessary. In order to gain a comprehensive overview of the services provided it is recommended that this report is read in conjunction with the inspection report of 13th May 2005. What the service does well: What has improved since the last inspection? The manager displayed ability to detect where improvements are needed, has developed constructive working relationships with staff and has a clear vision for the progression of the home. Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 Page 6 New care plans have been introduced, which provide improved documentary evidence of assessments, care planning and ongoing monitoring of residents needs. The manager has introduced innovative activities that include the relatives. Both staff and residents reported the success of such initiatives. There was evidence of good relationships between all grades of staff and that suggestions for improvements are listened to and piloted. Residents are involved with and influence the day-to-day running of the home. 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 DS0000016906.V259357.R01.S.doc Version 5.0 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 Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 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 The written information supplied to prospective residents is sufficient for them to make an informed decision about the home. The homes statement of purpose does not include all required information. EVIDENCE: Prospective residents are supplied with an information pack, which includes details about the home and the services provided. The statement of purpose was forwarded to CSCI shortly after the inspection, however the document did not include all items listed in schedule 1. Details in respect of fire precautions, how religious needs will be met, visiting arrangements, complaints, care planning and the number and sizes of rooms are required. Standards 2, 3, 4, and 5 were found to be fully met at the last inspection. Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 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, 9 and 10 Care plans are comprehensive in ensuring that all aspects of needs are identified and how they will be met, the advice of external professionals is readily sought. The system for the safe administration of medications was satisfactory with the exception of storage, which may put residents at risk. Procedures carried out by care staff indicated that resident’s privacy and dignity is respected. EVIDENCE: The home was in the process of implementing a new method of care planning. The gradual transition had resulted in gaps being evident at the time of the inspection. The care plans for two residents receiving respite care had not been completed at the time of the inspection. Shortly after the inspection the manager confirmed that the implementation to the new system has been completed for all individuals. The new files contain details in respect of likes and dislikes and the resident or their relative are invited to provide written details regarding background and life history. They also provide the facility for assessments of physical and mental health needs and care requirements. Risk assessments and regular monitoring notes were in place. Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 Page 10 Following the inspection the home advised CSCI that arrangements had been made for regular formal reviews to be conducted. The files indicated that a wide range of external professionals provide advice and support. All aspects of the administration of medications were examined and found to be satisfactory. The pharmacist regularly audits the stocks and systems utilised by the home. The inspectors expressed concerns regarding the storage of some prescribed medications in resident’s bedrooms. Such items must be retained within a lockable cupboard when stored in bedrooms. Throughout the visit staff were observed using the preferred term of address and providing discreet and constructive support. Two residents provided positive feedback in respect of staff practices. Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 Page 11 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 and 15 The comprehensive activities programme had been improved to encourage the increased participation of relatives thus enriching the quality of the lives of residents. Dietary needs are well catered for with a balanced and varied selection of foods that meets resident’s tastes and choices. EVIDENCE: Standards 12 and 13 were found to be fully met at the last inspection. The manager had introduced improvements whereby staff are encouraged to hold regular themed recreational pursuits. A cheese and wine party with relatives invited to attend has been well received, staff spoke highly of the outcome. Regular residents meetings are held independently on each floor, minutes are produced and are widely available. Each floor has a common agenda in order to ensure uniformity. The minutes suggest that residents are able to influence the day-to-day running of the home and indicates autonomy and independence. As with previous inspections the quality of the meals provided are satisfactory. Each kitchenette has a list of individual preferences regarding breakfast and beverages. Meals are served from a hostess trolley. Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 Page 12 Lunch was observed being served, the meal was well presented. Comments received from two residents were, “Enjoyed lunch, very nice, and “Too much but I liked it”. Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 Page 13 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 Arrangements for protecting residents from abuse are satisfactory. EVIDENCE: The written policy was found to provide adequate information and guidance. The home had two policies in place one of which did not contain sufficient information and should therefore be removed. All staff have received training in this aspect of care. Standards 16 and 17 were found to be fully met at the last inspection. Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 Page 14 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, 24, 25 and 26 The standard of the environment is good and well maintained, providing residents with an attractive, warm and homely environment. The toilet and bathing facilities are not acceptable in some areas of the home. EVIDENCE: Each floor provides an integral lounge/dining area with kitchenette off. These rooms are pleasantly presented and comfortable. A dedicated hairdressing area is incorporated within the reception area of the home. Two of the corridors require lighting to be changed to domestic style lighting. The home was found to be tidy and very hygienic throughout. All bedrooms are of single status including en-suites consisting of toilet and wash hand basin. Bedrooms are limited in size but the layout maximises the available space. Rooms are well appointed and personalised. The lockable facility in each room is accessible without use of a key by removal of the drawer. This issue needs to be addressed. Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 Page 15 Assisted bathing facilities are provided on each floor. The requirement to convert the bathroom for respite care to assisted bathing has been outstanding for some considerable time. Considerations are being given to a small ground floor extension to the premises to include a communal toilet for ease of access from the lounge. The lack of the communal toilet should be addressed as a matter of priority as the requirement again has been outstanding for an extensive period of time. Regular testing of the hot water outlets is carried out and the findings recorded. The front garden houses an attractive water feature and seating, there is an enclosed rear garden, which residents can also frequent. Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 Page 16 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 and 30 The home was well staffed with the exception of an administrator and contravention of Working Time Regulations. Staff training in some areas had lapsed resulting in significant gaps indicating lack safety procedures and staff knowledge to carry out their roles. EVIDENCE: The complement of senior and care staff was found to be acceptable. Relevant personnel carry out all ancillary tasks. The person employed to carry out laundry duties confirmed that she works seven days per week; this is a contravention of Working Time Regulations 1998 and therefore must cease. The presence of a signed disclaimer is not appropriate. A maintenance operative is also allocated to the home for one and a half days per week. Senor staff were observed carrying out day-to-day administration tasks such as answering the telephone, such tasks are inappropriate and the home should recruit an administrator. The training files were examined and it was noted that some staff had not received initial or refresher training in respect of manual handling and fire safety. This must be addressed as a matter of priority. Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 Page 17 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 and 35 The manager is well supported by senior staff in providing clear leadership and lines of accountability. EVIDENCE: The recently appointed manager has had previous management experience and has recently been successful in completing the registered managers award. She is currently exploring if there is a need to undertake NVQ level 4 training as she also has a diploma in welfare studies. A senior member of staff was formally interviewed she reported that the manager “Has good ideas, she liaises with us, and she is approachable”. No negative comments were received from any resident or staff member by either inspector. The system in respect of the homes procedures for the safe keeping of resident’s personal monies was examined and found to be satisfactory. Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 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 2 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 3 2 X X 3 3 3 STAFFING Standard No Score 27 2 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X X 2 Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 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 OP1 Regulation 4(1)(2) Schedule 1 13(2) 23(2)p Requirement The registered person must expand the content of the statement of purpose to include all items listed in Schedule 1. The registered person must ensure that all prescribed medications are securely stored. The registered person must replace fluorescent lighting with domestic style lighting on two floors of the premises. Agreed timescale of 31/03 for each floor, therefore completion date is for one floor. 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. The registered person must ensure full compliance with Working Time Regulations 1998. The registered person must ensure that staff roles are appropriate by the recruitment of an administrator. DS0000016906.V259357.R01.S.doc Timescale for action 15/12/05 2. 3. OP9 OP19 30/11/05 31/03/06 4. OP21 23(2)j 31/03/06 5. OP21 23(2)j 31/03/06 6. 7. OP27 OP27 18(1)a 18(1)a 02/11/05 31/12/05 Greswold House Version 5.0 Page 20 8. OP30OP38 18(1)c The registered person must ensure that all staff training in respect of manual handling and fire safety is current. 31/12/05 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 OP18 OP24 Good Practice Recommendations The second and inadequate written policy in regarding adult protection should be removed from the home. The home should ensure the integrity of the lockable facilities provided in bedrooms. Greswold House DS0000016906.V259357.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Birmingham 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 DS0000016906.V259357.R01.S.doc Version 5.0 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. 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