Inspection on 29/08/06 for Greta Cottage

This inspection was carried out on 29th August 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

Greta Cottage 25/11/08

Greta Cottage 30/11/07

Greta Cottage 22/02/06

Greta Cottage 25/07/05

Greta Cottage 08/11/04

Greta Cottage 27/08/04

Greta Cottage 06/01/04

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

CARE HOMES FOR OLDER PEOPLE Greta Cottage Greta Street Saltburn-by-Sea TS12 1LS Lead Inspector Katherine Acheson Key Unannounced Inspection 29th August 2006 09:45 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 Greta Cottage DS0000000087.V309837.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. Greta Cottage DS0000000087.V309837.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greta Cottage Address Greta Street Saltburn-by-Sea TS12 1LS 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) 01287 622498 01287 626400 Greta Cottage Limited Mrs Heather Yvonne Russi Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Greta Cottage DS0000000087.V309837.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2006 Brief Description of the Service: Greta Cottage is a converted Victorian House in a residential area of Saltburn. The home is registered to provide personal care for up to 19 older people. There are fifteen single rooms and two double rooms one of which has en-suite facilities comprising of a toilet and hand washbasin. Bedrooms in the home environment meet with size requirements of National Minimum Standards. A stair lift enables residents to access the first floor. Greta Cottage is managed by the provider and supported by a team of staff. There are two lounges, one dining room and a conservatory. There is an enclosed garden area for resident use. On the date of this inspection the cost of care at Greta Cottage was £345 per week. Greta Cottage DS0000000087.V309837.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection started at 09:45 and lasted for six hours. Five residents, two care staff and management of the home were spoken to during the inspection. Numerous records including care plans, menus, quality assurance and staff recruitment and training records were examined. A tour of the premises was carried out. Requirements highlighted at the last inspection in February 2006 were revisited. What the service does well: What has improved since the last inspection? There have been many improvements since the last inspection. The Manager and staff at the home have worked extremely hard to improve the standard of care plan documentation at the home. Since last inspection staff have received medication training and many of the systems in respect of the record keeping of medication have improved. Recruitment procedures are now robust with the Manager ensuring that appropriate checks are in place prior to the commencement of employment. Greta Cottage DS0000000087.V309837.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. Greta Cottage DS0000000087.V309837.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 Greta Cottage DS0000000087.V309837.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): 3, 6 The quality in this outcome area is good. This judgement has been made from evidence gathered before and during the visit to the service. Assessments of prospective residents are carried out to ensure that the home can meet their needs. EVIDENCE: The Manager said that all prospective residents receive an assessment that is carried out by a social worker or other health care professional to ensure that the home can meet their needs. Staff at the home then carry out their own pre-admission assessment to ensure that the needs of the resident can be met at Greta Cottage. Evidence was available on residents files examined during the inspection to confirm that this is the case. The home does not provide intermediate care. Greta Cottage DS0000000087.V309837.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, 9, 10 The quality in this outcome area is good. This judgement has been made from evidence gathered before and during the visit to the service. The home provides a high standard of care, care plans are detailed and specific to the individual resident which helps ensure needs are met. Residents are treated with respect and their right to privacy is upheld. Staff responsible for the administration of medication are trained to ensure safe practice, however the home’s medication policy requires further development and a separate, secure fridge obtained for the storage of medicines that require cold storage. EVIDENCE: Two plans of care were examined at random during this inspection. It is evident since that last inspection in February 2006 that staff at the home have worked extremely hard to improve the standard of care plan documentation at the home. Greta Cottage DS0000000087.V309837.R01.S.doc Version 5.2 Page 10 Care plans examined were found to be detailed and evaluated on a regular basis. Care plans examined contained signatures of the resident or their family member to confirm that they had been involved in drawing up the plan of care. Care plans had been developed so that every individual problem identified is recorded separately with the care/assistance required to manage the problem documented. Care plans examined were effectively evaluated. Files examined contained a record of visits carried out by chiropodists, G.P’s, opticians and other health care professionals. Staff at the home record accidents to residents appropriately and the Manager carries out an audit of the accident record on a regular basis. Five residents were spoken to during the inspection all of who spoke positively about life at Greta Cottage. One resident said, “I’m quite happy, the staff are pretty good, I get along with them quite well”, another said, “I have lived her for seven years the staff are very nice”. Residents spoken to confirmed that staff respected their privacy and dignity. The home’s system for administering medication was seen to be effective, and records of medication received at the home and given to residents were seen to be accurate. An appropriate system for disposal of medication is in operation. A record of controlled drugs is maintained. The Manager said that at present there are no residents who are able are to self medicate, however if there were a risk assessment would be carried out on the resident to determine ability and safety, and lockable storage for medication would be provided. It was identified during the inspection that medication that required to be stored in a fridge was stored in the domestic fridge in the main dining room area; this fridge is accessible to both staff and residents. It was pointed out to the Manager at the time of the inspection that this was not appropriate and that a separate and dedicated fridge must be available in the home for the storage of medicines that required cool storage. The temperature of the medication fridge must be taken and recorded on daily basis with staff aware of action to take if the fridge is out of normal range (between 2and 8 degrees centigrade, however staff should always check the medicine to confirm the temperature at which it should be stored) The Manager said that since last inspection staff at the home have undertaken medication training and in addition to this have received supervised practice whilst carrying out a medication round in order to check the competency of the staff member administering medication. Since last inspection the home’s medication policy has been further developed, however this is still not sufficiently detailed, a discussion with the Manager of the home took place during the inspection in respect of this. Greta Cottage DS0000000087.V309837.R01.S.doc Version 5.2 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, 15 The quality in this outcome area is good. This judgement has been made from evidence gathered before and during the visit to the service. Residents are able to exercise choice and control and visitors are made to feel welcome at any time. Food provided is wholesome, appealing and enjoyed by residents. Although activities are provided by the home they are limited and could be improved upon in order to provide stimulation to residents. EVIDENCE: The home does not employ an Activity Co-ordinator, however the Manager said that staff at the home carry out activities with residents and that an entertainer/singer visits the home every month. Activities mentioned included dominoes, bingo and crafts. A number of the residents are registered with Dial a Ride and as such are able to go out independently or accompanied by a member of staff. One resident spoken to during the inspection confirmed that she used Dial a Ride regularly she said, “I use Dial a Ride at least once a week, I am going to my sisters in Dormanstown today”. Greta Cottage DS0000000087.V309837.R01.S.doc Version 5.2 Page 12 Although residents were generally happy at the home two residents spoken to expressed that they would like more activities to be provided on a daily basis. One resident spoken to said, “It depends upon which care staff are on duty as to what activities we do, last week we played dominoes until we went to bed”. The same resident went onto say, “I have a bailey’s with ice most nights with another resident”. A discussion took place with the Manager of the home during the inspection regarding two residents identifying that they would like more activities to be provided on a daily basis. The Manager said that she would take action in respect of this. The Manager said that the home support residents to practice their religion and that visits from clergy are available to the home, residents spoken to confirmed that this was the case. Residents interviewed spoke of flexibility in routine and freedom of choice. Residents spoken to during the inspection said that contact with family and friends is encouraged and that visitors are made to feel welcome at any time. The home offers a menu with an alternative choice available at each mealtime. Menus examined were wholesome and showed variety. Records were available to confirm that appropriate temperature checks are carried out on fridge, freezers and food. Records of food provided were available for inspection. One resident spoken to during the inspection said, “The meals are good they always smell nice”, another said, “The food is quite reasonable, it’s not the Ritz but it is quite good. If I don’t like something they will alter the menu for me”. A resident who walked into the dining room area during the inspection was heard to be saying, “Lunch smells good”. Greta Cottage DS0000000087.V309837.R01.S.doc Version 5.2 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): 16, 18 The quality in this outcome area is adequate. This judgement has been made from evidence gathered before and during the visit to the service. Residents and relatives are encouraged and supported to make any complaints they feel necessary, however the complaint policy/procedure could be strengthened to include information of residents/relatives rights to complain to commissioning agencies such as Social Services and Primary Care Trusts. Residents residing at the home said that they felt safe. Adult protection procedures are in place, which help protect residents from abuse. Staff at the home were aware that they needed to report an incident of abuse to the Manager, however not all were not aware of procedures that followed. Staff at the home have not received adult protection training. EVIDENCE: The home has a complaints policy/procedure. This policy/procedure should be updated to inform residents/relatives of their right to complain to any commissioning authorities such as the Primary Care Trust or Social Services. The complaint procedure within the statement of purpose/service user guide should also to be updated to include such information. The Manager said that there have not been any complaints in the last twelve months. Greta Cottage DS0000000087.V309837.R01.S.doc Version 5.2 Page 14 Residents spoken to during the inspection said that they would feel comfortable in raising and concern or making a complaint to the staff or management of the home. Since last inspection the home has updated the adult protection policy/procedure this includes action that staff should take if abuse is suspected. Two Care staff were interviewed during the inspection and asked what action they would take if abuse were suspected. Both staff confirmed that they would report the incident to the Manager with one of the staff member being able to go onto describe procedures that followed, the other was not. The Manager said that she had been on adult protection training which she had intended to cascade to staff, however had not done so as yet. Residents spoken to during the inspection said that they felt safe. Greta Cottage DS0000000087.V309837.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 The quality in this outcome area is good. This judgement has been made from evidence gathered before and during the visit to the service. The standard of the environment within this home is good providing the people who live there with and attractive, homely and comfortable place to live. EVIDENCE: The Manager accompanied the Inspector on a tour of the home. In general the home was observed to be fairly well maintained, homely with appropriate and comfortable furnishings provided. The ground floor of the home has two lounge areas, one dining room and a conservatory. At the time of the visit the external woodwork was in the process of being painted. Gardens are generally well maintained. Greta Cottage DS0000000087.V309837.R01.S.doc Version 5.2 Page 16 The Manager said that the home had a policy in place for control of infection. Appropriate laundry facilities were in place. On the day of the inspection the home was observed to be clean and odour free. Greta Cottage DS0000000087.V309837.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 The quality in this outcome area is good. This judgement has been made from evidence gathered before and during the visit to the service. Robust recruitment procedures are followed. Staff receive induction training and a rolling programme of mandatory training is provided for staff. EVIDENCE: The Manager said that from Monday to Friday there are two care staff on duty one of which is a senior care assistant between the hours of 08:00 and 17:00 in addition the Manager and Co Manager are on duty. Between the hours of 17:00 and 21:00 there are two care staff on duty one of which is a senior care assistant. On a weekend there are three care staff on duty one of which is a senior care assistant between the hours of 08:00 and 17:00. Between the hours of 17:00 and 21:00 there are two care staff on duty one of which is a senior care assistant. On night duty there are two care staff on duty one of which is waking the other who sleeps but is contactable if the need arises. Greta Cottage DS0000000087.V309837.R01.S.doc Version 5.2 Page 18 The Manager said that 58 of care staff are trained to NVQ Level 2 with a number of other staff working towards the qualification. Two staff files were examined at random during the inspection. Records examined confirmed that a thorough recruitment procedure is followed. Files examined contained two references, appropriate Criminal Record Bureau checks that had been received prior to the commencement of employment and proof of identity. The Manager said that a training company now provides induction training to new staff and that this is in line with the new induction standards. Records were examined to confirm that one newly appointed staff member had undertaken a basic induction in the home and that she was undertake a full induction in September. Records were available to confirm that mandatory training is provided. The Manager said that as the home do not have a fast turn over of staff moving and handling training is carried out on commencement of employment and two yearly there after. Staff at the home are to commence a distance learning dementia care programme. Two care staff interviewed during the inspection confirmed that they received regular training. Greta Cottage DS0000000087.V309837.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, 33, 35, 38 The quality in this outcome area is good. This judgement has been made from evidence gathered before and during the visit to the service. The home is well managed, residents health, safety and well-being is promoted. The home seeks the views of residents, families and staff to ensure that it is managed with their best interest. Systems are in place to ensure resident’s money is managed appropriately. Greta Cottage DS0000000087.V309837.R01.S.doc Version 5.2 Page 20 EVIDENCE: The owner/Manager of the home, Heather Russi has many years of experience of working with older people in a social care environment. The Manager has completed her NVQ level 4 in Management and Care, however is still awaiting certification. There is also a Co-manager, Sue Tate who assists with the dayto-day running of the home. Sue also has many years of experience of working in a care home environment. Residents and relatives spoken to during the inspection spoke highly of the management, staff team and care that is provided. One resident said, “Heather and Sue are good for us they listen to you and you can talk to them”. Another said, “Staff go out of their way to help you. Staff interviewed during the inspection spoke of a stable staff team, one said, “This is a nice home that is why we all stay”. The home operates an effective system in which they look after the personal allowance of a number of residents. Accurate records of transactions and receipts were available for examination. Appropriate quality assurance and quality monitoring practices are in place; residents and relatives meetings are carried out on a regular basis. The results of the last quality assurance survey were made available during the inspection. The home operates a rolling programme of servicing appliances and equipment. Records examined at random confirmed that the home’s fire extinguishers, fire alarm system, gas boilers and electrical wiring are serviced on a regular basis. The Windows on the first floor of the home environment are restricted to ensure safety for the people living there. Records were available to confirm that tests of the fire alarm system are carried out and that the home has carried out a fire practice that involved evacuation of residents. Water temperatures are taken on a regular basis by the home’s handyman to ensure that they are within safe limits. Greta Cottage DS0000000087.V309837.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 X X 3 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X 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 3 X 3 X 3 X X 3 Greta Cottage DS0000000087.V309837.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP9 OP9 Regulation 13 13 Requirement The homes medication policy requires further development • The home must obtain a separate, secure and dedicated fridge for the storage of medicines that require cold storage • The temperature of the medication fridge must be recorded on a daily basis. Staff must be aware of action to take if the fridge is out of normal temperature range The Registered Person must consult with residents/families in order to improve/provide a varied suitable plan of activities for residents residing at the home Adult protection training must be provided to all staff Timescale for action 30/10/06 29/08/06 3 OP12 16 30/10/06 4 OP18 13 30/10/06 Greta Cottage DS0000000087.V309837.R01.S.doc Version 5.2 Page 23 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 OP31 OP16 Good Practice Recommendations The Manager should provide evidence of completion of NVQ level 4 in Management and Care The Complaints policy/procedure should be updated to include information of resident’s rights to complain to commissioning agencies such as Social Services and the Primary Care Trust. The homes statement of purpose and service user guide should also be updated to reflect such information Greta Cottage DS0000000087.V309837.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Greta Cottage DS0000000087.V309837.R01.S.doc Version 5.2 Page 25 - 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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