Inspection on 19/06/08 for Greville House

This inspection was carried out on 19th June 2008.

CSCI found this care home to be providing an Excellent service.

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

Greville House 15/11/06

Greville House 21/09/05

Greville House 27/04/05

Greville House 09/11/04

Greville House 28/05/04

Greville House 02/03/04

Greville House 04/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Greville House 40 Streetly Lane Sutton Coldfield West Midlands B74 4TX Lead Inspector Ann Farrell Key Unannounced Inspection 19th June 2008 08:00 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 Greville House DS0000016771.V363223.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. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greville House Address 40 Streetly Lane Sutton Coldfield West Midlands B74 4TX 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) 0121 308 8304 0121 308 8304 pamsanbren@aol.com Mrs Christina Sally Howard Mr Jonathan Keith Howard Pamela Thompson Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care (excluding nursing) and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories:Old age, not falling within any other category (code OP), for 20 persons. 2nd November 2007 Date of last inspection Brief Description of the Service: Greville House occupies premises, which are approximately a century old; many of the original features have been retained. The home is located in a residential area to the north of Birmingham, overlooking Sutton Park and is within a short drive or bus ride of Sutton Coldfield, Mere Green and Streetly. The building is a large, extended and attractive residential property, which is surrounded by gardens that provide a pleasant and secluded outlook from most bedrooms. There is sufficient off road parking to the side of the premises for eight vehicles and the main drive can accommodate a further vehicle. Bedroom accommodation is provided on the ground and first floors; the upper floor is accessed via a stair lift. All bedrooms are single occupancy, sixteen of which have en-suite facilities and the others have private facilities near by. There are two lounges situated on the ground floor and a separate exceptionally well appointed dining room. There is a stair lift to access the first floor and aids such as grab rails, raised toilet seats. The management team consists of two managers, one who is registered with us, and a deputy manager who between them provide cover during the weekends as well as weekdays. The home provides a comprehensive and interesting internal and external activities programme. Residential care is provided for up to 22 persons of 65 years of age or above but the home cannot accommodate wheelchair users. The service user guide was available on entering the home for people to refer to and other information was easily accessible and the inspection report is available on request. The weekly fee to live at the Home at the time of visiting was between £433- £503 depending on the room and facilities. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is three stars. This means the people who use this service experience excellent quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to plan the inspection, which included notifications received from the home or other agencies and an Annual Quality Assurance Assessment (AQAA). This is a questionnaire that was completed by the manager and it gave us information about the home, staff, people who live there, any developments since the last inspection and there plans for the future. In addition, random surveys were sent to people who live in the home and health professionals before the inspection in order to gain their views about the service. The inspector undertook this fieldwork visit over one day. One of the managers and the proprietor were available for the duration of the inspection. The home did not know that we were visiting on that day. At the time of inspection twenty people were living in the home and information was gathered from speaking to and observing people who lived at the home. Three people were “case tracked” and this involves discovering their experiences of living at the home by meeting or observing aspects of care, looking at medication and care files and reviewing areas of the home relevant to these people, in order to focus on outcomes. Case tracking helps us to understand the experiences of people who use the service. Staff files, training records and health and safety files were also reviewed. At the time of inspection seven people who live in the home, two visitors and three staff were spoken to in order to gain comments. The feedback was very positive and comments included; “They always have the residents interests at heart and do their utmost to make them feel at home”. “My family have been delighted with the care mum has received here. It has given us great peace of mind to know mum is safe, happy, well fed and very well cared for. We could not ask for more”. “It is very nice and homely – I give it the thumbs up”. “Staff are very caring; they are all very good” Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 6 “Food is A1, you get a choice and there is a good choice of desserts. Sherry is served with Sunday Lunch”. “If I had any complaints I would go to the manager and they would sort it out”. “They say their door is always open and they are ready to listen to you”. “The Laundry is highly efficient”. “I would recommend it to anyone”. “They try to keep peoples independence and maintain their individuality”. “Mum tells me the food is lovely”. “Staff are lovely; delightful”. “We are kept informed of any changes in mums condition”. What the service does well: People wishing to move into the home are provided with sufficient information and encouraged to visit the home, so they are able to make an informed decision about moving into the home. People living in the home have access to a range of Health and Social Care Professionals ensuring their health care needs are met effectively. They are encouraged to maintain their mobility and other strengths, so that their independence is maintained. People are cared for in a respectful manner by staff and this ensures that their self- esteem and dignity are maintained. People are involved in making decisions and are able to exercise control over their daily lives. This promotes their independence and individuality. Arrangements are made for people living in the home to practice their chosen religion, so their religious needs are met. Visiting is flexible and they are made to feel welcome, so that people are able to maintain relationships that are important to them. A good rapport had built up between people using the service, staff and their visitors. One visitor stated, “The staff always ask if we would like a drink”. There is a choice of wholesome meals, which meets any dietary needs for reasons of health, taste, culture or religion. All people spoken to stated they enjoyed the meals. People living in the home had no complaints, but stated if they had any concerns they would speak to the manager and they felt confident that they would be addressed appropriately. This provides confidence to people that they will be listened to and taken seriously. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 7 People are able to exercise control over their daily lives promoting their individuality. There is a wide variety of activities on offer for people living in the home should they choose, so they are able to lead a meaningful life. There is a rolling programme of decoration and refurbishment. The home is well maintained, decorated and furnished to a high standard, so that people have a pleasant, safe and homely environment to live. There are always a satisfactory number of staff on duty who are well trained ensuring people receive a good standard of care. Staff turnover is low and this ensures continuity of care for people living in the home. One of the management team, which consists of three managers, is on duty each day of the week and this provides good leadership in the home. Regular meetings are held with people living in the home and staff and suggestions are welcome and acted upon. This ensures everyone has ownership and is involved in the running of the home. There is a system for the safe keeping of small amounts of people’s money ensuring their money is safe. There are regular maintenance checks and servicing of equipment used at the home ensuring safety at all times. What has improved since the last inspection? A pre admission reassessment is completed for all people wishing to move into the home, so staff can determine if they can meet their needs and it provides confidence to the person moving in that their needs will be met. Suitable storage had been purchased for medication so that it is stored safely. The medication systems were of a good standard ensuring that everyone receives the correct medication, which is prescribed by medical professions. Formal care reviews have been implemented for people who are privately funded and this gives them the opportunity to discuss the care and support that they are receiving at the Home. The bathroom has been upgraded with an assisted bath and shower facility providing people with a choice of bathing facilities. A monthly managers review has been implemented enabling auditing of all areas to be undertaken. This ensures all areas are monitored and any areas for development can be identified and addressed. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 8 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. The summary of this inspection report can be made available in other formats on request. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 9 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 Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available for people so that they can make an informed decision about moving into the home. People’s needs are assessed before they move in, so they can be confident their needs will be met upon moving into the home. EVIDENCE: The home had a service user guide, which was available on entering the home and each person has a copy in their bedrooms. This document provides information about the services and facilities provided and enables people to make an informed choice about moving into the home. The home provides care for people who require long term or respite care with low dependency needs. People are encouraged to visit the home before moving in to view facilities, meet staff and other people who live there in order to sample what it would be like to live there. People can choose their bedroom Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 11 if more than one bedroom is available and this ensures that they can exercise control over their future living arrangements. At this time it also enables staff to undertake an assessment of the persons needs to determine if they are able to meet them appropriately. If people are not able to visit the home for any reason senior staff would visit them and a pre admission assessment would be undertaken at that time. On inspection of the records for one person who had moved into the home recently it was found that staff had completed a satisfactory assessment. On discussion with people living in the home one stated they had visited before moving in and another stated her relatives had visited. They confirmed the process of moving into the home was well organised. This process ensures the person is happy to move into the home and the staff are able to meet their needs. In addition, there is a trail period of one month, which provides further opportunity to discuss whether the person would like to continue living there and if their care needs were being met or any changes that are required. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems in place to ensure people’s health and personal care needs are met in a way that ensures peoples dignity is maintained. EVIDENCE: Each person living in the home had a care plan. This is a document that is developed by staff following an assessment of individuals needs. It outlines what they can do independently, the activities people require assistance with and the actions staff need to provide in order to support them. Three peoples care files were looked at in detail. There was evidence that risk assessments had been completed in respect of skin and nutrition. Risk assessments are completed in order to identify any areas of risk and enable staff to put appropriate strategies in place to reduce the risks, so that people live a meaningful life; risks are reduced and well being promoted. In one case it was noted that one person was at risk nutritionally and staff had Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 13 implemented a diet with extra calories in order to build them up and they had put on weight since moving into the home. The care plans were found to be satisfactory, but in some cases there were vague statements such as “to see the GP regularly for blood pressure checks”. The instructions should be more specific so that everyone looking at the care plan is aware of how often the person needs to see the GP. In one case it was noted that someone was complaining of a headache and did suffer with them, but there was no plan of care in place to say how they were being managed. On discussion with staff they had a good knowledge of peoples needs and how they were being managed. They will need to ensure that care plans include all the information so that conditions can be monitored and action taken if there are any changes. Everyone living in the home was registered with a local General Practitioner (GP). They have the option of retaining their own GP. on admission to the Home (if the GP was in agreement). People had access to other health and Social Care professionals as required including district nurses, social workers, dieticians, chiropodist and optician. Also there was evidence that people with chronic conditions such as diabetes have regular check ups. This ensures peoples health care needs are being met appropriately and their health status maintained. On discussion with people living in the home they confirmed visits by GP and health professionals when required. One stated, “They send for the doctor if you want one or if they think you are not well”. Feedback from GP’s included, “Treats residents as individuals. Staff always able to convey the nature of the resident’s problems when visiting the home. The staff know the medical problems of their residents perfectly”. Staff encourage people who live in the home to maintain their independence and mobility, so they maintain their abilities and promote well being. Walking aids, grab rails etc. were provided to assist with mobility. Portable hoists are available if there is an accident or someone is unsteady on their feet. Some people had poor eyesight and appropriate equipment had been purchased in order to help maintain their independence and retain control over their daily lives. One visitor stated, “They try to maintain people’s individuality; they try to keep them independent”. A number of people were independent with their personal hygiene needs; others were well supported by the home’s staff. People were well presented and were able to choose clothing, jewellery and make up appropriate for their age, gender, tastes and culture. Some people chose to have a bath every day and the staff provided support in this area as required. The homes medication system consisted of a blister and box system with printed Medication Administration Record (MAR) sheets being supplied by the dispensing pharmacist on a monthly basis. The home had copies of the original prescription (FP10’s) for repeat medication, so they were able to check the Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 14 prescribed medication against the MAR chart when it entered the home. Medication is stored correctly and adequate stocks maintained, which ensures a robust system for ordering medication. A fridge is used for some medication and the temperature is recorded daily. On inspection of the medication for the current month it was found that audits were correct. There was some difficulty with auditing one medication, as there was no record of the amount of medication carried forward from previous months. It is recommended that staff record the amount of medication remaining in stock from previous months to enable easier auditing. No one was administering their own medication at the time of inspection, but it was stated that they could do so if they wished. A new telephone system had just been installed with telephones in each bedroom, so that people living in the home were able to make and receive calls in private. Bedrooms were provided with locks on doors and lockable facilities, so improving the arrangements for privacy and security of valuables etc. During the inspection staff were noted to be caring, attentive and respectful to people living in the home ensuring their dignity and self-esteem was maintained. There was also noted to be good interaction between staff and visitors making them feel welcome. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People are able to have control over their daily lives and are provided with a choice of healthy meals that meet all dietary requirements. There is a wide range of activities people can partake in, so they experience a meaningful lifestyle. EVIDENCE: There was no evidence of any rigid rules or routines in the home and people who live there can go outside on their own or with friends and family as they choose, depending on their abilities. Visiting was flexible enabling people to visit at a time that suited them, so people living in the home could maintain contact with friends and family. This was confirmed on discussion with people who were visiting the home. They stated the home was always clean and warm and staff were lovely; delightful. Other comments included; “You always get offered a drink when you visit”. “Everywhere is very well maintained”. “The home has always been held up as an exception”. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 16 “They always have the residents interests at heart and do their utmost to make them feel at home”. “I feel the care home provides a happy and friendly environment for carers, residents and visitors”. People living in the home confirmed they could choose the times they get up/go to bed and they can go back to their rooms at anytime during the day. People are able to bring personal items of small furniture, pictures, ornaments etc. into the home providing a home from home atmosphere reflecting their personality. The home provides the opportunity for people to follow their own religion ensuring their religious needs are met. The vicar visits each week and Holy Communion is available at the home on a regular basis. There was a variety of activities on offer for people living in the home should they wish to participate. These included monthly entertainers, clothes sales, quizzes, crafts, ceramics, bingo, exercise sessions, discussion groups and coffee mornings. Some had recently visited the theatre and they had celebrated one person’s 90th birthday recently. There was a notice on entering the home about a summer fete that was being held in a few days time. People living in the home stated birthdays are celebrated and they are able to choose the lunch and a cake was made. They also have a Christmas party with a bar, which they enjoyed. One person stated “It’s a home” and another stated “I would recommend it to anyone”. Some people had chosen to have a daily newspaper delivered and the home has made a subscription enabling them to have a large print newspaper and radio times delivered. This ensures that people’s interest in current affairs is maintained. The library service visit every six weeks with a range of large print books, which are suitable for people with sight problems. The home also has a range of videos, DVD’s and CD’s for light entertainment. People living in the home stated that they went out with the owner to the garden centre to purchase plants for the garden enabling them to be involved in the running of the Home. A hairdresser visits the Home twice a week. A computer has been purchased and camcorder that people living in the home can use to communicate with their relatives if they wish. The four-week rotating menus identified a variety of nutritious meals and people living in the home confirmed that they are offered a choice each day. A large platter of fresh fruit followed breakfast, and a bowl of fresh fruit was available in the lounge, so people have the opportunity of eating a health diet. At lunch there was a choice of beef stroganoff or cheese and potato pie followed by a choice of three sweets, coffee and after dinner mint. A hot meal is available at teatime and hot beverages, light snacks and biscuits are available at suppertime and overnight. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 17 Special diets can be arranged for reasons of health, taste and cultural/religious preferences however these were not required at the current time. The dining room was furnished and decorated to a very high standard. Dining tables were laid attractively with good quality table linen, crockery, salt and pepper and fresh flowers. The meals were well presented and were served with fresh vegetables and cold drinks. Residents served their own gravy and sauces where able. On discussion with people they stated they enjoyed the meals. Comments received included; “The food is A1, you get a choice and you can get something different if you want”. “There is a good choice of desserts – they are lovely”. “You get sherry with Sunday lunch”. “Mum tells me the food is lovely” Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 18 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. 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. There are appropriate systems in place so that people are protected from harm. People living in the home are confident their views are listened to action taken where appropriate. EVIDENCE: A comprehensive complaints procedure was on display in a prominent position in the home advising people of the procedure if they wished to raise any concerns. Our contact details need updating to ensure that people have correct information should they wish to raise any concerns directly with the Commission. The manager on duty stated there is a manager on every day; they have an open door policy enabling people to approach them at any time. Where people are unable to access the office the manager ensure they give time to them each day so that they can express any concerns they may have. The manager stated they have developed an audit system since the last inspection enabling them to audit any complaints, so that learning can be achieved. There is a complaints book and “grumbles book” where staff would record any complaints or concerns and there had been none recorded since the last inspection. On discussion with people living in the home they stated they had no complaints, but if they did they would go straight to the manager and they Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 19 felt confidant that it would be sorted out. We have not received any complaints about the home. The adult protection policy included local multi agency guidelines and staff met during the fieldwork visit had a good knowledge of this and had received training. The manager stated that they had received some training in relation to the Mental Capacity Act and they had a copy of the Code of Practice. It is recommended that this training be provided to all staff, so that they are aware of the procedures for supporting people who lack capacity to make decisions. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a homely, comfortable and very well maintained environment where they feel safe and secure and their privacy is maintained. EVIDENCE: The home is a detached two-storey building with adequate off road parking for visitors. The exterior is very well maintained and attractive with flowering tubs, hanging baskets seating etc. for people to enjoy when the weather permits. The Home was warm, welcoming and cleaned to a high standard. Decoration, floor coverings and furnishings were of a good quality and there was a rolling programme of redecoration and refurbishment in place and a number of areas has been re-decorated since the last inspection, so the home was maintained to a high standard. It was stated that people are consulted about aspects of décor when it needs renewing, which ensure they have a say in their home. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 21 The main kitchen was clean, well located and well equipped for its purpose. There were two lounges and these were comfortable and decorated in a homely style in keeping with the age of the building. In addition, to these there were smaller seating areas located in quiet areas of the Home and this provided people with an alternative area to sit if they wished. The dining room was decorated to a very high standard, was well lit and spacious providing people with an area to enjoy their meals in comfort. There were three assisted bathing facilities and one had recently been upgraded providing a new assisted bath and shower, so people have a choice of bathing facility. Two bedrooms had en suite shower facilities and these were in the process of being upgraded to enhance facilities. Wheelchair users could not be accommodated at Greville House and the Home does not provide a passenger lift. A stair lift was available for people to access the first floor of the Home and it was noted that some people were using the stairs to access the first floor. Handrails were provided in corridors and near to toilets and raised toilet seats were provided. There were two mechanical hoists to be used in the event that a resident fell and staff confirmed that these were appropriate to meet the needs of the people currently living at the Home. All bedrooms were for single occupancy, some with an en suite toilet facility and others with a private allocated toilet located near to the bedroom. A number of bedrooms had lovely views of the garden areas and all were personalised to reflect the tastes and interests of individuals and providing a home from home environment. A call bell facility was available in each bedroom to call for assistance if required. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 22 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. 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. People are supported by staff who are trained and have the knowledge and skills to meet their needs effectively. There is a robust recruitment system for employing new staff for the protection of the people who live there. EVIDENCE: At the time of inspection there were satisfactory numbers of staff on duty to meet peoples needs. The duty rota indicated there were at least three care staff on duty at all times throughout the day with two care staff overnight and this was confirmed on discussion with staff. In addition, to the care staff there is a manager on duty every day of the week (this is shared between two managers and a deputy manager) In addition, to the care staff there are domestic and catering staff plus a number of staff who undertake activities during the week. People living in the home stated, “Staff are very caring; they are all very good”. There is a stable staff group with a low staff turnover, which provides continuity of care to people living in the home. Recruitment records sampled showed that appropriate checks had been made to make sure that staff were suitably experienced and qualified to work with vulnerable adults. Criminal Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 23 Record Bureau checks had been made and written references received before the employee began work, so that people were protected from the risk of having unsuitable staff work in the home with them. The manager may wish to consider the involvement of people living in the home in the recruitment process in future, to enable them to have some control over who works in their home. Following employment new staff undertake the homes induction training and are supernumerary for one week, which gives them the opportunity to develop the knowledge and skills to meet the needs of people living in the home. It was stated that if new staff did not have any NVQ training they would undertake the Skills for Care induction training. There is a rolling programme of basic training that includes fire safety, manual handling, health and safety, food hygiene etc. The Registered Manager was a moving and handling assessor and had undertaken recent refresher training in this area. Records indicated a number of the staff had completed the training or were in the process of undertaking updated training and some staff had also completed training in respect of caring for people with dementia. This training ensures staff have the appropriate skills and knowledge to care for people living in the home. On discussion with one of the managers they stated they were hoping to introduce other training that is more specific to people’s needs and conditions such as tissue viability, continence etc. This will improve staff knowledge and improve outcomes for people living in the home. Records indicated that 78 of staff had completed NVQ 2 training or above in care. This training improves staff knowledge and skills and leads to improved outcomes for people living in the home. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed and run in the best interests of people living there. Systems are in place to ensure the health, safety and protection of people living in the home EVIDENCE: The management team consist of the registered manager, an unregistered manager and a deputy manager, who are supported by the proprietor. All the managers have completed NVQ level 4 in care and the registered manager has completed the Registered Managers Award. This ensures there is a manager on duty every day of the week and one is on call when not in the home in case of any emergency. Each member of the management team had delegated responsibilities and it was apparent that they were enthusiastic and striving to Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 25 improve the quality of the lives of people living at the Home. One comment received: “Coming into Greville House from an outsiders point of view I have always noticed how friendly staff are and how attentive if anything is needed they are. It appears to be a well run establishment and the person I visit is very happy here”. The management office was well located opposite the communal living areas and this provided the opportunity for people living in the home and visitors to access them easily as there was an open door policy and this was observed during the inspection. It was stated that the manager speaks to people living in the home on a daily basis to gain feedback and identify any concerns. Two staff spoken to during the inspection were enthusiastic about working in the home, they stated the managers were approachable and they acted on any concerns raised straight away. They felt they worked well together and provided good care to people who lived in the home. One stated, “ It’s really good, everything is for the ladies, they could not want for anything more”. Another stated, “It’s like a home from home; it is family orientated and you get job satisfaction”. Meetings with people living in the home and staff are now being held regularly every two months and staff stated they could make suggestions and things were discussed providing staff with ownership and records of meetings were available. It was stated that if staff were not available for meetings minutes of the meeting would be sent to them to ensure good communication. Over the past year the managers have developed a systems of auditing and they undertake a review each month to ensure all areas are being attended to, so that the home runs well and people benefit from a well run home. They have recently sent out questionnaires to people who live in the home and staff for feedback as part of the quality assurance system. As a result of some feedback they have implemented changes demonstrating they listen to comments and act upon them to improve outcomes for people living in the home. Prior to the inspection an Annual Quality Assurance Assessment was completed. The document gave satisfactory information about the home, staff, and people who live there and the improvements over the past year. It also gave information about the plans and areas of development for the future. The senior staff do manage small amounts of personal money for some people who live in the home, but do not act as appointee of power of attorney. On inspection of the system it was found to be satisfactory with regular audits, ensuring a good system to safeguard peoples money. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 26 Health and safety maintenance checks had been undertaken in the home to ensure that the equipment was in safe and full working order. Maintenance checks were completed on the fire system and equipment, so that people are safe in the event of a fire occurring. Checks were made on hot water outlets to ensure it is maintained at a satisfactory temperature to prevent scalding. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 27 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 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 28 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. 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. 1 2 3 Refer to Standard OP7 OP9 OP18 Good Practice Recommendations Care plans should consistently give specific information as to how people’s needs are to be met, to ensure consistency of care. It is recommended that the system for recording medication from previous months be reviewed to enable easier auditing. It is recommended that all staff undertake training in respect of the Mental Capacity Act so they have the knowledge of how to support people in making decisions if they lack capacity. Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Greville House DS0000016771.V363223.R01.S.doc Version 5.2 Page 30 - 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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