Inspection on 29/07/05 for Greyfriars

This inspection was carried out on 29th July 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

Greyfriars 28/06/07

Greyfriars 11/05/06

Greyfriars 15/02/06

Greyfriars 01/03/05

Greyfriars 30/06/04

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

CARE HOMES FOR OLDER PEOPLE Greyfriars 26 Clarence Gardens Shankin Isle of Wight PO37 6HA Lead Inspector Annie Kentfield Unannounced 29th July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Greyfriars Address 26 Clarence Gardens, Shanklin, Isle of Wight, PO37 6HA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01983 864361 Mr David Cable, Mrs Ann Cable Mrs A Cable Care Home 9 Category(ies) of Old age, not falling within any other category registration, with number (OP) 9, Dementia - over 65 years of age (DE(E)) of places 2 Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st March 2005 Brief Description of the Service: Greyfriars is a small residential home offering care to nine frail and older residents. Situated in a very pleasant area of Shanklin, and close to the sea, the home is managed and run by the registered owner who lives close by. All of the residents are accommodated in single bedrooms on the ground or first floor. There is a stair lift to the first floor. There is a patio and small garden at the front of the house that is used by the residents in the warmer months of the year. Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place in the afternoon and the report is based on observations from a tour of the premises, discussion with some of the residents and staff, including the manager, and inspection of some of the home’s written records. It was not possible to engage with all of the residents; but the inspector spoke at length with 5 of the residents who expressed their satisfaction with the home and the care provided. Inspection comment cards were left for residents and visitors to complete if they wished to. One comment card was received after the inspection from a relative that indicated their satisfaction with the home and the care that their relative receives. All feedback about the home from residents and staff was very positive. What the service does well: What has improved since the last inspection? What they could do better: Action needs to be taken by the registered manager to ensure that at least 50 of the care staff achieve at least NVQ level 2 in care (this was a good practice recommendation from the last inspection). Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 6 Doors in the home must not be wedged open as this is a fire safety risk. A requirement has been made that the manager must consult with the Fire Safety Officer on whether doors are suitable to be held open with approved self-closing devices. The manager confirmed that in the meantime, doors will be kept closed. 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. Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4 & 6 Residents’ individual care needs are assessed before moving into the home to ensure that the home can meet their needs. EVIDENCE: Records show that all residents have an assessment of their physical, social and emotional care needs before moving into the home. The home does not provide intermediate care but can offer respite care if there is a room available. Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,&10 All residents have an individual plan of care to ensure that their health care needs are fully met. EVIDENCE: Records inspected show that each resident has an individual plan of care that gives guidance to the staff on the care to be provided. The manager confirmed that the use of any aids or equipment is subject to the home’s risk assessment and residents’ health care needs are monitored on a daily basis and changes recorded. The manager liaises closely with the community health services and specialist care providers to ensure that the residents’ health care needs are met at all times. Residents spoken to confirmed that privacy is respected and staff always knock before entering bedrooms or bathrooms. Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 & 15 The daily routines in the home are flexible and informal and activities are offered to suit the needs of the residents. EVIDENCE: The inspector arrived at lunchtime and after lunch, and in the afternoons, residents usually have some music or occasional bingo sessions. Residents said that they enjoy sitting on the patio area at the front of the house if the weather is sunny. Staff are encouraged to spend time in the afternoons with the residents, whenever they can. A music entertainer comes into the home once per month, a hairdresser every week and there is an annual garden party, and birthday celebrations whenever they arise. Visitors are always welcome and some of the residents were going out with relatives who live locally while the inspector was there. The home does not have a designated cook but menus are planned weekly and meals are prepared and cooked by the senior member of staff on duty. Residents expressed their satisfaction with the meals provided, both the quality and the quantity. Any dietary needs or preferences are catered for and drinks and snacks, or fruit, are offered throughout the day. Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Residents are protected from the risk of harm. EVIDENCE: The manager explained that the home has not received any formal complaints. As a small home, the manager is in daily contact with the residents and relatives and is aware of any worries or concerns that may arise and these are addressed at the time. The home does have a formal complaints procedure. There are policies and information for staff on the local adult protection procedures and the manager explained that any updates in information are fed back to the staff in the home. The home does not fit locks on bedroom doors unless requested by the residents. Residents do not have a dedicated telephone for their own use but can use the home phone in their room if they wish. The only drawback to this system is that residents may not feel able to ask to use the phone; this was discussed with the manager who is aware of this and will monitor residents’ wishes. Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 - 26 Residents live in a safe and comfortable environment and all residents are accommodated in single bedrooms. EVIDENCE: The home was clean and tidy and comfortably furnished and well decorated. Although domestic in scale, this provides a homely environment that the residents felt very happy with. The bedrooms vary in size but all of the bedrooms were sufficiently furnished to meet the needs of the residents and personalised with residents’ own possessions. Some of the residents prefer to spend time in their own rooms but the sitting room was well used and has close access to a toilet and bathroom. The home provides a sitting room and separate dining room on the ground floor, and there are two bedrooms and a separate bathroom. The ground floor bathroom has an assisted bath. Other bedrooms and toilets are on the first Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 13 floor that is accessible via a stair lift. Some of the bedrooms have en-suite facilities and all of the bedrooms have a wash-hand basin. The building is not fully and independently accessible for those residents who require assistance with mobility and who have bedrooms on the first floor. However, residents spoken to said that they were aware of the difficulties before they moved into the home and that the only bedrooms available were on the first floor but were very happy with the care and support that are provided by the staff in the home. There is a stair lift and this is used wherever appropriate with the assistance of care staff. The manager explained that the mobility needs of the residents are monitored regularly and aids and equipment provided to prevent the risk of falling. Where the use of bed rails has been identified as a need, a risk assessment has been undertaken in line with recommended good practice. Care staff confirmed that the home has a policy and guidance for the control of infection and hand washing facilities are provided in shared bathrooms and toilets with written guidance for staff on the home’s procedures. The washing machine is sited separately to the food preparation area and although domestic in size, staff confirmed that all laundry is washed at the appropriate temperature to meet infection control guidance. The home has a call alarm system with call buttons in bedrooms and bathrooms, however, at night, residents are given hand bells to use, as the alarm system tends to disturb residents’ sleep. Residents spoken to said that the system works and staff respond to any calls for assistance. Since the last inspection, the emergency lighting system has been upgraded. Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 - 30 Staff are employed in sufficient numbers to meet the needs of the residents. A training and development plan is required to ensure that at least 50 of the care staff achieve a recognised qualification in care – at present only one member of staff (out of 17) has NVQ level 2 or 3 in care. EVIDENCE: The staff rota shows that there is usually a minimum of two people on each work shift, with the manager/owner in addition. The manager lives close to the home and is on call if required at other times. Staff spoken to were happy that there were enough staff on duty to meet the needs of the residents. The needs of the residents vary and some of the residents are more independent in their personal care needs. The home employs 17 care staff who mostly work part-time shifts to fit in with other commitments. The National Minimum Standards recommend that at least 50 of the care staff should have a recognised qualification in care (NVQ level 2 or equivalent) and the home does not meet this and did not at the last inspection. Training was discussed with some of the care staff and they felt that the staff employed by the home were very skilled and experienced although not formally qualified. Staff were happy that they had sufficient training to maintain safe working practice for both the residents and the staff. As many Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 15 of the staff are part-time, there is a difficulty in arranging training that meets the needs of all of the staff. This is an issue that needs to be addressed in the home’s training plan by the registered manager. The manager confirmed that staff do receive training in all areas of safe working practice such as first aid, infection control, safe moving and handling and health and safety, and some staff are waiting to do dementia awareness training. The inspection report recommends that the registered manager develops a training plan to ensure that more staff are enrolled to achieve a qualification in care that is NVQ level 2 or equivalent. Although the home has it’s own induction programme for new staff, it is also recommended, as good practice, that the induction programme uses the national standards for care training as set out by ‘Skills for Care’ the national training body for skills and development in the care sector. The national standards for induction training link into further training and qualifications for care staff. Inspection of the home’s recruitment records show that not all staff have two written references on file. The Care Homes Regulations require all recruitment procedures to be thorough to ensure the safety and welfare of vulnerable residents and records should contain a clear history of previous employment and satisfactory written references. The deficiencies in the home’s procedures were discussed with the registered manager because this is a requirement that has not been met from the previous inspection. All new staff should have a satisfactory Criminal Record Bureau check (including a POVA check) before starting work in the home. New staff who already have a current Criminal Record Bureau check from a previous employer need to apply for a new check that includes an additional POVA check. (The POVA or protection of vulnerable adults scheme was introduced in July 2004 as an additional safeguard for vulnerable adults). Although the manager explained that all staff are supervised and staff are usually only employed on personal recommendation, failure to meet the requirements of the Care Homes Regulations has the potential to put the safety and welfare of the residents at risk. In addition, all staff must be subject to the same employment checks as part of the home’s commitment to equal opportunities. Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,37738 The home is well run by an experienced manager and records required by regulation are maintained and kept up to date. EVIDENCE: The registered owner has owned and managed the home for 9 years and is a registered nurse, previously specialising in the care of older people, and is also an experienced community nurse. Although the manager does not have a formal management qualification and has no plans to achieve this, there is evidence that the home is efficiently managed and staff are supervised and supported at all times. Comments from residents and staff show that the management approach is friendly and informal and the manager sees the residents on a daily basis and is very knowledgeable about the individual needs and preferences of all of the residents. The manager has good working relationships with care managers, Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 17 GP’s and District Nurses and with residents’ families and friends, and there were many cards and letters of thanks and appreciation on display. The manager confirmed that the home has current insurance with appropriate liability cover. Some of the home’s records were inspected and these were up to date and securely stored. On the day of the inspection the weather was very warm and most of the doors in the home were propped open. It was also noted and discussed with staff that a fire exit door was blocked by a piece of equipment. Whilst appreciating that residents sometimes want their bedroom door open, doors must only be held open with approved self-closing devices that automatically shut in the event of a fire. Door wedges must not be used as they present a fire safety risk. In discussion, the manager agreed that she will consult with the Fire Safety Officer about fitting self-closing devices to doors and in the meantime, doors will not be wedged open. (see requirements at the end of the report). The manager will also ensure that fire exit doors have free access. Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 3 3 3 x x 3 2 Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 19 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 29 Regulation 19(1)(b) and Schedule 2 Requirement Two written references and details of previous employment must be obtained for all new staff. All new staff must have a current CRB check and POVA check in place before starting work in the home. (This was also a requirement at the inspection of 1st March 2005) Doors must not be wedged open as this is a fire safety risk. The manager must consult with the Fire Safety Officer on whether doors may be held open with approved self-closing devices. Designated Fire Exit Doors must be kept clear at all times. Timescale for action 31 August 2005 2. 38 23(4) With effect from 31 July 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 28 Good Practice Recommendations The registered manager should develop a training plan that ensures that more staff achieve the minimum qualification in care (NVQ 2 or equivalent). It is recommended that at least 50 of the staff should have at H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 20 Greyfriars 2. 30 least NVQ level 2 in care) (This was a recommendation from the inspection of 1 March 2005) It is recommended as good practice that the registered manager ensures that the homes induction training programme meets the standards of the national body (Skills for Care) for the training and development of people working in care. Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Mill Court Furrlongs Newport, Isle of Wight PO30 2AA 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 Greyfriars H55-H04 S12495 Greyfriars V218125 290705 Stage 4.doc Version 1.40 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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