Inspection on 27/02/06 for Greyrigg Rest Home

This inspection was carried out on 27th February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Greyrigg Rest Home 08/11/07

Greyrigg Rest Home 30/08/06

Greyrigg Rest Home 17/03/05

Greyrigg Rest Home 03/08/04

Greyrigg Rest Home 12/03/04

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

CARE HOMES FOR OLDER PEOPLE Greyrigg Rest Home 421 Garstang Road Broughton Preston Lancashire PR3 5JD Lead Inspector Lesley Plant Unannounced Inspection 27th February 2006 2:00 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 Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 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. Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Greyrigg Rest Home Address 421 Garstang Road Broughton Preston Lancashire PR3 5JD 01772 863202 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) greyrigg@nhsrecruits.com Dr Zakir Habib Patel Mrs Kathleen Johnson Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 16 service users to include: up to 16 service users in the category of OP (Older people over 65 years of age) 14th July 2005 Date of last inspection Brief Description of the Service: Greyrigg provides residential care for up to 16 older people. The home is located on the outskirts of Preston, within reach of local bus routes, shops and amenities and provides a comfortable and homely environment for service users. Accommodation consists of ten single bedrooms and three double bedrooms, plus a good variety of communal lounge and dining space, including a conservatory. Communal areas are domestic and homely in character. All service user accommodation is on the ground floor. The home is surrounded by extensive, well-maintained gardens, which are accessible to service users and include good parking areas for staff and visitors. Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, started at 2.00 pm and took place over four hours. The inspector spoke to six of the 14 people living at the home, the registered manager, three members of the care team and the administrator. Feedback comment cards for relatives, people living at the home and a visiting GP were distributed, with three being returned from relatives and seven from service users. Medication, money held for safekeeping, training and certain administration records were viewed. Key standards not assessed at this inspection will have been addressed at the previous inspection on the 14th July 2005. What the service does well: What has improved since the last inspection? What they could do better: Although the home is generally well maintained, the registered provider, administrator and registered manager are advised to review and monitor systems for attending to repairs and maintenance. Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 Page 6 The registered manager is advised to compile a training matrix covering all the key training topics. This will help to identify any gaps and indicate when refresher courses are required. The registered provider is not in day-to-day management of the home and therefore must carry out monthly monitoring visits and send a copy of the reports to the CSCI. The registered manager should gain a management qualification at level 4 NVQ and so further develop her management skills. A photograph must be kept of each person admitted to the home, as identified at the last inspection. The registered manager is advised to remove completed forms from the accident book and so comply with data protection guidance. 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. Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 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 Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 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): None of the above standards were assessed at this inspection. EVIDENCE: Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 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): 9 Staff training and good practice promote the safe handling of medication at the home. EVIDENCE: Medication and accompanying records for two people were viewed, showing that administration is recorded appropriately and a risk assessment and signed disclaimer are in place for one person who stores and administers some of his medication. Medication is safely stored and staff have completed training regarding the medication system used at the home. The senior staff member responsible for ordering medication confirmed that the home has a good relationship with the pharmacist who carries out an annual check of procedures at the home. The inspector spoke to two people regarding their medication. Both said that they were happy with the arrangements and that staff always bring their medication to them at the times prescribed. Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 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 the following standard(s): 14 Individuals are helped to exercise choice and control over their lives, which helps to maintain independence. EVIDENCE: People manage their financial affairs according to needs, wishes and capabilities. For some individuals a relative or a solicitor may take on this responsibility. Each bedroom has lockable space for the safekeeping of valuables. Individuals are able to bring their own personal possessions with them to the home, according to available space. Information regarding advocacy is displayed on the notice board in the hallway. Individuals are able to access their records should they wish to do so and a written policy addresses this. The two people spoken to about finances explained that they look after their own money and have a place in their bedroom to lock any money or valuables. One person recently admitted to the home explained that she was told she can have a lie in in the mornings and can choose to eat in the lounge if she wishes. This person said that she liked having these choices in day-to-day matters. The three relatives who completed feedback comment cards all responded that they are consulted if their relative is not able to make decisions. The seven service users who completed feedback comment cards for the inspection all responded that they do not want to be more involved in decision making within the home. Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 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 the following standard(s): 18 Policies, good practice and staff training promote the protection of those living at the home. EVIDENCE: The home has written policies relating to; the prevention of abuse, whistle blowing, violence and aggression, restraint, unacceptable practices and the receipt of gifts by staff. A copy of the No Secrets in Lancashire document is also available. The registered manager has a good understanding of the procedures to be followed should a concern be raised. This being demonstrated during the week of the inspection, when a concern voiced by an individual at the home was appropriately dealt with and referred to the individuals’ social worker. Some staff have received training regarding challenging behaviour and abuse/protection is addressed within the NVQ programmes. All staff undergo Criminal Records Bureau clearance as part of the recruitment process. The inspector viewed well-maintained records of personal spending money held for certain people at the home and individuals also have the facility to lock valuables within their own rooms. The seven service users who completed feedback comment cards for the inspection all responded that they feel safe at the home. Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 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 the following standard(s): 19 and 26 The home is clean and generally well maintained, providing a safe and pleasant environment for those living there. EVIDENCE: Although the home is generally well maintained, the registered provider, administrator and registered manager are advised to review and monitor systems for attending to repairs and maintenance. Regular checks of the home take place, with any matters requiring attention being passed onto the administrator. Sometimes there are delays in attending to minor repairs. At the time of the inspection the hoover was broken and one of the double bedrooms required decoration, this being discussed with the registered manager. Arrangements should be made for the redecoration of this room, taking into account the possible disruption for the occupants. The administrator and registered manager meet regularly and it is advised that maintenance issues are given a higher priority at these meetings. The home appeared clean and hygienic. The inspector viewed the staff guidance regarding infection control, hand washing and the use of protective Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 Page 13 clothing. A member of staff, in post for nine, months confirmed that she had been instructed in these matters and protective gloves and aprons were provided in individual bedrooms as required. The home has a separate laundry room, with hand washing facilities. There are arrangements in place for the disposal and collection of clinical waste. The registered manager is aware of the importance of infection control and knows how to contact the health protection unit should advice be needed. Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 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 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): 29 and 30 Recruitment and staff training help to ensure that the staff team are equipped for their role. EVIDENCE: Examination of the recruitment records for a recently appointed member of staff showed that correct procedures are being followed. Documentation includes an application form, two references, a health declaration, photograph, terms and conditions of employment and criminal records bureau clearance. Staff training continues to be strengthened and developed. A new staff induction pack has been introduced, which covers mandatory subjects such as moving and handling, food hygiene and health and safety. The induction programme includes videos, exercises and questions, with each area being signed off when assessed. An external trainer provides certain training, such as food hygiene, with other areas being addressed in house. Each staff member has an individual training record. The registered manager is advised to compile a training matrix covering all the key training topics. This will help to identify any gaps and indicate when refresher courses are required. The staff team has remained quite static and there has been a strong focus on qualification training for staff, with over 50 of the care staff having achieved NVQ level 2 or above. The people living at the home made positive comments about the staff team and the care they receive, with one person saying that staff are “extremely helpful and always come when I need them”. Several people said how helpful and kind the cook was. The three relatives who completed Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 Page 15 feedback comment cards all responded that they are satisfied with the overall care provided. Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 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 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, 35, 37 and 38 The home is well managed, with training and good practices promoting the health and safety of those living at the home. EVIDENCE: The registered manager has over 30 years experience in the care sector and also has opportunities to update her knowledge and skills. The manager has completed NVQ level 4 in Care, but does not have a management qualification at this recommended level. The manager is keen to make any improvements to the service and responds positively to advice given during inspections. There are clear lines of accountability within the home, with the registered manager, administrator, and registered provider, having different roles and responsibilities. However, although the registered provider visits regularly, he is not in day-to-day management of the home and therefore must carry out monthly monitoring visits and send a copy of the reports to the CSCI. Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 Page 17 The inspector discussed the use of the offices on the first floor of the home and advised that the use of these rooms should be monitored in order that those living at the home are not adversely affected. People manage their financial affairs according to needs, wishes and capabilities. The inspector viewed well-maintained records of personal spending money held for certain people at the home, with an accurate record kept of the cash held. The registered manager is advised to store the cash box, containing these temporary savings, in a locked cupboard. Service users also have the facility to lock valuables within their own rooms, as confirmed by discussions with two individuals. A photograph must be kept of each person admitted to the home, as identified at the last inspection. Although this is in place for the majority of service users, there was no photograph for one person who had been resident at the home for over two months. As recommended at the last inspection the handover book does not now contain personal information about service users, but directs staff to the appropriate standex record. This means that records are now individually maintained. Health and safety checks regularly take place. Records of fridge and freezer temperatures, water temperatures and fire drills were viewed. There is a written fire risk assessment for the home. The staff induction programme includes training in safe working practices, such as food hygiene. Copies of the written health and safety policies and procedures are available to guide staff in their working practices. The accident records were viewed, with the registered manager being advised to remove completed forms from the accident book and so comply with data protection guidance. Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 3 X 2 3 Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP31 Regulation 26 Requirement The registered provider must conduct a monthly visit to the home and supply the CSCI with a copy of the report. A photograph must be kept of each person admitted to the home. Timescale for action 01/04/06 2 OP37 17 schedule 3 01/04/06 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 OP19 OP31 Good Practice Recommendations The double bedroom identified as in need of decoration, should be attended to. The registered manager should gain a management qualification at level 4 NVQ. Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Greyrigg Rest Home DS0000050985.V259809.R01.S.doc Version 5.1 Page 21 - 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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