Inspection on 30/08/06 for Greyrigg Rest Home

This inspection was carried out on 30th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Greyrigg Rest Home 08/11/07

Greyrigg Rest Home 27/02/06

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 Mrs Felicity Lacey Unannounced Inspection 30th August 2006 10:00 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.V302040.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. Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 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.V302040.R01.S.doc Version 5.2 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) 27th February 2006 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. At the time of this visit fees at the home ranged from £324.50 to £366.00 per week. Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit took place unannounced. During the visit the inspector spoke with residents, staff, the manager and the owner of the home. Records and documents where looked at. There was a tour of the premises. Information was provided by the manager who completed a Pre Inspection Questionnaire prior to the visit. Comment cards were received from residents, relatives and from 2 GPs. What the service does well: The staff and manager at Greyrigg are dedicated to providing a service which meets the needs and expectations of the residents. All residents spoken with and who completed comment cards were very positive about the attitude of the staff at the home. Their comments included; ‘Nothing is too much trouble’ ‘The staff are great-they see to your every need-I’ve never been looked after so well’ ‘Staff are helpful in every way’ Residents and relatives were pleased with the standard of care at the home. Medical needs are identified swiftly and acted upon. Residents who had recently experienced health problems felt that the staff had been patient and sensitive and had sought medical advise immediately. A number of residents felt that their health had improved considerably since moving to the home, and they attributed this to encouragement by staff, support with personal care needs and a good diet. The standard of food at the home was considered by residents to be very good. The food is home made and reflects the likes and dislikes of the residents. There is always an alternative available. One resident said ‘the food is marvellous-home made’. The manager of the home and the staff are committed to continually improving and adding to their skills. Training is actively promoted at the home, and this includes National Vocational Qualifications and other courses, for example Medication Management. Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,5 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. Prior to moving into the home, a full assessment takes place, which ensures that identified needs can be met. All residents and their representatives are encouraged to visit the home to enable an informed decision to be made. EVIDENCE: All comment cards received indicated that enough information about the home was received before a decision was made to move in. Residents spoken with felt that the home more than met their expectations. All residents were visited prior to moving to Greyrigg and a full assessment completed by the manager or a senior member of staff. Residents are fully involved in this process and whenever possible sigh the assessment to verify that it is an accurate representation of their individual support needs. One resident visited the home a number of times before making the decision to move to the home, and had not regretted the decision to move to Greyrigg. One comment card stated ‘very impressed from the beginning, whole building and atmosphere seemed friendly and down to earth.’ Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 ,10 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. Staff training and good practice promote the safe handling of medication at the home. Each care plan is regularly reviewed, which ensures that changing needs are responded to. Health care needs are met and respect and privacy is upheld. EVIDENCE: The residents each have an individual plan of care which is based on a full assessment of their personal care needs. The plans are signed by the resident. The plans are reviewed on a monthly basis or when necessary. The plans seen where up to date and identified individual care needs and how support was to be given to the resident. The importance of encouraging and respecting independence was evident when observing care practices. Residents felt that they were given the right amount of support and that their preferences where respected. One resident has a communication tool which she uses at times, the staff felt that her willingness to use this was more evident with family members however they continue to encourage the resident to use this but feel that they have a good understanding of the residents wants and needs. Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 10 The health care needs of residents are well met at Greyrigg. The home has good relationships with local health services. The GPs who returned comment cards indicated that the staff had a good understanding of health care needs, made appropriate referrals and incorporated any specialist advise into the care plan. The residents spoken with felt confident that they would receive any medical attention they required. A number of residents felt that coming to the home had led to a significant improvement in their health and well-being. The medication administration and storage arrangements at Greyrigg are satisfactory. The records seen at the visit were accurately completed. Residents can sign a disclaimer if they wish to self medicate, this is supported by a risk assessment and is reviewed when necessary. All senior staff have undertaken training in the safe management of medicines, and all staff receive in house training on the home policies with regard to medication. Residents spoken with felt that the staff of the home respected and promoted their privacy and dignity. The residents felt that the home had a warm and friendly atmosphere and that individual needs and choices were understood and respected. The arrangements for assisting residents with personal care demonstrated a good understanding of respect for the individual, residents said that staff always knocked on doors before entering, were always courteous and patient. A number of residents also commented that they observed the way in which staff members assisted other residents who had more complex care needs, and they felt that everybody was treated with respect and patience. Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. Individuals are helped to exercise choice and control over their lives, which helps to maintain independence. Social activities and contact with family and friends are actively encouraged. The meals are good and are enjoyed by people living at the home. EVIDENCE: The routines of daily living are flexible at Greyrigg. Residents can choose when they wish to rise and retire, and how they want to spend their day. Meal times are fixed, this was seen as a positive thing by some residents who appreciated the punctuality and reliability of the chef. If a resident misses the meal there is appropriate arrangements made. Some residents take part in daily chores, for example one lady sets the tables at lunch, and said that she enjoys the opportunity to keep busy and ‘do a bit around the house’. Information about the religious and cultural interests of residents is gathered at the time of admission. Staff members accompany residents to the local church of their choice, and arrangements can be made for clergy to visit the home. Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 12 A range of social activities are on offer at Greyrigg, these include quizzes, knitting and talking books. The home has an attractive garden and some residents make use of this. The residents had enjoyed a visit from staff of the local Marriot Hotel who provided refreshments and beauty treatments. Some residents also then visited the hotel for afternoon tea. There have been few outings arranged as interest in these is very limited, with some residents not wanting to go out when the day of the outing comes around. There are opportunities to go out to local pubs and eateries. Residents often go out with family and friends. Visitors are welcome at any reasonable time, and the staff are welcoming in their attitude. Most residents have made arrangements to appoint an agent or to manage their own finances. The manager acts as appointee in exceptional cases, and full records are maintained of transactions entered into. The residents were very pleased with the standard of food at the home. The main meal of the day is served at lunchtime and is home cooked. There is a choice available at all mealtimes, including salads. Through out the day drinks and snacks are available. The kitchen facilities are domestic in style, but appear to be adequate for the needs of the residents. Consideration is to be given to providing fresh fruit, this has been done previously with little success, however the manager is keen to respond to any request from the residents and will re introduce this. Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. Policies, good practice and staff training promote the protection of those living at the home. Arrangements for handling complaints are in place. People living at the home and their relatives and friends are confident that any concern would be responded to. EVIDENCE: All comment cards indicated that the staff listen to the views of residents. The complaints procedure is understood by residents and staff. There have been no complaints since the last inspection. Residents felt that if they had any concerns they would be able to raise these and they would be dealt with. Staff are aware of adult protection procedures. The induction pack gives guidance on the policy of the home. Staff receive training in adult protection and signs of abuse through their National Vocational Qualification training. Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,26 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. The home is clean and well maintained, providing a safe and pleasant environment for those living there. EVIDENCE: The communal rooms of the home have been recently redecorated. The residents liked the way in which this had been done. The home maintains many original features and the newly decorated rooms are in keeping with these. The home has a large garden which is used by the residents. The location of the home near the motorway causes high levels of noise in the garden, however the residents have become used to this and do not see it as a problem. Inside the home the noise is not noticeable. The garden furniture should be renewed as it is looking worn. There are adaptations within the home to aid mobility such as grab rails. The home has a chair lift in place, but currently all residents live on the ground floor. There is an assisted bath. Individual residents have their own mobility Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 15 aids that they have been assessed for. Access to the home and garden could be improved by the provision of a ramp, the manager is considering a portable ramp as an effective solution to this. All parts of the home were clean and tidy. Residents said that their rooms were well looked after. There are procedures in place to ensure the control of infection. Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. Recruitment and staff training help to ensure that the staff team are equipped for their role. The numbers and skills of staff meet the needs of those living at the home. The majority of care staff have undergone NVQ training, which has increased the competence and capability of the staff team EVIDENCE: All comment cards and residents spoken with indicated that staff were readily available. The attitude of the staff was praised by residents who felt that they were always respectful and approachable. 50 of staff have achieved National Vocational Qualifications at level 2, and 3 staff are now going on to complete level 3. Training is actively encouraged and staff spoken with felt that this was important and helped them to continually develop their skills. The recruitment procedure at the home ensures that all require checks are completed prior to an employee starting work at Greyrigg. The application form should be amended to include a full employment history of applicants, and that all gaps in employment are accounted for, this provides an extra safeguard. All staff complete an induction programme, which is supported by a manual and videos. All staff undergo a probationary period. The manager has devised a training matrix and this shows who has attended which courses and helps Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 17 identify any training needs. Training needs are also discussed in formal supervision. Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, with training and good practices promoting the health and safety of those living at the home. The home is well managed and quality monitoring promotes the best interests of the people who live there. EVIDENCE: The manager of the home is seen as a competent and experienced leader. Staff and residents consider her to be approachable and dedicated to ensuring that high standards are maintained at the home. She continues to add to her skills and undertakes appropriate training and development opportunities. She is currently working towards achieving her National Vocational Qualification at level 4 in management and care. As advised at the previous inspection the registered provider is not in day-today control of the home and therefore must carry out monthly monitoring Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 19 visits, and submit a copy of the report produced to the Commission for Social Care Inspection. The home has Investors in People Award. A quality survey is conduct each June, this gathers the opinions of residents and relative and visiting professionals. The results are displayed in a pie chart and areas for improvement identified. The nature of the home is such that there are daily conversations between the residents, manage and staff. There is a high degree of informal contact, and information is passed on at handover times. Staff meeting are held occasionally but these are difficult to organise to ensure that all staff can attend, however there are a number of ways in which views are sought and information shared, including regular formal supervision. Written records are maintained of financial transactions made on behalf of residents, where ever possible residents maintain control over their own financial affairs. The manager acts as appointee for two people, however this is the exception rather than the rule. Money held at the home is stored securely. The pre inspection questionnaire indicates that all health and safety checks have been complied with. All accidents are recorded, and the manager is currently carrying out a further survey of falls to try and establish any emerging patterns, these could be attributed to the effects of medication or a hazard within the home. Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 4 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 X 3 Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 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. (Previous timescale of 01/04/06 not met) Timescale for action 30/09/06 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 3 4 Refer to Standard OP19 OP22 OP29 OP31 Good Practice Recommendations The garden furniture should be replaced. Consideration should be given to improving the access to the garden and house by the provision of a ramp. A full employment history should be included in the application for employment form, and any gaps in employment accounted for. The registered manager should gain a management qualification at level 4 NVQ. Greyrigg Rest Home DS0000050985.V302040.R01.S.doc Version 5.2 Page 22 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.V302040.R01.S.doc Version 5.2 Page 23 - 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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