Inspection on 02/09/05 for Greystone House

This inspection was carried out on 2nd September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Greystone House 09/01/08

Greystone House 30/05/06

Greystone House 13/03/06

Greystone House 07/03/05

Greystone House 19/05/04

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

CARE HOME ADULTS 18-65 Greystone House 319 Blackwell Road Carlisle Cumbria CA2 4RS Lead Inspector Liz Kelley Unannounced 02 September 2005 10:30 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Greystone House Address 319 Blackwell Road Carlisle Cumbria CA2 4RS 01228 536349 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) Mr John Sibbald Ruddick Care Home 24 Category(ies) of MD - Mental Disorder registration, with number MD(E) - Mental Disorder, over 65 of places Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 24 people with a mental disorder (MD) some of whom may be over 65 years of age (MD(E)) 2. Two service users may only share the double room if both have made a positive choice to do so. Date of last inspection 7 March 2005 Brief Description of the Service: Greystone House is a large Victorian, two storey detached property on the outskirts of Carlisle city. It has been modernised and converted for its present use, including three purpose built extensions to the side and rear of the original building. Greystone House is home to twenty four people who have difficulties maintaining aspects of their mental health. Two carers, a senior and the manager staff a normal shift, with two waking staff on duty at night. The Home has three lounges situated on the ground floor, one of which is a designated smoking lounge, there are also two dining areas. One of the three bathrooms is equipped with a hoist to safely assist people with physical needs. There are twenty two single bedrooms and one twin bedded room. Fourteen of the single rooms have en-suite facilities. The Home has a central laundry and kitchen. Both laundry services and meals are provided to service users. There is a six-person passenger lift to the first floor. The Home has a private garden to the front and a smaller garden/patio area to the rear. The Home is well placed for local facilities including shops, post office and church. There is a regular bus service to the city that stops adjacent to the Home and Hammonds Pond Park is only a short walk. Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 4 hours. The majority of residents were at home across the day and spoken to. Two staff members, a senior and the trainee manager, Sian Ruddick, were interviewed. Feedback cards had been received from visiting professionals earlier in the year. A partial tour of the premises took place, as some bedrooms were locked and the occupants were not at home to seek permission to enter. Staff records and residents files were examined. What the service does well: What has improved since the last inspection? What they could do better: The manager needs to ensure that the recommendations made at the last Fire Officers visits are implemented as soon as possible, and reported back to the Fire Officer and the Commission for Social Care Inspection when complete. Please contact the provider for advice of actions taken in response to this Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,4 The home has suitable procedures in place to introduce new service users and ensures that each person has a full assessment prior to living at the home. This ensures that they only take people whose needs they can meet, and the individual has the opportunity to vet the home and make an informed choice of where to live. EVIDENCE: Files contained relevant paperwork, including social work assessments and reports from mental health care professionals prior to a person choosing to stay at the home. Documentation confirmed that service users were accepted only on the basis of a full assessment involving appropriate professional input and consultation with service users and their families. This procedure was in line with the Homes Statement of Purpose, and only those individuals in receipt of support from Carlisle Adult Community Mental Health Team were accepted as a referral. These measures resulted in the home being successful in settling new service users into the home. Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,9, New style care plans and risk assessments are a significant improvement and ensure that residents mental health and personal care needs are clearly identified and staff have clearer information on how to meet these needs. EVIDENCE: Individual care plans were well organised and laid out in a format that clearly identified needs and how they were to be met. These were supported by additional information such as life stories and pen pictures which further informed staff giving them greater understanding and knowledge of the individual. Files also included details of a persons mental health disorder and any restrictions imposed via the Mental Health Act or Guardianship Orders. Risk assessments included details of restrictions imposed on residents for example limiting cigarettes and alcohol, and these had been agreed by the resident, appropriate relatives and at review meetings with mental health professionals. Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,17 The home has made progress in offering increased opportunities to enhance the lifestyle of those living at the Home. Dietary needs of residents are well catered for with a balanced and varied selection of good quality food and home cooked meals. EVIDENCE: The majority of residents attended day services for people with mental health problems. However a significant number chose to direct their own free time and access the community independently to go to the shops, town centre, library and local parks. The home has recently focused on a number of organised day trips out and residents said these had been enjoyable. A white board has been set up to give information on activities within the home and locally in the area. The trainee manager said she would like to develop activities and is looking to replace an activity organiser for the afternoons. Discussion with the cook and examination of menus demonstrated that meals were of a good nutritional quality, varied and home cooked. Residents stated that the meals were very good and they had plenty of choice, some people said they were being helped to eat more healthily. Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 Staff have a good understanding of the support needs of residents. The staff team worked positively with local health care professionals to offer a responsive and supportive approach in assisting people to maintain their mental health. EVIDENCE: The home keeps comprehensive records and systems to monitor service-users health care needs. Each service-user was registered with a GP of their choice and had a named District Nurse, or Community Psychiatric Nurse. The Home and service-users made effective use of the Primary Health Care Team and more specialist services when required. Details of other healthcare professionals visits and advice were recorded on individual care plans and staff demonstrated a good working knowledge of service user healthcare needs. A CPN spoken to had a positive relationship with the Home and felt that the needs of service users was being effectively managed. The care of one service user with complex healthcare needs had been very well managed with joint working with the District Nurse Team. Increased involvement had been fostered with Mental Health care services, which has benefited residents by training of staff from this team and individual work within the home. This included regular meetings to develop strategies that help people remain at home and reduce hospitalisation. Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) This area was not looked at in any depth on this inspection, although no formal complaints had been received either to the home or directly to Commission for Social Care Inspection. This area will be examined at the next inspection. EVIDENCE: Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, Residents benefit from living in a well kept and safely maintained home that is centrally located for local amenities. EVIDENCE: Recent improvements to the building have been: new flooring to the dining room and rear of the property, new flooring in some residents bedrooms; redecoration of the exterior; internal decoration of the smoking room. All the windows to the front elevation had been replaced with UVPC double-glazing, including the large bay windows. Residents commented that they were pleased with the improved look this gave to the Home and the reduction in traffic noise. The trainee manager is drawing up a maintenance and development plan for the home that will detail future works which will be viewed at the next inspection. Considering its size, the Home blended in well with the community and provided a comfortable, homely environment with good access to the local community. A cleaner and handyman are employed to assist in keeping the home clean, safe and tidy. Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,36 A core group of established, experienced staff provide direction and support to new staff which ensures continuity of care to residents. Residents benefit and are protected by the thorough recruitment practices of the Home. Staff are benefiting from the increased opportunities for training and supervision. EVIDENCE: Training for the Home, along with staff supervision had been given a priority to assist in a move towards meeting this Standard. The trainee manager had been given responsibility to develop supervision and staff training. This had included developing an Induction pack and individual training plans for each person. These were in good detail and five staff were close to completing NVQ 2 in care. Other recent training had been First aid, Diabetic awareness, and short courses on mental health and dementia awareness. Good progress had been made on developing staff files and records which complied to the recruitment standards which ensure all the necessary checks are carried out prior to employment. The trainee manager offered to send into the Commission for Social Care Inspection the Development Plan for the Home. The home would benefit from having a clearly designated person in-charge over the weekend. Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,42 Residents benefit from a well-organised and well-run home that meets individuals needs. Good systems are in place to ensure the well-being and safety of those that live and work at Greystone House. EVIDENCE: A quality assurance system for the Home had been developed by the trainee manager, which had included the use of service user satisfaction surveys and regular meetings. The home had effective systems in place to ensure the safety and up keep of the physical environment, such as cleaning rotas and maintenance records. The trainee manager had recently attended a Fire Wardens course. However there were outstanding works required from the last fire officers visits that require attention. These should be reported back to the Fire Officer and the Commission for Social Care Inspection when completed. The trainee manager must pursue an application to become the Registered manager. Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score 3 3 x x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Greystone House Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x x 2 x F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 17 no 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 YA 42 Regulation 23 Requirement The requirements from the Fire Officers 20.04.05, report must be actioned Timescale for action 28.10.05 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 ya24 Good Practice Recommendations The manager should send into Commission for Social Care Inspection a planned maintenance and renewal programme for the fabric and decoration of the premises. Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP 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 Greystone House F58 F10 s22656 greystone house v229278 020905 ui stage 4.doc Version 1.30 Page 19 - 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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