Inspection on 15/01/08 for Greystones Nursing Home

This inspection was carried out on 15th January 2008.

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

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

Other inspections for this house

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

CARE HOMES FOR OLDER PEOPLE Greystones Nursing Home Parsons Road Heaton Bradford West Yorkshire BD9 4DW Lead Inspector Chris Levi Key Unannounced Inspection 15th January 2008 09:30a 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 Greystones Nursing Home DS0000070523.V354365.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. Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greystones Nursing Home Address Parsons Road Heaton Bradford West Yorkshire BD9 4DW 01274 542625 01274 480322 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) Adam & Co Accountancy Ltd Mr Matthew Adebayo Care Home 25 Category(ies) of Dementia (25), Mental disorder, excluding registration, with number learning disability or dementia (25) of places Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N; to service users of the following gender: Either; whose primary care needs on admission to the home are within the following categories: Dementia - Code DE; Mental Disorder, excluding learning disability or dementia - Code MD. The maximum number of service users who can be accommodated is: 25 N/a 2. Date of last inspection Brief Description of the Service: Greystones care home is located in a residential part of West Bradford, close to Lister Park. Accommodation is provided in a converted turn of the century house, set in its own grounds and within walking distance of main bus routes to Bradford. Greystones care home provides 24 hour psychiatric nursing care to Older Adults over 65. Bedroom accommodation is on three floors. There are 14 single bedrooms and 5 double bedrooms in the home. Access to the first floor is via a shaft lift and stairs. Access to the second floor is via stair lift only. This places limitations on service users who may have problems with mobility. Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This is the first inspection by the Commission for Social Care Inspection since the home was bought by Adam & Co Accountancy Ltd. in September 2007. Information about the home requested by the Commission for Social Care Inspection included a new document, the Annual Quality Assurance Assessment (AQAA) was completed by the home manager and returned to the CSCI. This enabled the inspectors to analyse information that included the number of reported accidents, complaints and compliments from residents and relatives and other relevant information to help plan for the visit to the home. It also provided opportunities to demonstrate how the home could improve its services to the people who live at the home. The providers were not notified of this inspection in advance. This enabled the inspector to observe how the home is run on a day-to-day basis, without any changes being made to the usual routines of residents and staff. The visit started at 9.30 am and finished at 3pm. The person in charge of the home was the Manager, Mr M Adebayo One inspector visited the home and spent time talking to residents, relatives, and staff, to find out what it is like to live, work and visit Greystones. A number of documents were reviewed relating to residents, staff and health and safety. Twenty residents and relatives survey forms, were sent to the home before the visit to enable them to provide the Inspector with opinions about standards at the home. Although competed forms were sent to the CSCI they were not received by the Inspector. However, during the visit all of the residents who spoke with the Inspector said, they were happy living at Greystones and all the staff were very kind and “would do anything for you”. Ten staff surveys were sent. All were returned and contained positive comments about working at the home. These included,” I had an induction booklet that really helped me out in my day to day activities with clients”. Another stated, “There is a good working atmosphere.” Any completed surveys will be sent directly to the Inspector at the local CSCI office. Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 6 The manager and owner were given feedback about the findings of the inspection at the end of the visit. What the service does well: What has improved since the last inspection? What they could do better: The laundry floor must be replaced. It is currently a health and safety hazard, because it is very uneven and difficult to clean. The quality audit undertaken by the manager last month, should include a written report of the findings, and any changes made to the service as a result of the information provided by those who took part. Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 7 When recruiting new staff the manager should ensure the applicant’s employment record is in sufficient detail that gaps in employment can be explored to ensure the person is suitable to work with vulnerable adults. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 8 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 Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is written information about the home to help people decide if they wish to live there. The needs of prospective residents are adequately assessed to ensure staff can meet their individual needs. EVIDENCE: The home has a written Statement of Purpose and the Service User’s Guide; but because of new ownership they are currently being up dated to reflect changes to the service. The previous information is still available until the revised copy has been produced. These documents enable people thinking about living at Greystones with information about the home to assist them in making an informed choice about moving in, either on a temporary or a permanent basis. Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 10 There was evidence that the assessed needs of people, before they move to the home, are detailed. This provides staff with opportunities to develop effective plans of support in preparation for the person as they move into the home. The written terms and conditions of occupancy for residents were seen. They identified the accurate weekly charges made by the owners as they are updated when fees charged are increased. This is good practice. Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, personal and social needs of residents are met, and the dignity of residents is maintained. EVIDENCE: The care plans of three residents were looked at. They all contained relevant, up to date information about the needs of the resident, to enable staff to provide care and support to residents in a person centred way. There are appropriate risk assessments in place such as the risk of falls, moving and handling, nutrition and pressure care. All care planning documentation, including risk assessments, is reviewed on a monthly basis. All contact with GP’s, Psychiatrists and other health and social care professionals is recorded. Health care professionals are involved appropriately, Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 12 for example- to undertake physiotherapy and mental health assessments, nutritional assessments are completed for residents and records seen by the inspector evidence that residents are weighed on a monthly basis. Accidents are recorded individually and are cross-referenced to daily diary notes. Records of these were seen, in addition to this recording, the manager undertakes a monthly analysis of accidents. This provides information that may result in changes to risk assessments or care needs for an individual who has sustained a number of accidents during the previous month. Medicines are stored safely, and checked to ensure they are correct when they arrive from the pharmacist. This reduces the risk of a resident’s medication being incorrect. Two members of staff sign the records for controlled drugs at the time of administration, and the remaining balance of medication is recorded on each occasion. This was checked for one resident and the total was correct. The nurse on duty administers medication, and sample signatures are recorded to enable medication administration records to be checked. A clinical waste company collects unused or discontinued medication; records confirming this were seen. Some medication is stored in a fridge in the medications room – fridge temperatures are recorded daily. The room where medication is held was clean and tidy. Throughout the visit, staff were observed respecting the wishes of residents within safe agreed limits, whilst maintaining their dignity. Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents at the home can spend their day as they choose, seeing whom they choose, when they choose, but for some their levels of frailty restrict some choices. Meal provision at the home is very good and offers service users ample choice. EVIDENCE: Residents said they were able to stay in their rooms if they wished. They decide when they get up, and within safe limits, how they will spend their day. A number of residents are used to spending the day away from the home, visiting friends, shopping, doing what they please when they please. This does present some risks to others. Many residents smoke cigarettes, but do not always ensure they do so in a way that is safe. This has resulted in three fires at the home, thus putting residents and staff at risk of harm. Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 14 The owners, manager and staff work hard to ensure the choice to smoke is available, but in a safe enclosed area of the home. Some residents do smoke away from the designated area, despite written agreements. This presents risks from fire to other residents who are physically frail, and staff. The management team continues to look at this problem, and improve fire detection, and gives continuous reminders to residents who smoke about the risk of fires. On the day of the visit, staff were observed encouraging the more frail residents to engage in a ball game being played in one lounge. One member of staff was playing cards with a resident. The television in this lounge was on continuously and the picture was poor, no one was observed paying attention to the programmes. Background music may be an alternative to provide stimulation, or relaxation for the residents using this lounge. The manager stated a new activities co coordinator had been recruited. A start date was yet to be agreed. Staff do engage residents in both one to one and group activities. These are recorded in the person’s plan of care. There was evidence that residents had appreciated the efforts of staff, which had arranged a firework display on November 5th. One resident said how much she had enjoyed spending Christmas at the home. The home holds information about advocacy services should this be required for people who have no relatives to act in their best interests. All the residents enjoy the food served at the home. The meals included those suitable to meet the dietary requirements of different cultural backgrounds. One resident said a cooked breakfast was available every day. At lunchtime bowls of salad were served in addition to the main meals, and staff asked each resident if they would like salad adding to their plate. Fresh fruit and yoghurts were provided in addition to the dessert. Hot and cold drinks were available throughout the day. The cook, who has worked at the home number years, is aware of everyone’s likes and dislikes relating to food. She works hard to offer them all the food they like eat. Although the kitchen space and layout is limited, it was clean and tidy. Records of food temperature are recorded to ensure food is served at the correct temperature. A recent inspection by an Environmental Health representative had awarded the home 4 out of 5 stars for the standards required to maintain a safe kitchen. Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can complain, and the system for the recording of complaints has been improved. All staff are aware of safeguarding procedures to ensure residents are safe from abuse. EVIDENCE: One complaint was received by the CSCI. in October 2007. It related to alleged unsafe working practices by staff and poor standards of food. A random unannounced inspection was undertaken by the Inspector to investigate the allegations. No evidence could be found to support the allegations made by the anonymous complainant. To the contrary, there was evidence that staff were trained to work safely with residents, and all the residents stated they loved the food served at the home. No other complaints have been received or reported to the home. Residents said they would talk to the person in charge if they had a concern. All staff have undertaken training in understanding adult protection and abuse. This gives them information to recognise different types of abuse, and what they must do if they witness an incident. Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 21 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides adequate, but improving accommodation for residents, and facilities for staff who work in the building. EVIDENCE: As identified earlier in this report, the home has a high risk fire assessment. This is due to some residents who smoke cigarettes in areas of the building identified as non-smoking areas. This has resulted in three fires in a year, putting residents and staff at risk. The most recent fire, on the 31st December 2007, was in an upstairs bathroom, which completely destroyed the bathroom. Due to staff diligence no one was injured. It was thought by the fire service, that the fire had been started deliberately. The owners are concerned about Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 17 fire risks, and are working with the fire safety officers’ and increasing the number of detectors in the home. Communal areas in the home are being refurbished, but some areas of the house, especially the smoking lounge still have an institutionalised feel. Improvements have been made to the downstairs shower room and the bathroom destroyed by the fire is to be fully replaced. Externally, the home has extensive grounds and the owners have started a renovation programme so that residents will have more accessible garden to enjoy in the summer months. The premises were clean, hygienic and free from unpleasant odours on the day of the site visit. A domestic assistant and a laundry assistant are employed every day and this enables care staff to concentrate on the care needs of residents. Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment, deployment and training of staff is thorough, to protect people living in the home. EVIDENCE: The number of staff on duty during the visit was appropriate for the needs of the residents. The staff group are from a wide range of cultural backgrounds and have been employed to meet the needs of intended service users, i.e. service users from an ethnic minority background. The recruitment files of two staff members were looked at. They demonstrated the home has a robust procedure for recruiting new staff. It was noted in one that there was not sufficient information about the person’s previous employment history. Is recommended that applicants be advised to put on applications forms the months and years of their previous employment. This will allow the manager to explore gaps in employment, and ensure the person is safe to work with vulnerable adults. It is positive to note, that more than 50 of care staff have achieved Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 19 a formal qualification in care. This should provide them with knowledge and information about working with good practice, to benefit the people who live at the home. The introduction of written annual training plan for staff has identified when, and what training staff will undertake during the year, to ensure their training and development needs are addressed. Records of all staff training are held at the home. These were seen and included moving and handling, adult protection, infection control, falls prevention, fire safety and health and safety. There was also evidence that staff are offered, and attend additional training relevant to their roles within the home. Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed for the benefit of residents who live at, and staff who work at Greystones. EVIDENCE: The manager is a registered nurse and has achieved the NVQ Level 4 Registered Manager’s Award. He is registered with the CSCI as the manager of Greystones. He attends in-house training with the rest of the staff group, and also facilitates some training sessions at the home. Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 21 During the visit staff were observed working well as a team with the manager, and the owner, who works regularly as part of the team. Both were said by staff to be approachable and supportive. One staff member said, “This is a good place to work.” Two people were on placement for work experience. Both said they had learnt a lot whilst at the home, and the staff had been very supportive. Despite poor attendance, the manager continues to offer relative/carer support meetings. Minutes of these meetings, plus separate staff, and resident meetings were seen. The quality audit undertaken by the manager last month, should include a written report of the findings, and any changes made to the service as a result of the information provided by those who took part. The system for recording residents’ personal allowances has improved. This should reduce the risk of mistakes occurring when staff make financial transaction on behalf of residents. Regular checks to maintain the health and safety of equipment used in the home to protect people are delegated to the handy man. Records of these checks were found to be up to date. No health and safety hazards were noted during the visit. Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 x x N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 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 2 2 3 x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 x x 3 Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 23 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 OP19 Regulation 12 Requirement The laundry floor must be replaced. It is currently a health and safety hazard, because it is very uneven and difficult to clean. Timescale for action 30/03/08 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 OP29 Good Practice Recommendations When recruiting new staff the manager should ensure the applicants employment record is in sufficient detail that gaps in employment can be explored to ensure the person is suitable to work with vulnerable adults. The quality audit undertaken by the manager last month, should include a written report of the findings, and any changes made to the service as a result of the information provided by those who took part. 2 OP33 Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Greystones Nursing Home DS0000070523.V354365.R01.S.doc Version 5.2 Page 25 - 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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