Inspection on 20/12/05 for Lower Greenfoot - Settle Elderly Persons Home - NYCC

This inspection was carried out on 20th December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lower Greenfoot - Settle Elderly... 15/11/06

Lower Greenfoot - Settle Elderly... 01/08/05

Lower Greenfoot - Settle Elderly... 10/02/05

Lower Greenfoot - Settle Elderly... 25/08/04

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Larchfield Manor

Hawkhills

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Lower Greenfoot - Settle Elderly Persons Home - NYCC 30 Lower Greenfoot Settle North Yorkshire BD24 9RB Lead Inspector Caroline Long Unannounced Inspection 20th December 2005 09:30 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 Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 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. Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lower Greenfoot - Settle Elderly Persons Home NYCC 30 Lower Greenfoot Settle North Yorkshire BD24 9RB Address 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) 01729 822 973 01729 825336 North Yorkshire County Council Mr Robin Keir Hargreave Care Home 31 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (7), Old age, not falling within any other of places category (24) Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Care for service users in category DE(E) will be provided in Flat 4 only. Category (DE) only applies specifically to one named service user. Date of last inspection 1st August 2005 Brief Description of the Service: 30 Lower Greenfoot is a care home run by North Yorkshire County Council and registered to provide a service for 31 older people of either gender aged over 65 years. The home was purpose built approximately 21 years ago and accommodation is arranged around four flats. Flats one, two and three have a lounge/dining area, and 8 bedrooms, Flat four which provides care for residents with dementia care needs, has a lounge/dining area and seven bedrooms. All bedrooms are intended for single occupancy. The accommodation is on the ground floor and there is level access to the main entrance. The home is set in large landscaped gardens. There is a day centred attached to the home and a separate team also provides meals for the community. Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 20th December 2005. It was unannounced, 2 hours were spent preparing for the inspection and 5.30 hours were spent in the home. Eight residents and two relatives were asked about their experience of living in and visiting the home. Three staff members were asked about working in the home. The Team Manager on duty assisted with the inspection until the Registered Manager commenced work at 2pm. Most of the shared areas and some of the bedrooms were visited. Sample of Resident files was examined and a check was made as to whether the home had complied with requirements and recommendations from the last inspection. Verbal and written feedback was given at the end of the inspection to the registered manager and the Team Manager. What the service does well: 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. Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 6 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 Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 7 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 Prospective residents’ needs are assessed prior to admission to the home. EVIDENCE: The Team Manager confirmed all residents, including residents who receiving respite care, are visited prior to entering the home and their needs assessed. Although residents, did not visit the home prior to admission many had already attended day care at the home. An inspection of case file of a Resident recently admitted to the home provided evidence that an assessment and personal information about the residents had been provided to the home by the care manager. Intermediate care is not provided Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 8 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): 7,8,9,10,11 Although residents’ health and personal care needs are met, these maybe compromised by the absence of regular reviews EVIDENCE: A sample of Service User plans was inspected. Where a resident had recently been admitted to the home, the care managers plan was used. All other files contained a Service User plan, the detail in each plan varied. Alongside the service user plans the home used daily task sheets, which were kept in the residents’ bedroom locked wardrobes, these often described their care and health needs and preferences in more detail. Although these could lead to duplication of the service user plan, the Registered Manager and Team Manager both believed they were beneficial to the residents. Some of the service user plans had not been reviewed regularly. The Team Manager also explained for each of the residents with dementia they had commenced a diary of daily events. Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 9 The Team Manager talked about the regular reviewing of risk assessments, this could not be confirmed from the sample of service user plans, and although all had a risk assessment many were old. Eight residents all talked about how the home met their needs and many commented upon how helpful the staff were. One resident had been provided their own smaller/lighter kettle to enable her to drinks when she pleased. Two residents relatives both stated they were impressed with the home, the care the residents received, and the staff attitudes when they visited, one stated he ‘would like to be here eventually’. The requirement to store medication that needed refrigeration securely had not been carried out at the time of the inspection but the Registered Manager proposed to purchase lockable boxes to store it in. The Team Manager explained two residents had recently asked to remain at the home prior to their expected deaths, the home had agreed to their requests, with the assistance of a critical care package and the district nurse. Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 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): 12,13,14,15. Residents follow a lifestyle that suits their individual needs and maintain regular contact with relatives. EVIDENCE: All the residents said the home matched and exceeded their expectations, in different ways. Many of the residents attended, the day and evening events when they choose, at the Day Centre. Staff members commented upon the number of trips, which were available to the residents. One resident had a keyboard in his room. Within the Dementia unit, the team manager confirmed the staff carry out social activities with the residents, such as baking. The interaction between Residents and staff was positive. Staff were observed to work with Residents in a considerate and respectful way. They were attentive to the individual needs of Residents. Residents said they enjoyed living in the home and that they found staff to be helpful and courteous. Staff members were observed talking to residents and making drinks on request. Relatives questioned said they were not restricted when visiting and all staff was helpful when they visited. Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 11 Residents held regular meetings; the minutes were displayed on the notice board. The notice board had information about other activities in the community. Residents are able to make a choice to smoke in their own rooms, following the completion of a risk assessment. The cook explained a choice of meal was available, if the residents did not want these a sandwich or soup would be offered. Each flat had a menu on the notice board, the menu appeared varied and to contain vegetables. Residents all said ‘the food was good’; one commented the quantity was too much for them. Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 12 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 Residents felt their complaints would be listened to, and acted upon, to ensure protection of residents from harm staff knowledge needs updating. EVIDENCE: The complaints log had no complaints registered since the last inspection. All residents, relatives and staff said they had no complaints about the home. Although when questioned three residents were unsure about the complaints procedure, they felt they would be listened to. Staff training records and discussion with some staff members confirmed they had attended abuse training. At the time of inspection staff were unaware of how to access the POVA register. Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 13 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, 23, 24, 25, 26 Generally residents live in a home, which is well maintained, and clean. EVIDENCE: On inspection the home, it was generally well maintained and clean. New domestic staff had been recruited since the last inspection. The hall and bedroom carpets were appeared clean but some of the bedroom carpets had been laid since the home opened and were in need of replacement. The Team Manager informed the inspector the odour in some bedrooms was due to drainage problems. Residents had access to the lounge/dining room and were observed making drinks when they choose. Outdoor facilities were available for the all the residents. All residents’ rooms visited, displayed evidence of their own possessions, residents who where in their rooms during the inspection, all said they were comfortable, and they enjoyed the views of the local landscape and town. Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 14 There is a longstanding matter, reported on in previous inspections, regarding the lack of control over the radiators in Residents’ bedrooms. This has not been resolved. Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 15 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): Residents are cared for by a competent staff group EVIDENCE: Two staff members who spoke to the inspector confirmed they had attended regular training. One who had recently commenced confirmed they had received induction training and carried out a period of shadowing other staff member. All felt there were sufficient members of staff on duty, normally there would be one member for each flat and two for the dementia unit. Although permanent staff were allocated to the Dementia Unit, others would help out when necessary. Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 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): 38 Residents are put at unnecessary risk by staff not carrying out health and safety inspections EVIDENCE: The record showed the water temperatures had not been checked regularly, the Registered Manager said he would attend to this, and the gas and electricity safety certificates were not up to date. Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 17 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 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 3 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 2 2 3 X X 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 2 Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 18 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 2. Standard OP7 OP9 Regulation 15 13 Requirement Service user plans must be kept under review Any medication requiring refrigeration should be stored securely. (Previous timescale of 31/08/05 not met) All staff members should be made aware of Protection of Vulnerable Adults Scheme. Water temperature should be checked at risk assessed intervals and records kept. Gas and Electricity Safety Inspections to be carried out and copies of certificates forwarded to CSCI. Timescale for action 31/01/06 31/01/06 3 OP18 13 31/01/06 4 5 OP38 OP38 13 13 01/01/06 31/01/06 Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 19 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. Refer to Standard OP19 OP19 OP26 Good Practice Recommendations Radiator controls should be installed in each bedroom The bedroom carpets that have been present since the building opened could be replaced. The offensive odour in the bedrooms could be investigated and removed. Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Lower Greenfoot - Settle Elderly Persons Home - NYCC DS0000034564.V273898.R01.S.doc Version 5.0 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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