Care Home: Greenacres Care Home

What the care home does well Greenacres delivers a good standard of care; it does this by maintaining competent care practices and good relationships with the service users and their families; the result is a homely, friendly atmosphere. The home provides a comfortable, safe and homely environment for people to live in. It is very well managed and organised. Residents have care plans and reviews are carried out frequently; families and other professionals are involved in the reviews. Staff members are well trained and feel supported by the registered manager. They have a sound knowledge of residents needs. The staff team work well together and have established a good working relationship with the community health care teams and local GPs. The building is decorated throughout to a high standard and is well maintained. What has improved since the last inspection? The newly-registered manager and her team have worked very hard to address all the requirements and recommendations made in the previous inspection report. These have included a revised statement of purpose and service user guide, new care plans and revised policies and procedures. Improvements to the environment have included a newly fitted kitchen, a new wall and paving and an enclosed outside area for residents to sit out in, redecoration of the dining room, new carpets and bedding in several bedrooms, creation of an activity area, digital flat screen televisions installed around the home and a wheelchair ramp to the front entrance. CARE HOMES FOR OLDER PEOPLE Greenacres Care Home Greenacres Care Home Ltd 71 Cameron Street Heckington Lincolnshire NG34 9RP Lead Inspector Julie Western Unannounced Inspection 27th August 2008 09:00 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 Greenacres Care Home DS0000063741.V370449.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. Greenacres Care Home DS0000063741.V370449.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenacres Care Home Address Greenacres Care Home Ltd 71 Cameron Street Heckington Lincolnshire NG34 9RP 01529 460935 01529 469162 greenacres_carehome@hotmail.com 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) Greenacres Care Home Ltd Helen Kopp Care Home 28 Category(ies) of Dementia - over 65 years of age (11), Mental registration, with number disorder, excluding learning disability or of places dementia (1), Old age, not falling within any other category (28) Greenacres Care Home DS0000063741.V370449.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Old age, not falling within any other category - Code OP. Dementia, over the age of 65 years - Code DE(E) maximum number of places 11. Mental disorder, excluding learning disability or dementia - Code MD. The category MD applies to one named person aged over 58 years. The maximum number of service users who can be accommodated is 28. 15th August 2007 2. Date of last inspection Brief Description of the Service: Greenacres Care Home is privately owned and managed and is situated in the village of Heckington, with access to local amenities, which include shops, a hairdresser, GP practice and dental surgery. A mobile library visits the home. The home is a detached house in the centre of the village, near to the church and has been adapted and extended from formally being domestic premises to provide the present accommodation. The first floor is used for storage and office accommodation. The home provides personal care for up to 28 people over 65 years, some with a Dementia and one being a named person under 65 years and with a defined mental health need. The home provides four day-care places. All bedrooms are single apart from 2 double bedrooms. There are en-suite facilities in 6 bedrooms. There is an enclosed courtyard and a large garden to the rear of the home, which includes an orchard, gazebo, garden chairs, trees, shrubs and a large lawn. A small car parking area is located to the side of the home close to the entrance. Greenacres Care Home DS0000063741.V370449.R01.S.doc Version 5.2 Page 5 Copies of inspection reports are maintained in the entrance to the home for service users and members of the public. The range of fees is from £460 to £520 per week and information about these and the home’s facilities is available from the manager’s office. Greenacres Care Home DS0000063741.V370449.R01.S.doc Version 5.2 Page 6 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 was an unannounced visit and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms ‘we’ and ‘us’ refer to The Commission for Social Care Inspection (CSCI). The visit lasted approximately two and a half hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We sent out surveys to people before we visited the service. The main method used to carry out the inspection is called ‘case tracking’, this includes following the care of a sample of four people through their records and assessing their care. We spoke to two people who use the service and saw rooms of those people who said we could and to one staff member. The manager and deputy manager were present throughout the visit and the general outcomes of the visit were discussed with them. What the service does well: Greenacres delivers a good standard of care; it does this by maintaining competent care practices and good relationships with the service users and their families; the result is a homely, friendly atmosphere. The home provides a comfortable, safe and homely environment for people to live in. It is very well managed and organised. Residents have care plans and reviews are carried out frequently; families and other professionals are involved in the reviews. Staff members are well trained and feel supported by the registered manager. They have a sound knowledge of residents needs. Greenacres Care Home DS0000063741.V370449.R01.S.doc Version 5.2 Page 7 The staff team work well together and have established a good working relationship with the community health care teams and local GPs. The building is decorated throughout to a high standard and is well maintained. 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. The summary of this inspection report can be made available in other formats on request. Greenacres Care Home DS0000063741.V370449.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 Greenacres Care Home DS0000063741.V370449.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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information provided is freely available to residents and clearly sets out what is available for them. A comprehensive initial assessment ensures that the needs of residents can be met. EVIDENCE: The manager confirmed that she and the deputy manager or a senior carer always visited prospective residents at home or in a care setting such as a hospital to undertake a thorough assessment of all their care needs. Records confirmed this. Written admission documentation was comprehensive and clear, giving staff the information they needed to meet the residents’ needs. Both the statement of purpose and the service user guide had been revised following the last inspection. The statement of purpose contained all of the information needed for prospective residents to make a decision. The service user guide was in a format that was easy to read by older people. Greenacres Care Home DS0000063741.V370449.R01.S.doc Version 5.2 Page 10 A resident described how he had visited for the day before he was sure she wanted to move in permanently. Another resident said ‘I knew this home because I came here for day care, so it was an easy decision for me when the time came to move in permanently’. Prospective residents are encouraged to take time before making the decision to move into the home on a permanent basis. A staff member described the admission process and the importance of making new residents and their families welcomed. The home does not provide intermediate care. Greenacres Care Home DS0000063741.V370449.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): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are in sufficient depth and detail to ensure that residents’ care needs can be met. EVIDENCE: The care plans looked at in depth had all been recently revised; they were very comprehensive and contained information about the residents’ health and personal care needs. They were reviewed regularly and signed where possible by the service user or relatives/advocates. They contained clear risk assessments. Social histories ensured that there was plenty of information to meet residents’ social needs. There was a clear medication policy and the pharmacist visited regularly, the most recent visit from the pharmacist being 8th June 2008. There were no issues from this visit. Records showed that, where appropriate, district nurses were involved in residents’ care and a visiting district nurse said that the standard of personal Greenacres Care Home DS0000063741.V370449.R01.S.doc Version 5.2 Page 12 care was excellent, with knowledgeable staff who communicated the resident’s care needs well. One resident spoken with said ‘They treat me like a queen!’ and another described how his medication was given to him and said ‘I’m well looked after, they do it all for me’. The staff team were observed carrying out their duties with kindness and sensitivity towards the residents, especially when attending to their personal needs. Greenacres Care Home DS0000063741.V370449.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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities are regular and are tailored to suit individual residents’ needs. Residents have a choice of meals from a balanced and varied menu. EVIDENCE: The home has a designated activities co-ordinator for one hour Monday to Friday and care plans seen included a list of all residents’ likes and dislikes. The service actively promotes independence, choice and privacy by listening to residents and relatives/representatives. Equality and diversity are promoted through the policies and procedures and through the staff induction procedures, ensuring that residents’ individual needs can be met. There is a programme of regular activities, including entertainers, adaptive sports and exercises, clothes shows, coffee mornings and various board and card games. Residents spoken with described trips out to local garden centres or shopping and the home has a people carrier, which the manager said was soon to be replaced with a car as residents had said they preferred to be in a Greenacres Care Home DS0000063741.V370449.R01.S.doc Version 5.2 Page 14 smaller vehicle. On the day of the inspection some residents were enjoying a sing-along in the main lounge, while others were watching television, reading or resting in the quiet lounge. Staff members spoken with described theme days, the most recent being a 40’s theme, with pictures from that era displayed around the home, a street party and dancers. The week’s activities were displayed on a notice board in the entrance hall and indicated that bingo was due to take place that afternoon; a resident said ‘I always look forward to the bingo’. Residents spoken with all said they had a choice of whether or not to take part; one resident said ‘My son takes me out, but if I needed to go anywhere, they’d take me’. Residents were observed eating the mid-day meal and all said they enjoyed the meals served; one said ‘It’s excellent - if I don’t like it, I’ll have a salad and it’s beautifully presented’. One resident was eating from a black plate and described how the optician had recommended this as it made the food easier for her to see and the care plan verified this. Menus were on a four-weekly rota and were balanced and varied. The cook was knowledgeable about the nutritional needs of service users and described cooking for diabetics and people needing pureed food. She described how each morning she went directly to the residents for their choice of main meal and tea-time meal for the day. The Environmental Health Officer’s recent visit had resulted in 3 stars for hygiene in the local award scheme. Greenacres Care Home DS0000063741.V370449.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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s procedures for addressing complaints and for protection from abuse are clear. Residents and their families are confident that their comments and concerns will be listened to. EVIDENCE: Residents spoken with said they did not wish to complain but knew how to make a complaint. The home had an up to date copy of the Local Authority adult protection procedures; staff members said they had read it. The training programme showed that there was a rolling training course for staff on POVA and safeguarding adults. Staff members spoken with knew what to do in the event of a serious concern. The manager said that residents and their families were regularly asked for their views regarding the running of the home. A resident said ‘I’m sure if I had a complaint the manager would see to it’ and visitors spoken with said that they were given information on how to make complaints. Since the last inspection there have been no complaints. Greenacres Care Home DS0000063741.V370449.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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a safe, comfortable and pleasant environment that is suitable for their needs. EVIDENCE: Overall, the standard of decoration internally was good and afforded residents a great degree of comfort. The gardens and courtyard areas were well maintained and offered pleasant places for residents to sit out in good weather. Staff members described how the maintenance worker carried out any repairs needing attention. Recent improvements to the home had included the complete re-fitting of the kitchen, a new wall and paving and an enclosed outside area for residents to Greenacres Care Home DS0000063741.V370449.R01.S.doc Version 5.2 Page 17 sit out in, redecoration of the dining room, new carpets and bedding in several bedrooms, creation of an activity area, digital flat screen televisions installed around the home and a wheelchair ramp to the front entrance. Residents’ rooms were well decorated and personalised. There were safety notices around the building to prevent the spread of infection. The toilets all had paper towels, but also had hand towels, which could cause cross-infection. The building smelled clean and fresh throughout. Greenacres Care Home DS0000063741.V370449.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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff members are suitably trained, qualified and competent to meet the needs of residents. EVIDENCE: The daily staff rota showed that in addition to the manager and deputy manager, there was one senior and three carers for 24 residents. The manager said there were usually four staff on duty in the mornings. The home also employed a cook, a kitchen assistant, two cleaners, a handyman and a gardener. Staff shared laundry duties. A visitor commented on how well the laundry was done. Staff members said that there were enough staff to complete their tasks in time and residents confirmed this; one said ‘they’ll always come and help you, even when they’re busy’ and a visitor said ‘my mother likes it when they stop for a word or a smile – she is very appreciative’. There were currently vacancies for one day and one night carer. Greenacres Care Home DS0000063741.V370449.R01.S.doc Version 5.2 Page 19 The manager said that eight staff members have completed the National Vocational Qualification [a nationally recognised qualification]. The deputy manager has also completed the NVQ at Level 4. The training records showed that recent training had included manual handling, POVA, infection control, dementia and medication. The home had two members of staff qualified to give first aid. A staff member described how she had an interview, gave three references and underwent an induction and CRB/POVA checks. Staff records confirmed this. Records demonstrated that staff received regular supervision. Greenacres Care Home DS0000063741.V370449.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): 31,33,35,38 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 and the health, safety and welfare of the residents are promoted. The views of the residents are listened to and they are involved in decisions affecting them. EVIDENCE: The manager of the home has been in post since April 2008. She has spent 30 years in the caring profession, 20 of these at Greenacres. She holds NVQ at level 4 and the Registered Manager’s Award. She, the deputy manager and a third senior carer work closely together as a team and staff members spoken with said that the management team were very approachable and accessible. Greenacres Care Home DS0000063741.V370449.R01.S.doc Version 5.2 Page 21 The owner visits once or twice weekly and residents said ‘He always stops and talks to us’. Health and safety policies are well documented and demonstrate a clear commitment to ensuring the wellbeing of residents. They are regularly updated, but updates of all policies and procedures should be recorded. There is a quality assurance system in place; this consists of sending questionnaires to residents and their families/advocates. On return, these are discussed with the manager and owners and any issues from the returned forms are addressed. Allowances for residents are kept in a locked box together with any receipts and are audited regularly to ensure that residents’ monies are kept safely. Survey forms sent to selected residents were returned and all were positive, including comments such as ‘You wouldn’t find a better home anywhere and at 94 I have no complaints’ and the staff are all very kind – the home is always very clean’. Greenacres Care Home DS0000063741.V370449.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 X X 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 3 X X 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 X 3 X 3 X X 3 Greenacres Care Home DS0000063741.V370449.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 OP26 Regulation 13[3] 16[2][j] Requirement Hand towels must not be used in toilets, in order to prevent the risk of cross-infection. Timescale for action 26/09/08 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 OP24 Good Practice Recommendations Lockable bedside cabinets provide a place for residents to keep their valuables privately and safely. Greenacres Care Home DS0000063741.V370449.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Greenacres Care Home DS0000063741.V370449.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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