Care Home: Greenauns

What the care home does well People are provided with a copy of the homes service user guide and welcome pack (updated 2009). This ensures that people are provided with information to enable them to choose whether they want to live at the home and if the home can meet their needs. The home ensure they have a copy of the Social Care and Health care assessment before people come to live on a trial basis before deciding to live permanently at the home. This means that people are being individually assessed before they are offered accommodation. There is care and medication planning information that the home undertakes about people. There has been an overview of health care assessments so that an holistic assessment is completed about peoples personal care needs. People, their relative and or their advocate are included in the assessment and this means that people will get their care in the way they want . There are examples of choices that people are encouraged to make, such as choosing clothing, activities in and outside the home and meal options. There is an Adult Protection policy and process for the home to follow when there are any allegations of abuse; this means that people will be protected. The home provides a staff rota of when staff are to be on duty so that peoples care needs are met. The complaints and compliments policy ensures that people can have their say and comment with confidence that their concerns will be heard and dealt with satisfactorily. What has improved since the last inspection? Safety assessments have been further developed to ensure that care is delivered in a safer way. The Control of Substances Hazardous to Health (COSHH) assessments are being completed so that staff have safety information to refer to and people receive safe care. Staff have been provided with mandatory and specific training such as mental health training and this means that staff can meet peoples changing needs. What the care home could do better: Manual handling assessments have been reviewed, however, they must include tasks relating to moving and handling so that staff can refer to the agreed tasks detailing safe systems of work. This will mean that people will be provided with safer care. Staff undertaking risk and manual handling assessments to be provided with the appropriate training so that safer care is provided for people. Key inspection report Care homes for older people Name: Address: Greenauns 81 Fountain Road Edgbaston Birmingham West Midlands B17 8NP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Zeta Joseph     Date: 2 2 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Greenauns 81 Fountain Road Edgbaston Birmingham West Midlands B17 8NP 01214203361 01214203361 greenaunscarehome@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr James Patrick Loftus,Mrs Mary Loftus care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 8 The registered person 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 to the home are within the following categories: Old age, not falling within any other category (OP) 8 Date of last inspection Brief description of the care home Greenauns is a small family run home for eight older people situated in a residential area of Edgbaston. The home is a five- minute walk from the main Hagley Road, from which one can travel into Birmingham by bus in one direction. In the other direction one can travel to Kidderminster and access the M5 motorway. The home is registered to care for older people who are frail and require 24-hour care, excluding people in need of care for reasons of dementia, learning disability and other categories. It provides a homely environment with consistent carers who know the residents Care Homes for Older People Page 4 of 24 Over 65 8 0 Brief description of the care home well. There are two double bedrooms and four single rooms decorated in individual style and with people?s personal belongings evident. All of the bedrooms have an ensuite facility consisting of toilet and wash hand basin. A lounge/dining area is situated on the ground floor that leads on to a small conservatory, which overlooks the garden. The garden is flat, has a patio plus table and chairs where residents can sit when the weather permits. A bathroom is situated on the ground floor that has an assisted bathing facility, but there is limited space. A stair lift gives access to the first floor and grab rails are available in toilets to provide assistance to residents with mobility problems. The home is generally well maintained with off street parking for two cars to the front of the property. Staff have developed a welcome pack, which provides information about the services and facilities for people who are considering moving into the home. However, it needs further development, as it does not include information about the range of fees and the arrangements for any additional costs to the fees. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Care Quality Commission (CQC) is upon outcomes for people and their views of the service provided. This process considers the homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. This unannounced key inspection took place over one day. Before we undertook this announced key inspection, we looked at information we received, or asked for since the last key inspection in August 2008. The home had completed an Annual Quality Assurance Assessment (AQAA) and this was completed and sent to us in time to assess the service prior to the inspection day. The quality of the AQAA was sufficient to assess the service on the day of the inspection. The AQAA is a self-assessment form that focuses on how well outcomes are being met for people who live at the home. It is an opportunity for the home to share Care Homes for Older People Page 6 of 24 with us what aspects of the service they believe they are doing well. The information from the AQAA helps us understand how well the home is meeting the needs of the people living at the home, what needs to improve and their future plans. We spent time at the home talking with the Deputy Manager, talking with residents, examining records, including policies, procedures, Service User Guide and Statement of Purpose, personnel files and information available to people who live at the home. The inspection was undertaken with the support and co-operation of the Deputy Manager. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 8 of 24 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home makes sure they have information about prospective residents before they are provided with care. Evidence: People are provided with information about the home before they make up their mind to live at the home. There is a welcome pack provided for residents and this contains information about the home. It includes fees and information about what the fees do not cover. The Statement of Purpose and Service User Guide has been updated so that people know that the home can cater for their needs. The home makes sure that they are provided with a care needs assessment from the referring authority before they provide people with a contract. This means that the home can assess whether they can meet peoples needs. The home does not offer intermediate care or rehabilitative facilities. Care Homes for Older People Page 11 of 24 Evidence: The home makes sure that prospective residents have the opportunity to visit and assess the quality and suitability of the home. There are records kept of trial visits and this information is used to assess whether people can be accommodated. There is a new resident living at the home since the last inspection and there is good information about their trial visit and move into the home. A resident said I made a choice of this home from the three other homes I visited. This means that people are making an informed choice of where to live. Care Homes for Older People Page 12 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents care plans ensure that residents health care needs and wishes are planned for and met. The management of medication is good and this ensures residents get their medication at the right time. Evidence: People have their own care plan drawn up from the assessment information. There is an individualised plan about what the resident can do independently. Three care plans were looked at and these included details of mobility, tissue viability, diet, health condition and exercises. There must be manual handling plans drawn up for when a resident is being assisted to transfer or being hoisted. This is so that a safer system of work is assessed for care staff to follow so that residents are provided with safer care. Management staff must undertake risk and manual handling assessment training and care staff provided with up to date manual handling training so that care is delivered in a safer way. Information about residents choice of GP, chiropodist, optician or dentist must be recorded in their care plan so that staff know who to contact and that residents get the care they want. There are photographs of the resident attached to their medication administration Care Homes for Older People Page 13 of 24 Evidence: record and the two looked at were accurate. The dispencing chemist inspects the management of medication and this has been graded as exellent. There needs to be information about daily management of the residents medication developed as medication risk assessments so that staff know whether residents have the capacity to administering their own medication. This means residents will get the right medication at the right times. Information needs to be developed about residents wishes at their time of death so they are given comfort with propriety and arrangements after death are carried out as the resident requires. Care Homes for Older People Page 14 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are encouraged to maintain contact with family/friends as they wish and this helps them to exercise choice and control over their lives. Residents receive a wholesome balanced diet at convenient times. Evidence: There are a range of activities available for residents to participate in if they choose to. Residents tell staff the activity they want to do and places they want to visit and this is accommodated as far as the residents capacity allows them to participate. Residents were wearing their own clothing appropriate for the time of year. They had their own personal possessions, pictures, photographs and personal care items in their bedrooms. There was no evidence of restrictions and people are free to go where they wished with assistance from staff. Meals are arranged in the dinning area of the lounge. The home had a food inspection on 28 April 2008 from Environmental Health and the home were awarded 4 stars for their achievement. Trained staff prepare meals and residents are given choices so they enjoy a wholesome and appetising meal. Care Homes for Older People Page 15 of 24 Evidence: Visiting is flexible and residents are able to have visitors at any reasonable time and links with the community are encouraged and maintained, such as links with an advocacy service. Residents relatives, friends and representatives are given written information about the home. There is evidence where visitors have commented on the quality of care. There needs to be information about how residents manage their own finances so that the home knows when to protect people when the need arises. Residents commented that The dinner was lovely Im well looked after Care Homes for Older People Page 16 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Adult protection and complaint processes are safe enough to provide care for residents. Evidence: There are records relating to four complaints since the last key inspection in April 2008. Information sampled shows these were managed within the homes procedures and this protects residents. The home adheres to its safeguarding policies and this means that residents will be protected. Management staff have been trained in Mental Capacity Act and Deprivation of Liberties (DOLs) and this means they have the appropriate knowledge to ensure that residents who lack capacity are safeguarded. Care Homes for Older People Page 17 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical layout was suitable for meeting the needs of residents. There are a number of ongoing improvements to enhance the environment and facilities for residents. Evidence: Accommodation is provided for residents on the ground and first floor, the second floor is private accommodation for management staff. The home has a hands free telephone and people can use this in any area of the home they choose. There are internet facilities and residents use this for their own interests. Communal facilities consists of a lounge and combined dinning area and separate conservatory; these are domestic and homely in character. There are two bathrooms, but one of them is being refurbished. This means there is one assisted bathroom currently available for residents to use. The assisted bathroom contains a hoist for people with mobility difficulties. The home needs to assess whether the shower cubicle with seat in situ is suitable and practical for residents to be assisted with personal care. Corridors are narrow with grab rails to assist people with mobility difficulties. There is a serviceable stair lift for residents to access the first floor. There is a step at the top of the stairs to be negotiated, this means residents need to have a degree of mobility to access the first floor. Residents care records state that staff supervise residents when they want to use the stairlift. The home has four single bedroom and two double bedrooms for sharing. The double bedrooms have suitable partition to enable privacy. All bedrooms Care Homes for Older People Page 18 of 24 Evidence: are ensuite with toilet and wash hand basins facilities. All bedrooms have an accessible nurse call facility and this enable residents to call for assistance at any time. Bedrooms are individually and naturally ventilated and windows are provided with restrainers and this means that residents are secure. Radiators are covered and hot water controlled and this reduces the risk of scalding. There is a domestic style kitchen, food items seen are suitable for people and the home had a food inspection in April 2008 and the outcome was rated with four stars. The microwave needs to be replaced as shown to the manager. Fridge and freezer temperature readings are recorded so that residents benefit from high standards of kitchen hygiene. There is a well maintained garden, accessible from the conservatory. People can bring items of personal furnishing into their home, so providing a homely atmosphere. Residents are consulted about decorating, colour choices temporary move to another bedroom and this enables them to have control over their environment. Staff were seen spending time with residents and they interacted well. Care Homes for Older People Page 19 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A consistent staff team have been working at the home for a number of years. Staff have undertaken training and arrangements are being made for staff to be provided with mandatory training. This means that trained staff provides care. Evidence: There is a stable staff team and this means that residents get a consistent service. Staffing consists of four family members and a family friend. All staff undertake a multi task role and this includes residents personal care, cooking, cleaning and laundry. Staff have a very good knowledge of residents and this enables residents to get consistent personalised care. Staff have the opportunity to to be provided with training including in house training and they have developed a training profiles. Mandatory training in manual , safe handling and fire safety, needs to be updated so that residents are provided with safer care. Care Homes for Older People Page 20 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The owner continues to make improvements so that resident benefit. Health and safety management is good and this ensures the safety of residents staff and visitors. Evidence: The Registered Manager was not available during the time of the inspection. The Deputy Manager was available and he has completed the Registered manager Award and is currently studying for the NVQ 4 in Care. The home will need to assess and record that resident have the capacity to manage their own money so that their finances are protected. There is evidence of relatives comments which include staff doing a wonderful job Feeling re-assured she is getting the best care possible Magnificent personal care from this family Wonderful and loving care There are records available about health and safety maintenance checks and this ensures that equipment was safe and in full working order. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 7 11 The manager to ensure that a moving and handlling plan is developed for people so that they get safer care. The manage to ensure that people are asked about their wishes at death so that arrangements are carried out in the way people want. The home must ensure records relating to maintenance and decoration of the premises is kept. This is so that there is an end date of people being moved into other rooms. The home must ensure that chairs are of good quality and suitable for peoples needs. This is so that people are comfortable. The home must provide grab rails in communal showers so that these are suitable for people to use. The home must ensure that peoples assessed needs are met where communal shower facilities have been modernised. This is so that people with wheelchairs or walking frames can have access. 3 19 4 20 5 6 21 21 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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