Care Home: Greenfield Nursing Home

What the care home does well At the time of the site visit both units appeared to have sufficient staff on duty. There was a calm atmosphere and staff were working well together for the benefit of the residents accommodated. Procedures are in place in order to maintain hygiene standards. What the care home could do better: In order to protect residents, the process of continuous monitoring of staffing levels should be maintained in order to ensure assessed needs are met and for the safety of residents. Random inspection report Care homes for older people Name: Address: Greenfield Nursing Home Tag Lane Ingol Preston Lancashire PR2 7AB two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Denise Upton Date: 1 7 0 9 2 0 0 9 Information about the care home Name of care home: Address: Greenfield Nursing Home Tag Lane Ingol Preston Lancashire PR2 7AB 01772723745 01772760836 CLIFFORR@BUPA.com www.bupa.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : BUPA Care Homes (CFHCare) Ltd care home 112 Number of places (if applicable): Under 65 Over 65 0 112 0 dementia old age, not falling within any other category physical disability Conditions of registration: 112 0 112 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: Old age, not falling within any other category - Code OP, Dementia - Code DE, Physical disability Code PD. The maximum number of service users who can be accommodated is:112. Date of last inspection Brief description of the care home Greenfield care home with nursing is part of BUPA care homes and is situated on the outskirts of northern Preston. The home is a purpose built modern property made up from four units, Oak, Elm, Beech and Maple each serving the needs of different Care Homes for Older People Page 2 of 8 Brief description of the care home residents. Each prospective resident is assessed prior to admission to identify if the home could meet current needs and requirements and to identify the unit that would best meet their needs. Greenfield Care Home can provide accommodation for up to 112 residents some of whom may need nursing care and also provides designated accommodation for people that have a diagnosis of dementia. There is a local garage that incorporates a news agency across the road and a modern pub that serves food daily. The home is accessible to the motorway and the local bus service regularly passes the home. Care Homes for Older People Page 3 of 8 What we found: We conducted an unannounced site visit to Greenfields Nursing Home during the morning of a mid week day. We spoke with the unit manager on the EMD unit and the senior nurse on duty on the EMI unit. The registered manager was unavailable at the time of the site visit. One concern of a family of a resident was that the residents individual bedroom had not been cleaned. We observed this bedroom, which on the day of the site visit was clean, tidy and odour free. From discussion with the senior nurse on the EMI unit, it is understood that a clean face and body cloth and a clean face and body towel are placed in each individual bedroom on a daily basis. Individual cloths and towels are used in the morning and then sent to the laundry. Fresh cloths and towels are provided in each bedroom in the afternoon period. As very few residents actually access their bedrooms during the day time period, cloths and towels are rarely needed. However if these were required, staff would ensure fresh cloths and towels were provided in that individual bedroom. There was further concern that the EMI unit smelt of urine. At the time of the site visit there was a mild odour near the door of the EMI unit. We were told that although staff try hard to keep odours at bay, one resident whos bedroom is near the unit door has an severe incontinence problem that sometimes results in a odour. There is also a sluice located in this area. At the time of the site visit no urine odour was detected in the communal lounge areas of the EMI unit. There was a further concern by the family of a resident that the resident had had her nails varnished in an inappropriate nail colour. It is understood that this resident enjoys having her nails varnished however the senior nurse on duty stated he had never seen inappropriate nail varnish used in the unit either by care staff or the hobbies therapist. It is understood that at present, although a hand massage is still provided for residents who enjoy this experience, no nail varnish is been used at this present time. Staff have in place procedures to maintain a hygienic environment in the EMI unit. If a bed becomes wet, staff are instructed to wipe down the bed, then leave to dry before remaking the bed with clean sheets. There is a similar procedure should cushions in communal areas of the home become wet. Concern had been expressed that these procedures had not been followed. We also explored whether there were sufficient staff on duty to meet residents assessed needs. We were told that staffing levels in the EMI unit were quite good a present with the normal staff ratio of one qualified member of staff on duty and five members of the care staff team during the waking day and one qualified member of staff and two care staff on during during the night time period. The only concern was when occasionally a qualified member of staff does not arrive for work and agency staff are not available at short notice. In these instances, one qualified member of staff has responsibility for more than one unit. We also spoke with the unit manager of the EMD unit. Again we were informed that the assessed needs of residents were being met within the existing staffing structure of three Care Homes for Older People Page 4 of 8 members of staff on duty during the waking day and two members of staff on waking watch during the night time period. During busy periods, for example at meal times, the designated activities person assists particularly when one to one support is required. We were also told that the majority of residents within the unit are incontinent of urine. To help address this, residents are generally asked every two hours if they would like to go to the toilet and residents are also prompted to go to the toilet before every meal. A number of residents require the assistance two staff on these occasions. In consequence there is potential that communal areas of the home could be without a member of staff present for short period of time to supervise residents. We questioned if residents could become aggressive during these times. We were told that a resident can sometimes provoke aggression but that this is almost always verbal aggression due to confusion. However this could potentially put residents at risk. It is important that the registered manager regularly reviews the staffing complement in each unit to ensure that assessed needs can be met safely. This is particularly so if the resident group changes or if existing residents dependency needs increase. The unit manager confirmed that staff are trained to attend to wet and soiled laundry and furnishing in a hygienic manner. It was also confirmed that there had been a previous problem with an incontinence odour but this had become considerably less of a problem as the resident group had changed. The unit manager was keen to point out that the majority of staff in the unit had achieved an NVQ qualification and had a lot of experience of working in the unit. The registered manager is currently formally investigating the concerns of the family by using the homes complaint procedure. In due course, the complainant will be informed in writing of the outcome of the investigation. What the care home does well: 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 set out on page 2. Care Homes for Older People Page 5 of 8 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 3 14(d) Prospective residents must 31/05/2008 be informed in writing of the outcome of the preadmission assessment and whether their needs could be met at the home. (Not assessed at this inspection)` The bathrooms throughout the home must be reasonably decorated. (Timescale of 30/09/06 not met). (Not assessed at this inspection) 31/12/2008 2 19 23(2)(d) Care Homes for Older People Page 6 of 8 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, 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 27 In order to protect residents, the process of continuous monitoring of staffing levels should be maintained in order to ensure assessed needs are met and for the safety of residents. Care Homes for Older People Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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