Care Home: Greenheys Lodge

What the care home does well The service ensure prospective residents are assessed prior to admission. This ensures that sufficient information is collated to make a decision about how suited the service would be to meet the prospective residents needs. One resident interviewed about the pre admission process stated, "I seen the home before I moved in, I chose it, it`s nice, I like it". Residents health and welfare is promoted. Care needs are identified and reflected in their care plans, which are individual to them. One of the residents interviewed stated, "We get very good care from staff". Residents individuality is promoted and choices available ensure residents are living the kind of life they wish to within their ability. One resident interviewed stated, "I get up when I want to and go to bed when I want to, they make sure you are settled alright at night and check you in the night". Residents were happy with the meals served and residents interviewed stated, "We get good food" and "There is plenty of choice with food". Residents health and welfare are protected by the policies and procedures within the service. Residents interviewed were confident that had they any worries that staff would deal with them promptly. One resident interviewed stated, "I feel confident staff would deal with complaints, I don`t think anyone has any complaints, they shouldn`t have really". The service is well maintained and provides residents with several lounges to choose from when entertaining their visitors. One resident interviewed stated, "I like my bedroom". Staff are trained to a good standard and provide residents with the care and support they need. Residents were very complimentary about the staff. Residents interviewed stated, "Staff are very good" staff are nice to us all" and "Staff are smashing, they are very obliging, nothing is too much trouble". The service is very well managed and residents health and welfare is promoted. Residents and staff were very complimentary about how the service is run. Residents interviewed stated, "The manager is good, she couldn`t be better" and "The manager is very obliging, she goes out of her way, she makes sure you eat". Staff interviewed stated, "Residents are a priority, If they need to speak to the manager, she will do so immediately" and "The manager is amazing, any problems and you can go to her, she doesn`t fob you off". What has improved since the last inspection? The service has improved the environment for residents by redecorating, replacing carpets and furnishings in residents bedrooms and lounges. Audits carried out over the past few months have identified areas needing improvement or refurbishment. Some of these have already been implemented or are planned to be upgraded over the next three years. Some of the work includes replacing all the windows therefore this will take some time. The improvements have made the service much more pleasant andcomfortable for the residents. Staffing levels have improved and the rota shows sufficient staff are on duty to meet the residents needs. Mandatory training is up to date for staff including food hygiene and manual handling. This ensures staff are trained and skilled at meeting the residents needs safely. Regular weekly testing of fire detection systems takes place with records to evidence this. Fire drills are carried out monthly to ensure staff and residents are familiar with the routine in case of an emergency. This promotes the safety of residents and staff. Daily records are written legibly and the language used promotes residents dignity. The daily reports are clear and easy to understand. A thermometer is in place in the medication room. The temperature is measured daily and records show that medication is stored correctly. Activities are reviewed regularly at meetings and through surveys. The activities team record the activity that each resident is involved in. Residents confirmed through interviews that they were happy with the activities provided. Residents interviewed stated, "We play cards at night", "I get asked to join in all, I like going out, bingo and I watched Gone with the Wind last week". When one to ones with residents take place this is recorded in care documentation also. None of the residents at present wish to use the sensory room. Food temperatures are checked immediately prior to serving with records kept. Where the food needs to be, it can be microwaved. None of the residents interviewed had any complaints about the food temperatures. One resident interviewed stated, "Meals are warm, just nice to eat". The adult protection procedures in place have the correct contact details. What the care home could do better: When references are sought from a prospective employee`s employer the service must ensure that the returned reference is referred to the named person in charge to ensure authenticity. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Greenheys Lodge Sefton Park Road Toxteth Liverpool Merseyside L8 3SL     The quality rating for this care home is:   three star excellent service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Claire Lee     Date: 2 7 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 29 Information about the care home Name of care home: Address: Greenheys Lodge Sefton Park Road Toxteth Liverpool Merseyside L8 3SL 01512917822 01512917821 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) : European Wellcare Homes Ltd care home 33 Number of places (if applicable): Under 65 Over 65 33 old age, not falling within any other category Additional conditions: 0 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 - Code OP The maximum number of service users who can be accommodated is: 33 Date of last inspection Brief description of the care home Greenheys Lodge is a purpose built service situated in the Toxteth area of Liverpool and close to Sefton Park. The service is near the city centre and close to local shops, bus, rail and road links. The registered manager is Mrs Evonne Robinson. The service can accommodate up to 33 residents and provides personal care. It is located within a care village owned by a large private organisation, European Wellcare Homes LTD. The care village consists of other similar services that are all connected via a corridor. All homes share the same kitchen and laundry facilities, which are located within Greenheys Lodge. The home is on two floors, with a lower ground floor facilitating the laundry and has a Care Homes for Older People Page 4 of 29 Brief description of the care home selection of dining and lounge areas. One lounge is a designated smoking room. Call bell systems are in place throughout the service. Gardens are easily accessed by residents. A large car park is also available. The cost of the service is between £330 and £518.88 per week. Care Homes for Older People Page 5 of 29 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: three star excellent 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: A site visit took place as part of the unannounced key inspection. It was conducted over one day by one inspector and lasted 8 hours. Twenty nine residents were accommodated at this time. As part of the inspection process most areas of the service was viewed including many of the residents bedrooms. Care records and other documentation was also viewed. Discussion took place with residents, a relative, a visiting hairdresser and staff. The inspection was conducted with the registered manager Mrs Evonne Robinson. During the inspection three of the residents were case tracked (their files were looked at and their views of the service were obtained). All of the key standards for older people were inspected. Previous requirements and recommendations made at the last Care Homes for Older People Page 6 of 29 inspection have been met. Satisfaction forms Have your say about.... were distributed to residents, their relatives and staff prior to the inspection. A number of comments included in this report are taken from the surveys and interviews. An AQAA (Annual Quality Assurance Assessment) has been completed. The AQAA consists of two self assessment questionnaires that focus on the outcomes for people. The self assessment provides information as to how the manager and staff are meeting the needs of the current residents and a data set that gives basic facts and figures about the service including staff numbers and training. What the care home does well: What has improved since the last inspection? The service has improved the environment for residents by redecorating, replacing carpets and furnishings in residents bedrooms and lounges. Audits carried out over the past few months have identified areas needing improvement or refurbishment. Some of these have already been implemented or are planned to be upgraded over the next three years. Some of the work includes replacing all the windows therefore this will take some time. The improvements have made the service much more pleasant and Care Homes for Older People Page 8 of 29 comfortable for the residents. Staffing levels have improved and the rota shows sufficient staff are on duty to meet the residents needs. Mandatory training is up to date for staff including food hygiene and manual handling. This ensures staff are trained and skilled at meeting the residents needs safely. Regular weekly testing of fire detection systems takes place with records to evidence this. Fire drills are carried out monthly to ensure staff and residents are familiar with the routine in case of an emergency. This promotes the safety of residents and staff. Daily records are written legibly and the language used promotes residents dignity. The daily reports are clear and easy to understand. A thermometer is in place in the medication room. The temperature is measured daily and records show that medication is stored correctly. Activities are reviewed regularly at meetings and through surveys. The activities team record the activity that each resident is involved in. Residents confirmed through interviews that they were happy with the activities provided. Residents interviewed stated, We play cards at night, I get asked to join in all, I like going out, bingo and I watched Gone with the Wind last week. When one to ones with residents take place this is recorded in care documentation also. None of the residents at present wish to use the sensory room. Food temperatures are checked immediately prior to serving with records kept. Where the food needs to be, it can be microwaved. None of the residents interviewed had any complaints about the food temperatures. One resident interviewed stated, Meals are warm, just nice to eat. The adult protection procedures in place have the correct contact details. 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 4. The report of this inspection is available from our website www.cqc.org.uk. 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 29 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 29 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 service ensure prospective residents are assessed prior to admission. This ensures that sufficient information is collated to make a decision about how suited the service would be to meet the prospective residents needs. Evidence: The manager carries out all of the pre admission assessments of prospective residents. Prospective residents are encouraged to visit the service prior to admission so that they can view what the service has to offer and meet with the residents and staff. The entrance hall at Greenheys Lodge has a display that contains information with regard to the service. The information displayed includes the statement of purpose, complaints procedure, summary of surveys carried out and a copy of the most recent newsletter. Pre admission assessments are recorded in detail and evidence the assessors signature Care Homes for Older People Page 11 of 29 Evidence: and date of assessment. All assessments show that they were carried out prior to the residents admission. The assessments looked at showed good collation of evidence with regard to prospective residents needs. Residents needs were identified and the information gained was used to form care documentation including the care plan. The assessment information evidences all areas were assessed including personal care, mobility, diet, oral health, skin integrity, communication, sleeping pattern, continence, health professional input and the support from family and friends. Residents were canvassed for their views about the admission process and confirmed it was a pleasant experience. Residents interviewed stated, My nephew chose this home for me, he chose the bedroom and I seen the home before I moved in, I chose it, its nice. A relative interviewed about the admission process stated, We went to quite a lot of homes in the area and liked this one a lot, the manager saw mum when she visited the home. Greenheys Lodge does not provide intermediate care. Care Homes for Older People Page 12 of 29 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 health and welfare is promoted. Care needs are identified and reflected in their care plans, which are individual to them. Evidence: Three residents were case tracked. Following the pre admission assessment of prospective residents a care plan is set up using the information that was collated. The three residents case tracked all had care plans in place. The care plans reflect regular reviews of care with the dates and signatures of residents and staff to agree the planned care. Dates of when family attend any reviews of care was logged also. The care plans evidenced that all needs identified in the assessment process have been addressed. Care plans are detailed and relevant to the individual resident. The care plans evidence they are person centred. Details of how care and support is to be provided is clear. The care plan evidences what you need to know to support me, which is written in the first person. This provides staff with the information to understand the assistance needed for that individual. In addition to this, the next area Care Homes for Older People Page 13 of 29 Evidence: is how you can help me stay healthy and safe. This gave information with regard to the safety of the individual including bathing and mobility. Some of the residents go out each day and this has been addressed in this area. Support and care needs are recorded in detail so that the input required from staff is quite clear. A detailed night care plan outlines the care and support for the individual also. The care plans are easy to read and evidence what residents can do for themselves. The daily records were legible and the language used promoted residents dignity. The care plans and other care documentation was well organised and easy to follow. All files are locked away when not in use. To support the care plans, a pen portrait was observed in the care documentation. This has been replaced by a newer document, which looks at the residents previous life and helps formulate the care plan. Social care assessments gave further information, which assisted the care planned. Risk assessment are in place for residents with regard to their individual care needs and include areas such as mobility, falls, bed rail use, smoking, nutrition, skin integrity, scalds, going out and continence. Specialist equipment is in place for the residents who need it including bed rail bumpers. The manager has also recently contacted the PCT for advice with regard to a residents specialist needs and this has been documented. Care documentation evidences regular health professional visits including Gp, optician, chiropodist, community matron and district nurses. The district nurse notes were kept separate from the care documentation in relation to one of the residents. The notes were up to date and reflect the treatment and progress of the wound. An annual re assessment of needs is carried out and this is evidenced in care files with dates recorded. Where particular needs are required the care plan and documentation highlights these, such as needing two staff to care for some of the individuals and amount of supervision required. Residents living at Greenheys Lodge were happy with the support and care they received. Residents canvassed for their views commented, They take care of us well. Residents interviewed stated, We get very good care from staff and I have seen my care plan. Relatives canvassed commented, All aspects of care is excellent and The service cares for my Nans needs at all times. A relative interviewed stated, She has seen the Dr a number of times, chiropodist and optician, all the services come to the home, if she is ill they ring me straight away. Im very happy with how my Nan is cared for. Medication storage was looked at during the visit. All of the medication is stored in a locked medication room. A medication fridge is in use with daily records of Care Homes for Older People Page 14 of 29 Evidence: temperatures kept. A controlled drugs cabinet is also in place. Medication storage is good and evidenced good stock control. Medication records were examined. The records were clear, evidencing allergies, medication dose, amounts received, dates received and signatures of staff who received the medication. The medication record evidences all staff signatures following administration of medication. The drugs return book was viewed and showed regular entries of medication returned to the pharmacy with staff signatures, dates and pharmacy signatures. A room thermometer was in place to measure the room temperature with records kept. The controlled medication was audited and found to be correct. The manager audits these on a regular basis as evidenced on the controlled drug register. The manager has arranged for the local pharmacist to audit the medications as it is almost a year since their last audit. Staff and residents interacted in a friendly and respectful manner. None of the residents share a bedroom and all have an en-suite facility. Where residents have requested to have care and support provided by the same gender this was promoted. None of the residents has a land line telephone but there is a public telephone and the office telephone, which is portable can be used for residents who wish it. Some of the residents have their wishes with regard to death and dying recorded in care files. The manager does respect the wishes of residents who do not wish to discuss this area. Care Homes for Older People Page 15 of 29 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 individuality is promoted and choices available ensure residents are living the kind of life they wish to within their ability. Evidence: Residents who live at Greenheys Lodge like living there. Residents canvassed for their views commented, It is a happy home and It cares well and has good meals and entertainment. Relatives canvassed for their views commented, It creates a homely feeling. There are various activities for residents to participate in or not. An activities programme is in place and the service employ three activities persons. Care documentation evidences residents preferences and a social assessment. Where possible it is evident that staff try to encourage residents to take part in the arranged activities. Each resident has an activity record and these are completed on a regular basis and evidence the event attended. Residents who do not wish to take part have their wishes supported. Residents who are unable to attend any activity had a one to one with the activities person. Care Homes for Older People Page 16 of 29 Evidence: The activities available for residents include, the gardening club, card school, bingo, trips out, film afternoons, movement to music, shopping trips and outside entertainers. It is evident from the many photographs on the hallway walls that residents enjoy the events that they have attended. Where residents are unable to attend events regular entries have been recorded on the activities record to show that staff have spent time with the resident on a one to one basis. One of the activities persons interviewed confirmed that they did spend time with residents on an individual basis and stated, some of the residents like to play cards, reminisce or we just have a social visit. Residents religious preferences are recorded on admission to the service and their religious needs have been addressed through regular visits from local churches. Contacts of the local church representatives are displayed on the residents notice board. Residents are given choices about how they live their lives. Residents interviewed stated, I go to bed when I want to, they make sure you are settled in the night, I get up when I want to and I have what I wanted of my own things in my room. Care plans evidence resident choices about how much they can do on their own and how much support they want from staff. Residents are encouraged to retain their independence and risk assessments are in place with staff support where needed. Residents have the use of a large dining room, which has been recently redecorated in a domestic style. Individual tables are set up with matching crockery and cutlery. Residents requested they have their own set of sauces and this has been accommodated at each table. Residents individuality has been promoted by the service providing crockery requested by them such as a large mug for some of their drinks. Other residents use a cup and saucer. Residents were interviewed and asked for their views about the meals provided. Residents interviewed stated, I have cornflakes and toast for breakfast and I get a cup of tea anytime I want, we get a choice, the food is good but not cooked right, They will go out of their way to get something for you, meals are warm, just nice to eat, there is plenty of choice of food, there is bacon, sausage, tomatoes and hash browns for breakfast and cereals too and We get good food. The menu is displayed and evidences nutritious various choices for residents. Specialist diets are catered for including diabetics. Home baking is a regular treat also. Care Homes for Older People Page 17 of 29 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. Residents health and welfare are protected by the policies and procedures within the service. Evidence: The complaints procedure is clear and easy to follow. Copies of the procedure were on display in the front hall. Contact details of local advocacy services was also evident on the resident notice board. The complaints log evidences that complaints and concerns are logged, investigated and outcomes are recorded. This shows that complainants are listened to. The manager is aware of the local adult protection procedures and understands the processes. The service have made four referrals since the last inspection and three of these have been fully investigated and unfounded. The most recent one referred has still to be completed. The investigation and outcomes are not yet known. Confidential records of those raised have been kept secure. All of the staff have attended safe guarding training provided by the company. Staff interviewed confirmed they had attended training. Residents living in the service were confident that had they any concerns that they would be dealt with promptly and had no worries about raising concerns. One resident Care Homes for Older People Page 18 of 29 Evidence: interviewed stated, I know how to make a complaint but I have no complaints. I feel confident that staff would deal with any complaints. I dont think anyone has any complaints, they shouldnt have really. Care Homes for Older People Page 19 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well maintained and provides residents with several lounges to choose from when entertaining their visitors. Evidence: The service is purpose built and provides spacious public space and hallways that are easy for residents with mobility difficulties to move around. The rear lounge has a large cinema screen and licensed bar. It is spacious but needs decorating. New chairs have been requested therefore this will improve residents comfort. Another lounge has been recently decorated to a good standard and shows new chairs, tables and carpeting and compliments the adjoining dining room. A smoking room is available for residents use. There are two further lounges upstairs. New furniture has just been delivered for one of the lounges providing more choice for residents. All bedrooms are for single occupancy and have en-suites. Residents bedrooms have been personalised with their own belongings. There are four bathrooms including a shower room. All are spacious and easily accessed by residents. Specialist equipment is avaible for residents use. The service has a server kitchen with permanent staff managing this service. Food is transferred from the main kitchen in a heated trolley to the server kitchen. The staff member then waits on the residents as they come into the dining room. Hot and cold Care Homes for Older People Page 20 of 29 Evidence: drinks are prepared here. Although there are set times for meals some of the residents choose to come later and this is accommodated. The server kitchen was clean and organised. The notice board had information with regard to the various diets and supplements for residents. The waterproof floor is intact and walls are painted with tiles at the sink surround. The fridge in use storing cold drinks only. The main kitchen was very busy but clean and well organised. All three services are supplied from this kitchen. We looked at the training programme and this identified that the chef was up to date with his food hygiene training. The safe food diary is used daily and food delivered to the service arrives in refrigerated containers. Records show evidence of food temperatures delivered and hot foods served at mealtimes. A cleaning schedule is in place. The laundry is situated on the lower ground floor. It is large and serves the three services. Staff have sufficient equipment to maintain the laundry service including hand washing facilities. The laundry room was very busy. The service was clean and tidy. Garden grounds are easily accessed through the lounge French windows and provide residents with a choice of several seating areas. There are many mature shrubs and pots of flowers for residents enjoyment. The service now have a gardening club and one of their aims is to grow some of their own vegetables. An area has been set aside for this purpose. Care Homes for Older People Page 21 of 29 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. Staff are trained to a good standard and provide residents with the care and support they need. Evidence: The duty rota evidences sufficient staff were on duty and staff and residents feedback confirmed staffing levels were adequate. The AQAA stated that the manager and deputy have completed the NVQ Level 4 leadership and management training and four care staff are enrolled to commenced NVQ Level 2. The NVQ qualification will soon be held by most of the staff employed in the service. Staff were satisfied with the induction and training provided. Staff interviewed stated, My induction lasted a few months and I was happy with it. Staff canvassed for their views commented, The induction information was given clearly and Im booked on an infection control course. Training records show evidence of staff induction and training attended. The skills for care website is used to source and update training. Some of the training is provided in house using the company policies and procedures Staff interviewed confirmed they Care Homes for Older People Page 22 of 29 Evidence: had attended various training courses whilst employed in the service including, health and safety, control of hazardous substances (cosh), abuse, food hygiene, manual handling, first aid, infection control and fire. Further training to update staff has also been booked for this year. Three staff files and training records were viewed. The staff files and training records were organised. Staff files evidenced police checks and two references were taken up prior to employment. One of the staff references was addressed to whom it may concern. This is not acceptable and must be addressed to the manager or senior person identified during the selection process. Application forms were in place with previous work history and previous training attended. Evidence of personal identity is also evidenced in staff files. Staff employed in the service were happy to work there. All of the staff approached confirmed that they were supported in their role and kept up to date with residents care. Staff canvassed for their views commented, Up to date information is given at the morning handover and throughout the day if circumstances change, Verbal and written communication is usually very good, Senior staff work alongside staff to ensure needs are met, I enjoy working at Greenheys and We make sure our residents are being cared for as they should be. Residents who live in Greenheys Lodge were happy with the care and support received from staff. Residents interviewed stated, Staff are very good, we get very good care from staff, the staff are nice to all the residents, They look after you, no problem, Staff are smashing, they are very obliging, nothing is too much trouble. A relative interviewed was very happy with how staff cared for their family member and stated, They are great, all really nice and friendly, its a nice family atmosphere. Care Homes for Older People Page 23 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is very well managed and residents health and welfare is promoted. Evidence: The registered manager has been employed in the service for approximately nine years. The manager has gained many NVQ qualifications including the most recent NVQ Level 4 management and leadership qualification. The manager is up to date with all mandatory training. Residents are confident under the care of the manager and when interviewed stated, The manager is good, she couldnt be better and The manager is very obliging, she goes out of her way. Staff interviewed, stated, Its well managed, If residents wish to speak to the manager, she will do so immediately, The manager is amazing, any problems and you can go up to her, she doesnt fob you off and The manager is very supportive. Regular visits are carried out by the company including the compliance team throughout the year with reports made with each visit. Some of these reports were Care Homes for Older People Page 24 of 29 Evidence: viewed. The most recent in May 2009. Monthly provider visits are carried out also with reports to evidence this. The service have been canvassing the views of visiting health professionals and these were viewed during the visit. There responses were positive. Residents are surveyed for their views and the service summarise their views anonymously and publish the results. The most recent survey results are displayed in the front hall for residents and visitors to the service to see. The response to the surveys showed a positive view of the service. Staff meetings are held with various teams regularly throughout the year with the minutes of these viewed. Health and safety meetings were commenced this year and one resident is invited to this meeting. The results of these meetings are displayed on the residents notice board for residents and their relatives to see. Some of the residents have small amounts of money held on their behalf. Financial transaction records were viewed and evidenced good record keeping. Residents sign to agree this service. Individual wallets and financial transactions are in place for each resident. Records are kept for all the maintenance that goes on throughout the year. Weekly and monthly checks are carried out with dates and signatures of each check evidencing this. The AQAA stated that all servicing for the equipment used in the service is up to date. Records were viewed at random and evidence up to date servicing of equipment that is in use. Certificates were available for all servicing and all showed they were up to date. A call bell system for residents use is serviced regularly also. Fire checks of all equipment has been carried out with records kept including weekly fire checks of fire points at various sites. Records show that when checks have been carried out any issues discovered have been dealt with. Fire drills are carried out monthly, which includes residents and visitors. Annual audits of the building, external and internal including residents bedrooms have been carried out with records kept. Areas identified as needing work have been highlighted. Work has been planned for specific areas identified during the audits with some work already done. Structural work such as replacing windows has been planned over a three year period. Accident records have been completed accurately and the manager is familiar with the reporting of disease and dangerous occurrences register (RIDDOR). An annual audit is Care Homes for Older People Page 25 of 29 Evidence: carried out with regard to the older person standards and falls are looked at in detail. Care Homes for Older People Page 26 of 29 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 27 of 29 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 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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