Care Home: Greenlands

What the care home does well Greenlands is a small home, which has a homely feel. The home provides comfortable accommodation, which has been greatly enhanced with the recent redecoration and refurbishment. There has been little staff turnover since our last visit offering people at the home stability in the care provided by staff that know them. Comments were received from a number of people about the care and support provided at the home. People said; `I`m very happy living hear, the food is very good and the home is very clean`, `staff are very good`, `all areas of the home are fine` and ` the home is very comfortable and clean`. Relatives also expressed; `the staff know each residents needs, they are always kind and considerate`, `home from home, nothing too much trouble for any member of staff` and `we can rest easy knowing our father is getting the very best of care`. A new staff member was also spoken with during the visit. They said that they had settled well and were enjoying the work. What has improved since the last inspection? The owners have worked hard in trying to address the majority of requirements made during our last visit to the home. Time has been spent making a number of improvements to the home. This has included the redecoration of the dining room, a lounge, new furniture items and new carpeting all of which have improved the appearance of the home. What the care home could do better: Information needs to clearly evidence that the weight and nutrition of people are being monitored and that where necessary the support of relevant health professionals is sought so that people`s well-being is maintained. An annual training plan needs to be developed showing what is to be undertaken by staff ensuring they have the knowledge and skills to meet the needs of people living at the home. An up to date electric check needs to be carried out within the home ensuring people are not placed at risk. Action identified on the gas safety certificate needs to be addressed ensuring appliances are safe. Accurate readings and records need to be maintained with regards to water temperatures ensuring people are not placed at risk of harm. Minor improvements are needed to the medication records so that they clearly show what people are being given and it is safe to do so. Information provided by people applying to work at the home need to be checked ensuring information is accurate. The staffing rota needs to show what hours have been allocated for the domestic and catering staff. CARE HOMES FOR OLDER PEOPLE Greenlands 46 Green Lane Bolton Lancashire BL3 2EF Lead Inspector Lucy Burgess Unannounced Inspection 15th July 2008 09:30a 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 Greenlands DS0000061961.V368206.R02.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. Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenlands Address 46 Green Lane Bolton Lancashire BL3 2EF 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) 01204 531691 greenlands@btinternet.com Mrs Asma Ali Khan Mrs Shagufta Parveen Rasul Hussain Mrs Shagufta Parveen Rasul Hussain Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies 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: 28 Date of last inspection 19th September 2007 Brief Description of the Service: Greenlands is a private residential care home registered to provide care for up to 28 older people. Placements made at the home are made from the local authority or through private referral. The fees are £365.00. The property is detached and set in its own well-maintained gardens. There is also parking to the rear. The Home is situated close to all local amenities and easily accessible for local transport to Bolton. The Home comprises of four single bedrooms and twelve double rooms. They are individually decorated and furnished and include a wash hand basin and a call bell system. There are no en-suite facilities. The Home offers the choice of two lounges and a separate dining room. The standard of cleanliness is good. There has been an on-going programme of maintenance and re-decoration, which has enhanced the environment. Greenlands provides comfortable accommodation for the people living there. Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 5 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 to the home. The inspection was carried out over one day, between the hours of 9.30am to 6.30pm. During the visit time was spent looking at paperwork and the environment as well as observing staff interactions. We also spoke with people who live at the home, staff and one of the owners. As part of the inspection process the manager, who is also one of the owners, was asked to complete an Annual Quality Assurance Assessment (AQAA). This was completed and sent to us before we visited the home. The information provided was detailed and looked at both the strengths and weaknesses of the home and the plans made to develop and improve the service further. Feedback surveys were sent to people at the home, their relatives and staff prior to our visit. We received a good response. Completed surveys were returned by 6 people who live at the home, 5 relatives and 7 staff. Comments have been included in the report. The home is registered to provide accommodation for 28 people, however the occupancy level at the time of the inspection was only 14. Discussion was held with the owner about what steps they are taking to promote the home and encourage further placements. All the key standards were looked at during this inspection visit as well as the action identified during the last visit. What the service does well: Greenlands is a small home, which has a homely feel. The home provides comfortable accommodation, which has been greatly enhanced with the recent redecoration and refurbishment. There has been little staff turnover since our last visit offering people at the home stability in the care provided by staff that know them. Comments were received from a number of people about the care and support provided at the home. People said; ‘I’m very happy living hear, the food is very good and the home is very clean’, ‘staff are very good’, ‘all areas of the home are fine’ and ‘ the home is very comfortable and clean’. Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 6 Relatives also expressed; ‘the staff know each residents needs, they are always kind and considerate’, ‘home from home, nothing too much trouble for any member of staff’ and ‘we can rest easy knowing our father is getting the very best of care’. A new staff member was also spoken with during the visit. They said that they had settled well and were enjoying the work. What has improved since the last inspection? What they could do better: Information needs to clearly evidence that the weight and nutrition of people are being monitored and that where necessary the support of relevant health professionals is sought so that people’s well-being is maintained. An annual training plan needs to be developed showing what is to be undertaken by staff ensuring they have the knowledge and skills to meet the needs of people living at the home. An up to date electric check needs to be carried out within the home ensuring people are not placed at risk. Action identified on the gas safety certificate needs to be addressed ensuring appliances are safe. Accurate readings and records need to be maintained with regards to water temperatures ensuring people are not placed at risk of harm. Minor improvements are needed to the medication records so that they clearly show what people are being given and it is safe to do so. Information provided by people applying to work at the home need to be checked ensuring information is accurate. The staffing rota needs to show what hours have been allocated for the domestic and catering staff. Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 7 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. Greenlands DS0000061961.V368206.R02.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 Greenlands DS0000061961.V368206.R02.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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are appropriately assessed before admission to the home to ensure their needs can be fully met. EVIDENCE: At present there are only 14 people living at the home. However the local authority has made recent placements at the home on a long term and respite basis. The assessment information for two people was looked at. On the first file the person had been admitted to the home for a period of respite following a fall. Information had been provided by the funding authority, which included a client care specification and risk assessment. Information clearly detailed the areas of concerns as well as the persons support needs. There was also evidence on file of arrangements being made for the relevant equipment i.e. bed and moving and handling aids, as well as arrangements for the district nurse involvement. We spoke with this person to Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 10 see how they had settled at the home and ask their opinion about the support provided. The person explained that they were quite comfortable and had been provided with everything they had needed and that their health and mobility had improved whilst at the home. On the second file this too contained a client care specification and risk assessment screening tool. This provided staff at the home with information about the person, including some background information, family involvement, support needs and areas of potential concern. Feedback received within the feedback surveys from relatives was very positive about their relative living at the home. Comments included; ‘I visited several homes in the Bolton area before choosing Greenlands, I regard it as the best’ and ‘we got good information about everything we asked about, they were very helpful’. The assessment information had then been used to inform the persons care plan and risk assessments so that staff were aware of the persons support needs and the care to be provided. Standard 6 does not apply, as Greenlands does not provide intermediate care. Greenlands DS0000061961.V368206.R02.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported in meeting their personal and health care needs however information recorded in the plans needs to reflect their current and changing needs so that any areas of potential risk are minimised. EVIDENCE: Records were looked at for 3 people. This included the 2 new people and another person where there were issues due to weight loss. People living at the home have their own personal care file. Other records are also held including weight records, professional visits, daily reports, minutes from formal reviews, health care assessments, accidents and incidents and finances. Files were found to be orderly and included a care plan and risk assessments covering moving and handling, pressure care and nutrition. On the first plan this detailed the improvements in the persons physical health and that they were more able to move around their room with the support of staff. However on the nutritional assessment and pressure care assessment Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 12 the person was scored as being at very high risk. There was no information within the plan to show how this was being managed. On the second file information was clear about the level of support required. This person was able to manage the majority of their own care needs. This was a clear plan and directed staff in encouraging the person to remain as independent as possible. Risk assessments had been completed and no areas of concern were identified. Specific information was looked at with regards to the management of weight and nutrition on the 3rd file. Records for one person showed that between April and July they had lost 9.4kg in weight (approximately 20lbs). Whilst it is recognised that they had been in hospital in May due to a fall resulting in a fracture, they had continued to lose weight on returning to the home. Looking at the persons plan, information stated that the person enjoyed their meals and that staff were to encourage more fluids to reduce any risk of infection. Other records included a nutritional risk assessment, which was scored at 6, low risk, the moving and handling assessment scored 9, medium risk and the pressure care assessment scored 15, high risk. Whilst there was evidence of the manager identifying weight loss and the need to contact the GP and dietician there was no evidence of this being done. Information on each of the files had been reviewed on a monthly basis. People continue to have access to a number of health and social care professionals ensuring their health and well-being is maintained. These include a GP, district nurses, podiatry, social workers, diabetic clinic, audiologist, anti-coagulant clinic and opticians. Records are maintained with regards to accidents and incidents. Incidents identified on the AQAA with regards to accidents, hospital admissions and deaths had been passed on to CSCI in line with Regulation 37. The medication system was examined. Individual administration records (MARS) are in place for each of the people receiving medication. A photograph is on file so that people can easily be identified. All stocks are held within the two medication trolleys held in the dining rooms, which are secured to the wall. Records continue to be maintained with regards to all items received by the home and those returned to the supplying pharmacist. Medication is generally administered by senior care staff or those staff who have received the relevant training. A check was made to the controlled drugs. A separate drug register is maintained. Stocks corresponded with the information recorded. Minor shortfalls were identified, which the manager is asked to address. This included eye drops being dated once opened and disposed of within the Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 13 timescale stated on the instructions. That written entries are signed by a second member of staff to evidence that the information recorded is correct and that staff identify the number of tablets they have administered with regards to PRN medication such as co-codamol ensuring people are not given more than the prescribed dose. The storage of information about people living a the home could be improved. Whilst care files are held on the 1st floor other records are held within the dining room. These would be easily accessible to people and visitors and therefore offer no privacy to people with regards to their personal information. The manager is advised to review these arrangements and whilst ensuring all information including the care files are accessible to staff that they are also held securely and confidentiality is maintained. Five relatives also sent us their comments on the feedback surveys. They too expressed; ‘100 for the staff and management, can’t say anymore!’, ‘ I know my mother is well cared by kind well trained staff’, ‘we are happy with the care our mother is given’ and ‘the staff are always friendly and helpful and the standard of care is good’. Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 14 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are encouraged and supported to exercise choices in their daily routines in relation to lifestyle, food and activities and to maintain contact with their relatives. EVIDENCE: People continue to be encouraged to maintain contact with family and friends and visits at the home are encouraged. Feedback received from the 5 relatives who visit the home was very positive. In relation to day to day routines and activities people are able to follow a lifestyle of their choosing. Two people spoken with during the visit said that they preferred to spend most of the their time in the comfort of their own rooms either watching television, reading or chatting with family and friends. Others spend most of their time in one of the lounge/seating areas on the ground floor. During the visit people were able to enjoy a massage from someone who regularly visits the home. Other people spent time chatting and playing a game with a young person on work experience. Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 15 Other activities are organised by the staff, these include ball games, nail care, foot massage, quizzes, sing a long and discussion groups. Residents also enjoy watching the television. Those people who request to have a newspaper or magazine then have them provided. A hairdresser also visits the home as well as an outside entertainer. Records are maintained with regards to what has been offered and who has taken part. We previously noted that new tables and chairs had been purchased. During this visit we found that new flooring had been fitted and the room had been redecorated as well as new curtains. Tables were nicely set with cloths, flowers and cruets. Meal times continue to be unhurried. Menus are said to be reviewed and alternative options provided for those who request it. Generally a larger lunch is served with a lighter meal in the evening. Hot and cold drinks are served with meals and throughout the day. Two people living at the home have a halal diet. Adequate arrangements are made within the home with regards to providing meals. The relatives for one person also bring food to the home. People commented; ‘I’m very happy living here, the food is very good and the home is very clean’, ‘staff are very good’, ‘all areas of the home are fine’ and ‘ the home is very comfortable and clean’. Relatives also said; ‘visitors are made welcome and asked if we want a drink’ and ‘residents are always dressed cleanly’. We identified during our previous visit that the kitchen looked tired and in need of some attention. This work has been planned by the owners as part of the refurbishment. A visit has also taken place by the food hygiene inspector in January of this year. Action was identified with regards to the completion of food safety records and food hygiene training. The manager must ensure that this is addressed. Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 16 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place with regards to responding to complaints and concerns. Whilst training has been provided, staff must be aware of the local authority safeguarding procedure ensuring residents are fully protected. EVIDENCE: A copy of the home complaints procedure is displayed within the home and accessible to the people living there and any visitors to the home. No issues were identified on the AQAA in relation to complaints or concerns brought to the managers attention. One issue was raised with us by the local district nurse team. This was in relation to the moving and handling of a person. Information was requested from the manager in relation to this concern. Arrangements were in place with regards to equipment and staff training. We observed staff moving and handling practices during the visit. Staff appeared competent using the aids provided and supporting people safely. Policies are held within the home with regards to the local authority adult protection procedures, however training in this area is yet to be provided. Some staff have previously received training with regards to abuse awareness however this does not address the procedure, which staff need to follow. The owner has received information from the training providers with dates for the course. Arrangements should be made so that all staff are aware of the procedure to follow should an incident arise. Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 17 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home appeared clean, comfortable and had been enhanced following recent redecoration and refurbishment, providing a pleasant environment for people living at the home. EVIDENCE: Since our last visit the owners have made a number of improvements within the home. The home also received a grant from the local council to assist in making improvements for the benefit of those living there. Work has been carried out in the dining room, with new décor, flooring, curtains and dining furniture. All of which co-ordinate and provide a pleasant area for people when having their meals. The two lounges have also been improved with new flooring and seating. Rooms looked bight and comfortable. Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 18 Each of the bath/shower rooms have been refurbished. Facilities are assisted with grab rails shower chairs and raised seating. Hand washing provisions and call bells were also in place. The owner was asked to remove personal toiletry items. These should be kept within individual bedrooms. Other work has included a new carpet which has also been fitted throughout the hall, stairs and landing areas, 2 new boilers and new doors to the passenger lift. Some of the bedrooms have also been repainted and new carpet fitted. Work was still needed to the woodwork, which has been knocked and damaged. The owner stated that this is being addressed as part of the ongoing refurbishment as well as further attention to bedrooms including the replacement of furniture and redecoration of the landing area outside the office. Outside of the home the mature gardens continue to be well maintained. There is also a new canopy across the front door offering visitors shelter. Minor issues had been noted during the visit in relation to a strong odour in one of the bedrooms and damage to the ceiling in another bedroom. Arrangments are in place with regards to regular carpeting cleaning ensuring any issues are quickly addressed. On going maintenance work is also carried out where neceessary. In relation to hygiene, the home was found to be warm, clean and tidy. The home employs domestic staff that take responsibility for the majority of domestic tasks however some areas are undertaken by the care staff. On the day of the visit the home was found to be warm, clean and tidy. Issues have been identified under standard 38 with regards to safety checks for the electric, action following the gas safety service and accurate records for water temperatures ensuring people living and working at the home are safe. Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are appropriately recruited, receive training and are supported in carrying out their duties. This would be enhanced with further training specific to the needs of residents ensuring their needs are fully met. EVIDENCE: At present there are only 14 people living at the home. Staffing levels were looked at for the week during the inspection visit. On the day of the visit there were 2 carers, a domestic and a cook as well as one of the owners. This provided sufficient cover to meet the needs of people at the home as well as ensure the home was clean and tidy. On examination of the rotas staffing levels at present generally comprise of 2 staff throughout the day and night, with designated domestic and catering staff each day. The manager/owners also work at the home throughout the week. Their hours are also specified on the rota. The team currently comprises of the 2 owners (one of whom is the registered manager), 21 care staff, 1 domestic and 2 cooks. The manager needs to clearly identify on the rota the hours allocated for care, domestic cover and cooking. Staff recruitment files were looked at for 3 new staff. Files are held securely in the upstairs office. Information was orderly and easy to read. Information contained on each of the files contained and application form, written Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 20 references, POVA 1st check, CRB disclosure, copies of identification, contract and induction record. Staff training certificates are also held on file. A minor shortfall was found on one file with regards to the employment history. This did not correspond with the person’s date of birth. In relation to staff training information was seen with regards to courses planned for staff. These are facilitated by en external training provider at the home so that the majority of staff are able to attend on one day. Recent training being held includes 1st Aid, moving and handling and health and safety. A medication courses was also attended by 3 staff in June 2008 It was noted that one staff member had recently completed relevant training with their previous employer. The manager is asked to undertake an assessment of the persons competency particularly in relation to moving and handling and medication to evidence that they are satisfied that the staff member is competent to carry out the role. Training videos have been purchased. However following discussion with one of the owners we were advised that these are an additional aid to support staff and that formal training courses by qualified training providers are undertaken by staff. A contracts review has been carried out by Bolton Social Services. Issues were identified in relation to staff training. The manager/owners are fully aware of their responsibility in making sure that staff are trained to carrying out their roles and responsibilities safely. Appropriate action had been taken to address any concerns identified. An up to date staff training matrix was received. This shows the shortfalls in training, which need to be undertaken by staff. The manager is asked to provide a plan for the forthcoming year showing training planned and dates for completion. This will ensure that all staff have the knowledge and skills required to carry out their role safely. Further training continues to be offered with regards to NVQ at level 2 and 3. Of the 21 carers working at the home at present 9 staff have achieved level 2/3 and a further 3 staff are currently completing their training. The manager has also completed her NVQ level 4 and Registered Managers Award. There are also 2 staff completing a health and scoial studies degree as well as 4 overseas qualified nurses. As identified during our previous visit, all new staff, on commencement of their employment, are supported by the manager in completing a 6 week TOPSS induction programme. The manager may wish to replace these booklets with documents now provided by Skills for Care. Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 21 Staff felt that; ‘they worked well as a team’ and ‘we have good relationships with residents family and each other. Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 22 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owners continue to make improvements within the home so that the service is ran in the best interests of people who use the service. Some areas in relation to health and safety need to be addressed ensuring people are safe. EVIDENCE: The manager of the home is also a qualified nurse who has experience of caring for older people. She has completed the NVQ Level 4/Registered Managers Award and as requested has proivded us with copies of her certificates. We received a good response with regards to our feedback surveys from staff, relatives and people who live at the home. Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 23 The owners continue to be members of the National Care Association (NCA) and attend the local Provider meetings (BARCH) where information and guidance is shared between care home providers within the Bolton area. Both the manager and co-owner continue to work at the home throughout the week, supporting both residents and staff. The owners have completed a development plan for the forthcoming year, 2008 to 2009. This looks at staff training and development, care, CSCI requirements, environment and questionairres to be sent to familiies and other representatives. Information gathered should be used to inform the home’s annual improvement plan and evidence that the views of people at the home and other stakeholders are listened too. Copies of the information should be made available to relevant parties including CSCI. In Novemebr 2007 the home was also awareded IIP status. Records in relation to people’s finances were looked at. The owners have opened a resident’s bank account, which is used for one person living at the home. All other individuals are either supported by family members or a nominated representative who oversees their finances. Records and receipts are maintained in relation to all transactions and people are invoiced for any money owning to the home. Records were examined in relation to health and safety checks. Certificates were looked at for all areas requiring annual/periodic servicing by external professionals. Up to date checks were in place for fire equipment, emergency lighting, call bells, small appliances, hoists and passenger lift. Action is needed with regards to the 5year electrical check as this is now due and 2 areas of action were identified on the gas safety certificate. The manager should advise us formally of the action taken to address these areas. An up to date fire risk assessment was in place as well as the insurance certificate. Records were seen for water temperatures. It was found that not every temperature recorded was at 43°C. This was discussed with the owner who stated that the water was supplied from different boilers and therefore one of the boilers had been turned up earlier that day. The manager must ensure that all temperatures are maintained at or near to 43°C and that accurate records are maintained of the readings taken ensuring residents are not placed at harm. Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 24 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 Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 25 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 2 9 2 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 12(1) 15(2) Requirement Information needs to clearly evidence that the weight and nutrition of people are being monitored and that where necessary the support of relevant health professionals is sought so that people’s wellbeing is maintained. Arrangements should be made for all new staff to receive training in adult protection to ensure that they are aware of the procedure to follow and residents are protected. (Outstanding requirement not met – 30.12.07) A staffing training programme needs to be developed for the forthcoming year ensuring staff have the knowledge and skills required to meet the needs of people safely. An up to date electric check needs to be carried out within the home ensuring people are not placed at risk. DS0000061961.V368206.R02.S.doc Timescale for action 30/08/08 2 OP18 18(1) 30/09/08 4. OP30 18(1) 30/08/08 5. OP38 23 30/08/08 Greenlands Version 5.2 Page 27 6. OP38 23 Action identified on the gas safety certificate needs to be addressed ensuring appliances are safe. Accurate readings and records need to be maintained with regards to water temperatures ensuring people are not placed at risk of harm. 30/08/08 7. OP38 23 30/08/08 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 OP9 Good Practice Recommendations Items of medication should be dated on opening or recorded in relation to numbers given ensuring medication is administered safely. Handwritten entries should be double signed to ensure that the information recorded corresponds with the prescription ensuring the system is safe. Information provided by people applying to work at the home need to be checked ensuring information is accurate. The staffing rota needs to show what hours have been allocated for the domestic and catering staff. The annual development plan for the home should evidence the involvement of people who use the service and other stakeholder to show that they have been listened too. 2. OP9 3. OP27 4. 5. OP29 OP33 Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Greenlands DS0000061961.V368206.R02.S.doc Version 5.2 Page 29 - 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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