Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Care Home: Greenleigh

  • 219 Wolverhampton Road Dudley Sedgley West Midlands DY3 1QR
  • Tel: 01902664023
  • Fax:

  • Latitude: 52.553001403809
    Longitude: -2.125
  • Manager: Mrs Susan Francis
  • UK
  • Total Capacity: 36
  • Type: Care home with nursing
  • Provider: Select Health Care (2006) Limited
  • Ownership: Private
  • Care Home ID: 7287
Residents Needs:
Old age, not falling within any other category, Physical disability

Latest Inspection

This is the latest available inspection report for this service, carried out on 19th January 2010. CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

For extracts, read the latest CQC inspection for Greenleigh.

What the care home does well The acting manager had a proactive approach in that she had started to audit records and the environment taking action where necessary and where she had the authority to make improvements. We received some positive comments from people living at the home which included, ""All the staff are lovely", "they look after me very well" and "excellent food menu." People looked well cared for, with clothing appropriate to the weather and according to their preference. People could make choices about their daily routines, activities and meals. They were encouraged and supported to take part in meetings and surveys at the home. The residents meetings had notes of topics discussed and action taken as a result. People had contributed their views about the activities, planned outings and food. Most people told us they enjoyed their meals, which looked appetising. The home had achieved 4 Stars for food safety and healthy eating. There were good links with local churches and arrangements were in place for people to practice their faith. People knew how to raise concerns and make complaints and were confident these would be dealt with and staff had completed safeguarding training. People were encouraged to personalise their bedrooms with their possessions, furniture and bedding if they wished. The staff on duty were genuinely caring and friendly and made conversation with people living at the home. We saw staff talking to people and offering choices and assistance at a level and pace that they needed. We saw and heard lots of laughter and banter with people at the home. What has improved since the last inspection? Care records were improving with clearer guidance for to staff meet people`s need more effectively, though further improvements were needed. Medication practices were generally improved, though additional improvements were needed. There was a documented audit of the environment with an action plan though this was mainly reactive because timescales were dependant on decisions by the company. Some parts of the home had been redecorated. Improvements had been made to staffing arrangements with increased numbers, skills and knowledge of staff to meet the needs of the people living at the home. The acting manager had started to undertake quality assurance audits so that failings could be proactively recognised and actions taken to improve the service. People told us the manager was approachable and supportive any events affecting people living at the home were notified to us. What the care home could do better: Care plans need further development, so that they are person centred, include all assessed needs and show that each person and where appropriate their representative is involved and in agreement. Some aspects of medication practices needed further improvement to make medication administration as safe as possible. Comments from relatives surveys included, "It would be pleasant for X to go on short outings even its if its just to the shops or the pubs for lunch" and "probably more stimulating activities" and "more staff at times." The persons responsible for decision making in the organisation must make sure swift action is taken to progress the maintenance of the whole premises to acceptable standards. All equipment, such as bedrails and electrical hard wiring must be serviced and maintained to demonstrate compliance with legislation to safeguard the health and safety of all persons at the home. Key inspection report Care homes for older people Name: Address: Greenleigh 219 Wolverhampton Road Dudley Sedgley West Midlands DY3 1QR     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jean Edwards     Date: 1 9 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 39 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 39 Information about the care home Name of care home: Address: Greenleigh 219 Wolverhampton Road Dudley Sedgley West Midlands DY3 1QR 01902664023 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Select Health Care (2006) Limited care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 36 The registered person may provide the followng categories of service only: Care Home with Nursing (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 (OP) 36 Physical Disability (PD) 6 Date of last inspection Brief description of the care home Greenleigh is a purpose built care home registered to provide care to a maximum of 36 people. Since the last inspection the home no longer provides nursing care. The home has two floors. Bedrooms, bathrooms and toilets are situated on both floors, communal areas, lounges, conservatory and the dining area on the ground floor. Kitchen and laundry facilities are also provided on site. The home has parking facilities to the front and side of the property. The home is situated on the A459 Wolverhampton Road and is on a main bus route between Dudley and Wolverhampton. The weekly fees as Care Homes for Older People Page 4 of 39 1 9 0 3 2 0 0 9 0 6 Over 65 36 0 Brief description of the care home published in the Service User Guide, range from £352 - £645. There are no third party top up fees charged. Some items that will not be covered by the weekly fee include hairdressing, non NHS chiropody, toiletries and newspapers. People are advised to contact the home for up to date information about fees. Care Homes for Older People Page 5 of 39 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last Key Inspection was on 19/03/09. We, the Care Quality Commission (CQC), undertook an unannounced key inspection visit. This meant that the home had not been given prior notice of the inspection visit. We monitored the compliance with all Key National Minimum Standards at this visit. A Pharmacist Inspector accompanied us to assess the homes medication systems. The range of inspection methods to obtain evidence and make judgements included discussions with the registered manager and staff on duty during the visit. We also talked to people living at the home, and made observations of people without verbal communication skills. Other information was gathered before this inspection visit including notification of incidents, accidents and events submitted to the Commission. We looked at a number of records and documents. The acting manager submitted the homes Annual Quality Assurance Assessment (AQAA) as requested prior to the inspection visit. We looked around the premises, including communal areas of the home, the Care Homes for Older People Page 6 of 39 bathrooms, toilets, laundry, kitchen areas, and peoples bedrooms, with their permission, where possible. Responses to CQC surveys have been included throughout the report. The acting manager added the range of fees to the service user guide during this inspection. The weekly fees range from £352.00 to £645.00. People are advised to contact the home for up to date information about fees charged. Care Homes for Older People Page 7 of 39 What the care home does well: What has improved since the last inspection? Care records were improving with clearer guidance for to staff meet peoples need more effectively, though further improvements were needed. Medication practices were generally improved, though additional improvements were needed. There was a documented audit of the environment with an action plan though this was mainly reactive because timescales were dependant on decisions by the company. Some parts of the home had been redecorated. Improvements had been made to staffing arrangements with increased numbers, skills and knowledge of staff to meet the needs of the people living at the home. The acting manager had started to undertake quality assurance audits so that failings could be proactively recognised and actions taken to improve the service. People told Care Homes for Older People Page 8 of 39 us the manager was approachable and supportive any events affecting people living at the home were notified to us. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. 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 39 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 39 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The statement of purpose and service user guide did not provide entirely accurate and up to date information about the home. People living at the home had contracts terms and conditions of occupancy, which contained some ambiguous terms. This has the effect that people and their representatives do not have accurate information regarding their rights and entitlements, and how care will be provided. The home uses comprehensive assessment tools so that each persons needs are assessed to ensure that their needs and preferences will be met. The home actively encourages introductory visits and people have the opportunity and time to make decisions, which are right for them. Evidence: The information contained in the homes AQAA (Annual Quality Assurance Assessment) about what it did well stated, Greenleigh provides all its service users with an up to date service user guide, and a statement of purpose is always available Care Homes for Older People Page 11 of 39 Evidence: for service users, their families or advocates. This can be made available in other formats if required. Service users are admitted to the home following a full needs assessment undertaken by the manager. This assessment is undertaken using information forwarded by professional agencies and family involvement is encouraged. A copy of the plan of care is written up and forwarded to the manager, funding is agreed and then an admission date is arranged which is acceptable to all parties. A letter is then given to the service user, a copy of which is then kept in the service users care plan. The AQAA told us about improvements in the last 12 months, All service users care portfolios have been reviewed with a new care plan template implemented which is more user friendly than previous documentation and staff are being actively encouraged to use the new system. It also informed us about plans for improvements over the next 12 months, To provide staff with more training in the formulating of person centred care planning. We were able to verify the information in the AQAA and we saw that the home had an up to date statement of purpose and service user guide on display and in welcome packs in each bedroom. There were some omissions in the documents such as room sizes; and some information about the Organisation had changed very recently. The acting manager told us that these documents could be provided in alternative formats on request. The aims and objectives, admission criteria were clearly set out and information about the home was easy to read and understand. Generally the information was useful for people to help them make decisions about their choice of home. We looked at a sample of care files of people recently admitted to the home, which showed that each person was provided with a contract and statement of terms and conditions. This document contained some ambiguous statements about what was included in the fee, such as payments for staff escorts for health appointments outside the home. There was information about the role and responsibility of the provider, and the rights and obligations of the person living at the home. The home did not provided terms and conditions of residency for people using the short stay respite service, which would demonstrate good practice. We saw evidence from examination of care records at the home and from discussions, which confirmed the good practices claimed in the homes AQAA. Pre admission assessments were conducted professionally and sensitively and had usually involved the family or representative of the person. The pre-admission assessment documentation was generally well completed. This meant that staff had good and Care Homes for Older People Page 12 of 39 Evidence: accurate information about each persons needs and preferences about how they wished their care to be provided. We saw that the manager had written to each person and their representative confirming the home could meet their assessed needs. We saw evidence that the acting manager kept each persons health and care needs under review and made referrals for reassessments to appropriate healthcare professionals. There were examples of medication reviews and additional support from the Speech and Language Therapist for someone with speech and swallowing difficulties, following a stroke. Some people staying at the home for short respite breaks told us they felt they had been looked after well. Care Homes for Older People Page 13 of 39 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are care plans and risk assessments, which are adequate to identify peoples needs and provide staff with guidance. There are generally assurances that individual needs will be met for each person. The arrangements for administration of medication do not entirely ensure people receive their medicines as prescribed by their doctor, which may pose risks to their health and well being at times. People are generally treated with respect and their privacy and dignity is maintained. Evidence: We looked at a sample of care records of people living at the home. The acting manager had started to make improvements, which were at an early stage of implementation. Information was in the process of being reviewed and used to formulate more person centred plans to meet each persons needs. More development was required, for example choices regarding personal hygiene should be specific as to whether the person preferred to be bathed or showered, how often, at what time of Care Homes for Older People Page 14 of 39 Evidence: day and what type of toiletries the person liked to use. Some care records were being transferred from the old Style formats to new records, this process was not complete, which meant that staff had to look in two care files for some important information relating to preferences and care needs. From records and discussions we saw that each persons health was monitored with appropriate action taken. There were health care assessments, and screening tools, such as falls assessments, tissue viability and the Malnutrition Universal Screening Tool (MUST), which were used to assess skin condition and weight. We visited peoples bedrooms and saw that there were pressure relieving mattresses in place, where there was an assessed need. However there were no records to show the correct setting for each persons body weight and there were no documented checks to make sure the mattresses were maintained at the correct pressure. This meant that the equipment might not be effective in preventing pressure damage to vulnerable people. There were moving and handling risk assessments, which gave score but did not record what assistance was required for each transfer and did not give staff guidance about what equipment should be used, such as walking aids, hoists and slings. There were examples where significant changes had been referred to doctors and health care professionals such as dieticians for advice and support and appropriate reviews and monitoring. During the inspection visit a senior carer noted that a person was refusing to eat and hiding food and had lost weight. We saw action taken to refer this person for advice from their doctor and social worker. We were told by a visitor that they were concerned that their relative at the home was sometimes dehydrated and became confused. We noted that this person was prone to frequent urinary tract infections. Following discussions the acting manager gave the visitor reassurances that a urine sample would be tested, fluid balance charts would be put in place, and staff would be instructed to diligently monitor fluids for this person. A visiting district nurse told us that she felt staff were helpful and knowledgeable about peoples needs and she was satisfied with the care and monitoring arrangements for people with diabetes living at the home. People had generally good access to health care services to meet their assessed needs. The home used the services of a contracted GP, though we were told that people could choose their own GP within the limits of geographical borders. There were records to show there was good support from the district nursing service. We saw that some people had access to community services such as opticians and speech Care Homes for Older People Page 15 of 39 Evidence: and language therapists. There were assessments and support from the speech and language therapists to speech for people requiring this service. We saw that people had appointments with dental and chiropody services where they had assessed needs for these services. The acting manager had introduced a key worker system to improve individualised care and support. We were told that each person would have life history information, giving staff improved insight into personal preferences such as bedtime routines and the way people. There were some areas, which needed further improvements such as care plans for people with dementia, which needed to be expanded to include all presenting symptoms. The care plans for people with diabetes needed to be expanded to include areas such as diet, blood glucose monitoring, skin, feet, and eye sight, where more specialised checks were necessary. There was no information about what the normal blood glucose parameters were for each person. This meant it would be difficult for staff to make an accurate assessment of when to inform the doctor of abnormal readings. We saw that some people had been prescribed antibiotics for time limited infections but there were no short term care plans to give staff guidance to meet increased care needs. The plans for night care for people who required supervision and assistance during the night were not sufficiently detailed. This meant that staff did not have information and guidance as to how to meet these needs and there was no review and evaluation as to how night time care needs were being met. The care plans and evaluations provided a space to show that the person or their representative had been involved but there were no signatures to demonstrate their active involvement. Relatives and a person living at the home told us they had not been shown information or asked to confirm their agreement. The acting manager acknowledged there were people living at the home who were capable of giving informed consent and this was an area, which needed to be improved. The monthly evaluations and daily records contained very basic information and should be improved to show how each persons care was being provided. The information was difficult to find in some files, which as previously mentioned were being transferred to new formats. All care files should be reorganised for easy access to information. Care Homes for Older People Page 16 of 39 Evidence: The pharmacist inspector visited the home on 19th January 2010 to check the management and control of medicines within the service. We arrived at 9.55am and stayed until 1.30pm. We looked at medication storage, some care records and medication administration records. We spoke to one member of care staff and the manager. We saw that medication was stored in a locked medicine trolley, locked cupboards and locked refrigerator. We saw that medication was kept neat and tidy which meant that it was easy to locate peoples medication. The temperature of all medication storage was checked and recorded daily. We saw records for the temperature of the refrigerator, which were within the recommended two to eight degrees C. We saw records for the temperature of the room, which were mainly below the recommended 25 degrees C although we saw one record at 26 degrees C. This meant that records showed that medication was stored within the recommended temperature ranges. We saw that a window was open to ensure the room was kept cool. We discussed security measures that should be in place to ensure the security of peoples medicines. Some medicines for named individuals were not stored correctly. For example, in the medicine trolley we saw a bottle of nail solution, which was prescribed for a fungal nail infection stored in a basket containing eye preparations. We expressed concern that a preparation intended for External Use Only was stored in the same container as eye drops and eye ointments. This meant that there was an increased risk of contamination between the medicines and also the potential for a medicine error. We looked at the medication administration record (MAR) charts and overall found that they were documented with a signature for administration or a reason was recorded if medication was not given. For example, one person was prescribed an anticoagulant to thin the blood. This medication required blood checks to ensure the correct dose was prescribed, which could vary depending on the result. We looked at the MAR chart for the medicine and saw that the records were easy to follow and we could see exactly how much medicine had been given to the person. We saw that the majority of the MAR charts were printed by the pharmacy and sometimes the MAR charts were handwritten by care home staff. We saw that the majority of the handwritten MAR charts were checked and signed by two staff for accuracy; however we saw that this checking system did not always ensure accurate MAR charts. We saw two examples of MAR charts that were not clear. The first example was for a handwritten medicine that we could not read which had been signed and double checked by two staff. The second example was for a new MAR chart which did not include the name of the person, the date of the MAR chart and included errors and deletions which were confusing. We discussed these findings with the manager. This Care Homes for Older People Page 17 of 39 Evidence: meant that although there were arrangements in place to ensure that the MAR charts were accurate sometimes the records were not clear and therefore increased the risk of a medicine error. We found that other medicine records were up to date. For example, we saw current records for the receipt and disposal of medication. The date of opening of boxes and bottles of medicines were recorded and balances of medication were carried forward from old records to new records. These records helped to ensure there was a clear audit trail of medication. We checked the medication available for one person who was prescribed seven different medicines and found that six of the medicine checks were accurate. We found a discrepancy for one of the medicines, which we discussed with the manager. This meant that overall people who live in the service were being given medicine as prescribed by a medical practitioner. We found information relating to medication was not always available in the care plans for individual people living in the service. We looked at two care plans. The first care plan we looked at included information relating to a medicine to be given when required. The person was prescribed a tablet used to treat anxiety and agitation. We saw a protocol dated December 2009 which informed staff under what circumstances the tablet should be given. This meant that there were written directions for care staff to follow and ensured that the health and well being of the person was protected. The second care plan we looked at was for a person who was prescribed 17 medicines. We were not able to find information in the persons care plan about their medication. We spoke to the Manager who informed us that there should be a separate list attached to the assessment form dated 30/12/2009, however this was not available. This meant that details relating to peoples individual medication needs were not always clearly documented to ensure safe administration of medication. We were informed by the Manager that staff had received medication training from the pharmacy and further medication training will be provided. This meant that medication was being given to people by trained staff. From our observations and in discussions it was evident that all staff were aware of how to treat each person with respect and to consider their dignity when delivering personal care. Care Homes for Older People Page 18 of 39 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. There are some activities for some people, and access to social stimulation in the local community. People are enabled and encouraged to maintain good contact with family and friends. People can choose from a balanced and varied selection of foods that meet their preferences and nutritional needs. Evidence: The homes AQAA cited the following evidence of what was done well, Routines of daily life and social activities are flexible and varied and are designed with the needs and wants of our service users paramount. All service users are encouraged to participate in an activity of their choosing e.g. arts and crafts, bingo or communion. All service users are offered the opportunity to participate in our fortnightly sing along sessions with the keyboard player, and often families and staff are involved too. The home has access to a mini bus from another home within the group, and service users have enjoyed trips out to the pub for lunch and on a canal barge. Forthcoming events and activities are advertised on notice boards throughout the home and special events are celebrated and the home decorated accordingly. We also celebrate the birthdays of all individual service users. Visitors are encouraged to visit at any reasonable time and Care Homes for Older People Page 19 of 39 Evidence: facilities are available for them to visit in private if they wish. All menus are formulated following consultation with service users and are varied and nutritious. We saw evidence for the accuracy of the claims made in the homes AQAA. We saw that staff generally listened to people living at the home and made efforts to provide flexible daily living routines, which enabled people to make choices according to their personal preferences. We noted earlier in the report that the acting manager had implemented a key worker system, which should enable closer relationships between the people accommodated and staff, where likes, dislikes and needs could be known in more detail and could be met in a person centred way. We were told that a new activities co-ordinator had recently been employed for three days each week and she was encouraging more people to participate in a wider range of activities. We saw pictures of events and trips displayed in the home and information displayed attractive formats bringing peoples attention to community events and activities. The home had held a Christmas fete, which raised funds for extra activities, some people had enjoyed a Christmas lunch at a local pub, and a local church and local school had visited to give carol concerts. A Christmas party and play had also been arranged for people at the home. Most people appeared to enjoy games, bingo, quizzes and exercises to music. The activities organiser was trying to arrange future outings to Dudley Concert Hall, the Safari Park, the Black Country Museum and a canal boat trip. The home has the use of a minibus shared with other homes in the organisation. We looked at a sample of peoples individual activities records, which were well completed, with refusals recorded. We received some comments from people who felt there could be even more time dedicated to activities and social stimulation, which we discussed with the acting manager during the inspection. She acknowledged the needs for more stimulating, individualised activities. We were told that there were arrangements for people to practice their faith. There were regular church services at the home every three weeks for anyone wishing to attend and we were told that some people had visits from their own minister. We saw that family and friends were welcomed and people told us they knew they could visit the home at any reasonable time. We were told that the management and staff team made time to talk to visitors and share information where this was appropriate. We were also told that two people living at the home were supported to Care Homes for Older People Page 20 of 39 Evidence: make regular visits to their spouses who lived in a nearby nursing home. We saw that people were encouraged to bring in their personal possessions to personalise their room. However there were no up to date inventories of personal possessions on the sample of files examined. These should be put in place and be kept up to date, signed and dated by the person or their representative and witnessed by the member of staff. We noted that there were telephone numbers for advocacy groups displayed on the notice board, which meant that people could contact external agencies for independent support as they wished. We discussed nutrition with the staff and the acting manager and the cook who had worked at the home for many years. They were knowledgeable about each persons nutritional needs and we saw that a choice was always offered. We saw plenty of cool drinks available around the home and heard staff offering frequent warm drinks. Special diets such as diabetic and soft diets were provided. There was also added calorific value at mealtimes for people with poor appetite or at risk of weight loss, using cream, butter and cheese. The home had achieved the Silver Award from Dudley Environmental Health for healthly eating and a 4 star rating for Scores on Doors award for food safety. There were written menus for each meal, with choices. There were no other formats for people unable to understand the written information but the acting manager told us that she planned to devise and put in place pictorial menus to help people make realistic choices. We discretely observed mealtimes, and staff were aware to the needs of people who found it difficult to eat and we noted that they offered sensitive assistance with feeding. They were aware of the importance of offering food at the persons pace, so that they were not hurried. A small number of people chose to have their meals at a different time, or in their bedrooms, to allow them time and space to eat at their own pace. Efforts had been made with the dining room to make it look inviting. The meals appeared appetising, and meal times were protected to provide a sociable, enjoyable experience. We asked a sample of people about the food at meal times, and received generally very favourable comments, such as the food here is very good and we have plenty of it Care Homes for Older People Page 21 of 39 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. People can generally feel assured that any concerns and complaints are listened to with action to investigate using systems to record findings and outcomes. There are arrangements in place to safeguard people living at the home. Evidence: We looked at the homes systems to deal with complaints. We saw that there was a complaints procedure displayed in the home and available in the Service Users Guide. Some of the information was out of date. There were no other alternative formats for people who may not be able to read or understand written information. There had been no complaints since the last random inspection in March 2009. We looked at the homes complaints log. There were no recorded complaints about the home or people living there. We spoke to relatives and people living at the home, who told us they felt they could tell the staff or manager if they wanted to complain. The responses during the inspection and from surveys returned to us indicated that generally people were aware of how to raise concerns or use the homes complaints procedure. The home had policies and procedures to inform staff about abuse and responsibilities for reporting suspicions or incidents. Some of these needed to be reviewed and updated. We were told that there was a programme of safeguarding training. The Care Homes for Older People Page 22 of 39 Evidence: acting manager told us that she would consider booking training places for staff who had not received safeguarding training through the Local Authority training programme so that they were aware of multi-agency reporting procedures. We spoke to some staff who told us that they knew where they must report allegations or suspicions of abuse. There was a copy of the multi-agency Safeguard and Protect procedure for the protection of vulnerable adults at the home. We recommended that all staff should read and sign policies to demonstrate awareness of procedures to safeguard people at the home. There had been one situations of concern, reported by a visiting student nurse, which had been referred to Dudley Directorate of Adult, Community and Housing Services (DACHS) under the Safeguard and Protect multi agency procedures. The management of the service co-operated fully, with investigations into the incidents, and remedial measures were introduced to improve care practices and safeguard all persons using the service. The homes AQAA told us, Any complaints received are taken very seriously and are dealt with in accordance with company policy. The plans for improvements in the next 12 months were, To continue our good relationships, to listen to our service users and their representatives. To provide staff with customer care training. The recruitment processes should be improved to be more rigorous to make sure staff are suitable to work with vulnerable people living at the home. Care Homes for Older People Page 23 of 39 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a generally homely and comfortable environment for people living there. The systems in place for maintaining infection control are not sufficiently robust. Evidence: The homes AQAA told us, Greenleigh is a purpose built care home, which provides our service users with a clean, safe and well-maintained home. It is situated on a main bus route close to town centres, schools and churches. The maintenance of the home is carried out by employed maintenance person, and is overseen by the manager and the companys estates manager. The building complies with the requirements of the fire service and the environmental health service. Greenleigh is a cosy, pleasant home and rigorous infection control procedures are in place. The homes AQAA cited the following improvements to the environment, New flooring has been laid in bedrooms and in one lounge, bedrooms are being decorated and residents wishes taken into consideration. The AQAA informed us of proposed improvements planned for the next 12 months, To continue with our rolling programme of maintenance and refurbishment and to look into the possibility of creating more single bedrooms within the home. We were not able to verify all of the claims made in the homes AQAA. The size of the Care Homes for Older People Page 24 of 39 Evidence: home meant that continual maintenance and repair work was needed to meet standards required. We had reported at the previous key inspection that improvements were needed to maintain the home to acceptable standards. The acting manager told us that she had audited the premise with the maintenance personnel and had put together a maintenance and renewal plan. There was also a reporting system for minor repairs, which required a reactive response. We were told us that the maintenance persons had to carry out renovations and redecoration at this home and another home in the organisation. We saw some work taking place on one unit during this inspection visit. The maintenance staff stated they found it difficult to cope with the amount of work required at the two homes. The acting manager offered to arrange a meeting with them and the manager responsible for the other home so that a work programme could be prioritises and agreed. There were parts of the home, which were looking tired and shabby, such as the paintwork in corridors and bathing facilities, which were very clinical. There were pitted areas on the laundry floor and walls, which needed attention to maintain good infection controls. There was a ventilation duct with an open area and a build up of dust and fluff. The acting manager told us that she had done a walk around the home and had identified areas of the home where cleanliness needed to be improved. She had introduced a new cleaning schedule the previous week, following discussions at a staff meeting, which she told us would be monitored in four weeks. We looked at a sample of bedrooms with peoples permission where possible. Some were adequately furnished but needed renovation and redecoration, acknowledged by the acting manager. Others had been attractively redecorated and personalised according to individual preferences, such as family photographs, ornaments and small items of personal furniture. We noted that some people had old style metal hospital beds and they would benefit from having a more up to date comfortable bed suited to their needs. We saw that some people had bedrails, which were loose, with excessive gaps when we checked them, which could pose risks of entrapment or injury. We discussed with the acting manager the need for improved risk assessments, regular documented checks and staff training so that they would be knowledgeable and competent. She gave us assurances the improvements would be made and the maintenance person showed us replacement clamps, which were used to secure the bedrails securely. The kitchen was maintained in good order, and it was clean and tidy and very well organised. We noted that appropriate food hygiene and safety measures were in place, with records, monitored by Environmental Services. However we noted that the Care Homes for Older People Page 25 of 39 Evidence: colour coded chopping boards were much worn and should be replaced. The large fridge was also very noisy and should be rectified or replaced. The cook had worked at the home for twelve years and the home had achieved the Dudley MBCs Environmental Health Four Star Scores on the Doors and Silver Food Award for healthy eating and food hygiene. People told us that the home was generally clean, warm, and comfortable. These views were also confirmed in responses in surveys returned to us. Care Homes for Older People Page 26 of 39 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. The numbers and skill mix of staff generally meet peoples needs and recruitment processes safeguard vulnerable people living at the home. There is a training programme in place to equip staff with skills to meet peoples needs. Evidence: The homes AQAA cited the following as evidence of what they do well, Greenleigh has an excellent staff team whom work well together. Most of the staff have worked at the home for a number of years. Care staff are given the opportunity to complete induction programmes in care standards and are encouraged to complete an NVQ. Most carers have already completed an NVQ 2 or are currently working towards it. All senior care staff already have an NVQ 3 or are working towards it. All recruitment is done within the companys policies and procedures. All new staff have a POVA check and 2 references in place before commencing work within the home and are supervised until a full CRB is available. Regular supervisions are undertaken for all staff and new starters initially start on a 13 week probationary period, during which their progress is monitored. We were able to verify the majority of good practices claimed in the AQAA during observations, discussions and examination of samples of records during this visit. We noted that there were 30 people accommodated, with a variety of dependency Care Homes for Older People Page 27 of 39 Evidence: levels and diverse needs. The acting manager told us that she reviewed staffing levels on a regular basis, taking account of the occupancy and dependency levels of the people accommodated, which demonstrated an improvement from the last key inspection. Assessment of staffing rotas and information from the AQAA and staff personnel records demonstrated that the home was maintaining generally satisfactory staffing levels. The Home had a relatively stable staff team including 19 care staff, 10 ancillary staff, and the acting manger. Three staff had left the homes employ in the past 12 months. There were two new kitchen assistants and three care staff had transferred from another home in the organisation at their request. We looked at a sample of three personnel files of staff recently employed. The files were generally well organised with a recruitment checklist. The acting manager had improved the recruitment process, which was generally robust and provided safeguards for people living at the home. However the organisations application form only requested a 10 year employment history. A full employment history should be obtained with documented explanations of any employment gaps. We also recommended that references should be dated. Two people under 18 years had been employed as kitchen assistants prior to a new (Criminal Records Bureau) CRB clearance being obtained. There were risk assessments in place but these should be expanded in compliance with up to date guidance from the Independent Safeguarding Authority (ISA), including the named supervision arrangements. We saw evidence of in house inductions and the Skills for Care Common Induction Standards. The acting manager told us about her commitment to staff training and development and had improved plans to provide all staff with appropriate training to raise awareness and skills to respond to peoples changing needs. We saw evidence that 13 of 19 care staff had achieved an NVQ level 2 care award with all new care staff registered for training. The majority of the senior team had achieved an NVQ level 3 care award with three additional senior carers enrolled as candidates. We spoke with a visiting district nurse who told us the staff were welcoming, knowledgeable and helpful. The staff told us they felt supported and this was confirmed in surveys returned to us. Care Homes for Older People Page 28 of 39 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management arrangements do not always provide sufficient safeguards for people living at this home. There are systems for consultation with people living at the home. Evidence: The acting manager was appointed in August 2009 and told us she would be submitting an application to be registered as manager for this home. She had previously worked with older people over a number of years and she held a nursing qualification. She had undertaken accredited dementia and medication training and she told us she had registered as a candidate for the Leadership and Management for Care Services Award. During discussions there was evidence of an open, approachable ethos, which encouraged good communication with people living at the home, their relatives and staff. We saw that the acting manager was generally well supported by the Responsible Care Homes for Older People Page 29 of 39 Evidence: Individual for the organisation. We saw that the Regulation 26 visits and reports were usually undertaken by the Responsible Individual with informative reports about the conduct of the home. However whilst this person was not available the registered manager from another home in the organisation was offering support, including undertaking the unannounced Regulation 26 visit and had provided a report. We noted that the acting manager had started to carry out some quality assurance checks, such as care files and staff files. She had also put in place maintenance and development plan and action plan, though the timescales were mainly reactive. There were some areas needing attention identified during this inspection visit, which were not recorded on the maintenance programme, for example relating to the premises. The acting manager told us that she had started to devise an annual business and development plan for the home with input from the staff. There were records of recent staff meetings and staff told us they were useful and that they could share their views openly. We saw that the acting manager had encouraged the activities organiser to hold residents / relatives meetings. These are important for people to give their views about their home. We were told that people were offered the opportunity to manage their own money if they wished, and there were facilities to help keep it safe. We looked at a random sample of balances and records of monies held in temporary safekeeping on behalf of people living at the home, which were accurate, with records of all transactions. We saw supervision records, which showed us that staff had been receiving regular supervision since August 2009. We saw evidence that the acting manager was arranging mandatory training to ensure each person received training appropriate to their roles, such as fire training, drills twice each year, moving and handling, first aid, food hygiene, health and safety and infection control training. We looked at a sample of heath and safety, fire safety and maintenance documentation, which were generally well organised. The acting manager told us that the company had used an external consultancy, which had undertaken a Health and Safety Audit of the home. There was a report, which identified areas to be improved, such as a range of risk assessments and the Legionella or Asbestos risk assessments, which were out of date. We were told the external consultants were updating all risk assessments. We looked at the Five yearly fixed wiring report completed in January 2009. The Care Homes for Older People Page 30 of 39 Evidence: servicing company had identified work to be carried out in various areas, such as, the earth bonding in the corridors, laundry and boiler room but there was no satisfactory service certificate available. The acting manager told us that some service documents may be kept and the head office. There should be evidence of that all maintenance and services are carried out and that the premises and equipment are in a safe condition and do not pose risks to people at the home. The acting manager told us that she had reviewed the use of bedrails at the home and risk assessments had identified that the majority were not needed and they had therefore been removed. However as reported at the environment section, we saw a person with bedrails in place, used with an overlay pressure relieving mattress, where the height of bedrails was less than the permitted height dimension of 200mm from uncompressed mattress to the top of the bedrails. There were also sets of bed rails with excessive gaps, with loose fittings, though new clamps were provided during the inspection visit. Although there were risk assessments in place, they did not include all of the high risk areas and there were no regular documented checks. This meant that the equipment could pose risks of harm to people whilst they were in bed. We looked at Regulation 37 Notifications held at the home and accidents, incidents and falls, recorded for January 2010. The acting manager told us that there were monthly accident analysis reports. There should be regular recorded analysis and evaluation of accidents with remedial actions held at the home, so that trends and risks are identified and minimised. Care Homes for Older People Page 31 of 39 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 32 of 39 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 1 7 12 To ensure that there are care plans, which include all of each persons assessed needs that are appropriately evaluated and updated to accurately reflect all changes to health and needs. This is to ensure care for each persons health and well being is properly provided at all times. 01/03/2010 2 9 13 To make arrangements to ensure that medication administration record charts are accurately documented. This is to ensure that care staff are able to administer the right medicine at the right dose at the right time to the right person. 01/03/2010 Care Homes for Older People Page 33 of 39 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 3 9 13 To make arrangements to ensure that medication for external use is stored separately from medication for internal use. This is to ensure that peoples medication is stored safely and to prevent the risk of a medication error. 01/03/2010 4 9 13 To make arrangements to ensure that care plans include detailed information and instructions for staff in respect of administration and management of medicines and to ensure that they are kept up to date. This is to ensure that there are clear directions for care staff to give medicines as prescribed by a medical practitioner. 01/03/2010 5 26 13 To ensure that all areas of the home are appropriately cleaned and maintained to meet infection control criteria. This is to ensure the health and well being of people living in the home is safeguarded. 01/03/2010 6 26 13 To audit and replace any damaged or defective 01/03/2010 Care Homes for Older People Page 34 of 39 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 equipment, for example the sluice, to maintain effective standards of infection control. This is to ensure the health and well being of people living in the home is safeguarded. 7 38 13 Risk assessments for bed 01/03/2010 rails must be expanded to incorporate all areas of risk to the person, including risks of entrapment and incompatibility with the bed and or mattress; and staff must be provided with training, so that a competent person undertakes visual checks of bedrails in the home on a regular basis to ensure that they are safe. A record must be made of these checks. This is to ensure people living at the home are safeguarded at all times. 8 38 13 The management systems must ensure that the premises and equipment have robust risk assessments and evidence of satisfactory maintenance and servicing as required by legislation. 01/03/2010 Care Homes for Older People Page 35 of 39 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 This is to ensure people living at the home are safeguarded at all times. 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 1 The homes statement of purpose and service user guide should be revised, updated and reissued to people living at the home in easy to understand formats suited to their capabilities. The contract / terms and conditions of residence should be revised, updated and reissued to each person living at the home to and should reflect good practice guidance issued by The Office of Fair Trading. All care files should be reorganised to easily access information. There should be evidence such as signatures to show person or their representative had been actively involved in the development of their care plan and monthly evaluations. There should be regular documented checks to ensure pressure relieving mattresses are maintained at the correct setting for each person. That advice from diabetic nurse specialists and community dieticians be sought for all residents assessed to be nutritionally at risk, with records of support and advice offered and that a record be maintained of staff training in relation to nutrition. Moving and handling risk assessments should include information about how staff should provide assistance and details of any equipment to be used such as walking aids, hoists and slings. The service should undertake a risk assessment for the overall security of medication stored in the dedicated Page 36 of 39 2 2 3 4 7 7 5 8 6 8 7 8 8 9 Care Homes for Older People 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 medicine room. This is to ensure that peoples medication is stored safely and securely. 9 14 Inventories of personal possessions should be fully completed, updated, signed and dated by the person or their representative and witnessed by the member of staff. Menus should be produced in alternative formats for people who cannot read or understand the written menus to help them make realistic choices. The complaints procedure should be revised and updated and should be available in appropriate formats so that people can understand their rights. All staff should be given time to read and familiarise themselves with the homes safeguarding procedures and the Safeguard and Protect procedure for vulnerable adults with signatures and dates to evidence their awareness. The home policies and procedures relating to safeguarding vulnerable people should be revised, simplified and updated to reflect current good practice guidance. The organisation should make sure that maintenance staff are allocated with sufficient hours to maintain the environment to satisfactory and safe standards at all times. The excessively noisy fridge in the main kitchen should be rectified or replaced. 16 17 18 26 29 29 The heavily worn colour coded chopping boards should be replaced to maintain effective food hygiene. The management should ensure all references are dated by the referee. Risk assessment for young people and staff employed prior to a new CRB should be expanded to include fuller information, such as named supervision arrangements and must be signed by the assessor. Application forms should be expanded to include full employment history and any explanations of employment gaps or queries should be documented. A copy of the DoH guidance Essential Steps should be Page 37 of 39 10 15 11 16 12 18 13 18 14 19 15 26 19 29 20 38 Care Homes for Older People 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 used to audit and improve infection control measures at the home. Care Homes for Older People Page 38 of 39 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 39 of 39 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

Other inspections for this house

Greenleigh 18/03/09

Greenleigh 05/12/07

The Provider has not yet updated their profile and added details of the services and facilities they offer. If you are the provider and would like to do this, please click the "Do you run this home" button under the Description tab.

The Provider has not yet updated their profile and added details of the services and facilities they offer. If you are the provider and would like to do this, please click the "Do you run this home" button under the Description tab.

Promote this care home

Click here for links and widgets to increase enquiries and referrals for this care home.

  • Widgets to embed inspection reports into your website
  • Formated links to this care home profile
  • Links to the latest inspection report
  • Widget to add iPaper version of SoP to your website