Care Home: Greenroyd Residential Home Ltd

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What the care home does well This is a home where the manager and staff take the welfare of people who live there seriously. By looking at records, talking to people and making observations, we found the home provides care in a flexible way, so that people have the opportunity to live their daily lives as they choose to. Comments included, "we make this a homely as we can and people can move a round the home as they choose", " my relative gets the best care I could possibly imagine". The way we saw staff speak to people show they do it with sensitivity and consideration. They make sure peoples needs are being met, so that they are comfortable. We talked to the staff team on duty who confirmed they have a good knowledge of the individual care needs, social and cultural needs of people living at the home so that they are not disadvantaged in any way. Comments included, "We get to know all the different characteristics and try and make people feel really comfortable". What has improved since the last inspection? This is the first inspection of the service since registration in December 2009. What the care home could do better: The home should continue to develop good practices seen during this inspection of the service. Key inspection report Care homes for older people Name: Address: Greenroyd Residential Home Ltd 27 Hest Bank Lane Hest Bank Lancaster Lancs LA2 6DG     The quality rating for this care home is:   three star excellent 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: Jacqueline Riley     Date: 1 0 0 6 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 25 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Greenroyd Residential Home Ltd 27 Hest Bank Lane Hest Bank Lancaster Lancs LA2 6DG 01524824050 01524825540 greenroydhome@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Greenroyd Residential Home Ltd Name of registered manager (if applicable) Mrs Christine Barbara Parker Type of registration: Number of places registered: care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE. The maximum number of service users who can be accommodated is: 23 Date of last inspection Brief description of the care home Greenroyd is a large detatched property situated in a rural location, although close to Morcambe, Lancaster and surrounding villages. The home is registered to provide residential care for up to twenty-three people with a dementia condition. One place is a designated respite room for people requiring short stay care. 23 Over 65 0 Care Homes for Older People Page 4 of 25 Brief description of the care home The home has three floors. There are two lounges and two dining rooms on the ground floor. Access to upper floors is by way of a passenger lift and stair lift to the first floor. All rooms are single spacious and have en suite faciltities in them all. The call system is mobile and can be used in various parts of the room, in addition there are options for people to use a mobile wrist band if in the grounds of the home in order to call for assistance. All areas of the home are very spacious and has wheelchair access throughout. Bathing and toilet facilities are in place on all floors of the home in numbers to meet the needs of people living there. There is a wide range of bathing facilities inlcuding walk in showers with seating, and a bath with fitted chair for ease of access. The home has a Statement of Purpose and Service User Guide for people using the service so they are informed of the services the home has to offer and therefore they can make an informed choice about moving into the home. At the time of the inspection of the service on 10th June 2010 the range of fees were £476.50 to £478.50. Additional costs are included in indivdual contracts. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The main inspection of Greenroyd Care Home was undertaken including a visit to the service over a five hour period on 10th June 2010. We spoke to the registered owner/manager and three staff members. A number of visitors were spoke to through the inspection process whilst they were visiting their relatives. We spent time in and around the communal areas of the home making general observations to get a flavour of how the home operates on a daily basis. As part of the inspection process we talked to people using the service and asked staff about those peoples needs. We also looked at their rooms, care plans, records and daily notes this is called case tracking. We also invite others using the service to pass on their opinions if they wish, however due to the level of dementia some of the comments were limited. Care Homes for Older People Page 6 of 25 We had some responses from questionnaires sent to people who use the service for their views on how they experience the service. Comments were very positive and some are included in this report. Every year the person in charge or manager is asked to provide us with written information about the quality of the service they provide, and to make an assessment of the quality of the service. We use this information, in part, to focus upon our inspection activity. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. 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 8 of 25 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 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents, families and friends have information about what services they can expect to receive if they choose to live at the home. Admission and assessment procedures are in place so that the home knows they can meet the individual needs of people. Evidence: We looked at the records of three people living at the home. Two records were for people living there on a permanent basis, and one for somebody on a short term respite break. We saw they had assessment details in place from social workers, and other health care professionals including, hospital discharge teams. In addition the home has their own admission assessment which is used by the homes manager so they can gather information they feel they might need to provide care to the person. The information showed the home is informed through these assessments of the needs of the person. Staff spoken to said they use this assessment information to determine the level of care the person needs. Comments received said, we make sure we get all the information we can before a person comes to the home so we Care Homes for Older People Page 10 of 25 Evidence: know we will be able to meet their needs. We saw the home has in place information about the home and what services it provides. This information is generally given to relatives and advocates, so that they know what the home can provide and make an informed decision based upon information they receive. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Promotion of health is taken seriously. Peoples welfare is monitored and their health needs are identified and met. Evidence: The three care planning records we looked at were accurate and up to date. There was good information about individual health care needs as well as how those needs are going to be met. Staff we spoke to said the information is clear and they can follow the plans to maintain and support people who live in the home. Comments included, the care planning records are important so we know what the current needs of people are, by reviewing the care plans regularly means we can make any necessary changes. We found the home has been working closely with other organisations to introduce risk assessment for people relating to the Deprivation of Liberty Safeguards (DoLS). This resulted from the Mental Capacity Act 2005 to protect people who may be at risk of being deprived on any basic human right. The home would provide a confidential assessment to identify any one specific area which may result in deprivation, however Care Homes for Older People Page 12 of 25 Evidence: at the time of inspection there were no DOLS assessments required for any of the persons living there. The manager spoken to said they have received training for this and identified with the importance of deprivation being recognised and managed so people are not disadvantaged in any way. The records we looked at show there are risk assessments in place for people, which highlight what the risk is, how it can be managed and what the outcome is for the person. There was evidence of risk assessments and care plans being reviewed on a monthly basis by the manager. In some instances we saw evidence of changes being made as the needs of the person changed, so that staff were able to meet the presenting need at the time. By looking closely at the records we found there are links between the home and other health care professionals including, doctors, district nurses, Psychiatric professionals, so that peoples health care and psychological needs are being met. Medication records and observation of practices in administration showed us it is safe. Only trained staff or the manager administers medication. We looked at three records and found them to be complete and up to date. We looked at how the home stores medication and found it to be in a locked purposeful facility. We saw peoples privacy and dignity is respected during the visit by looking at how staff talk to and respond to people. We found staff to be respectful and sensitive to individual needs throughout the inspection. Staff spoken to said, we make sure in training that staff are aware of the need to respect peoples and treat them with dignity, caring for people with dementia can be distressing sometimes but with the training and support we know how to manage situations that arise. Care Homes for Older People Page 13 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals are arranged to meet peoples needs, activities are varied so that people have choice. Evidence: We spoke to some of the staff about routines in the home. They said they are flexible and people can get up and go to bed when they choose. We saw there is space in the communal areas for people to use, and a number of residents spent time walking around the communal lounges and corridors without any restrictions. Staff were seen to interact well with people living there, talking to them, spending time with them when they were having a drink or just chatting. The interaction between staff and residents was seen to be positive at all times during the inspection. Staff told us they like the way they can spend time with people, comments included, we like to spend time with residents as a group and individually, as some of their moods change quickly you have to be on your toes, they all have their own characters and thats what makes it interesting. The home prepares its own meals which are based upon a balanced nutritional diet. The manager and staff told us of the flexibility in meals for people living at the home. Comments we received told us people like the food and say there is choice available. Care Homes for Older People Page 14 of 25 Evidence: Staff told us they are informed of a persons nutritional needs when they are admitted to the home, and they cater for medical conditions such as diabetes or any other nutritional need. The home has recently introduced a nutritional tool for staff to use so that nutrition is monitored and reviewed. They told us they know the individual likes and dislikes of people living there so that they can meet their nutritional needs on a daily basis. There are a range of activities and outings available to people living at the home. Outings include trips to Bowness, Cleveleys, Blackpool Illuminations as well as other trips. We saw individual records for people living there for activities they are involved with, including hand massage, aromatherapy, board games, use of Wii Fi and accompanying some people to hairdressing appointments. There are also parties arranged for various events. There was bunting and flags in place for the world cup, which some people said they were looking forward to. The home has a friends of Greenroyd group, who meet regularly and raise funds with events for additional trips and activities for people living there. The notice board is informative and tells people about whats going on now and in the future. There are no restrictions for visitors to the home. We spoke to a number of visitors during the inspection process and there comments were very positive about the home. Comments included, my relative gets the best care I could imagine, its and excellent place and the staff are very good and helpful. They told us there were no restrictions on visiting the home. Care Homes for Older People Page 15 of 25 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 using the service are protected by the complaints and safeguarding procedures, which were understood by staff. Evidence: We looked at the homes complaints procedure, which is made available to people using the service including their relatives or advocates during the admission process. We were told by staff they are aware of the complaints procedures and how to use them. Comments included, we are made aware of the complaints procedure and how to use it during our induction. Visitors we spoke to and information we received told us people using the service are aware of the complaints procedures and feel comfortable raising any issues with the manager. There have been two complaint investigations in the previous twelve months where there is evidence the management team worked closely with the investigating authority to address the concerns and make changes for the benefit of people using the service. We spoke to the manager and staff about how people are protected. We were told all staff have access to safeguarding adults guidance which is used by the manager during the induction programme in order to ensure people are protected. Staff we spoke to demonstrated they were knowledgeable in protecting people by using the procedures in place. Care Homes for Older People Page 16 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in an environment which provides excellent standards and equipment for the benefit of people who use the service. Evidence: This is the first inspection of the service since a major refurbishment programme. The result of this has ensured the home provides an excellent environment for people to live in. We looked around the home and found it to be furnished and decorated throughout to a high standard. All rooms are spacious and well furnished, with spacious en-suite facilities in all rooms for peoples comfort and ease of access for wheelchairs or other mobility aids. Comments included, I couldnt wish for a nicer room for my relative, its got everything they need. The home has three floors with each floor providing spacious corridors, access to the first floor is by stair lift of passenger lift. All other floors can be accessed by the passenger lift. There is a secure stairwell designed for emergency exit but can be used by people. Each floor has a range of bathing and toilet facilities so people have choice and staff said they find the facilities excellent for providing personal care to people. There is an excellent communication system in the home with a cordless call system for people so they can be more mobile. In addition there is a call system for people using the garden area so people are protected. There are telephones situated on all floors so that staff have communication access if needed. All rooms have telephone Care Homes for Older People Page 17 of 25 Evidence: points and some people living there take advantage of this and have their own personal telephone in their room. In addition all rooms have access to satellite TV if chosen, there are also computer connections should people choose this option. Each persons room has been designed to a high specification, in some instances people have brought pieces of furniture from home. Comments included, My relative has brought bits and pieces in with them and they seem to encourage this, it makes it more personal. There is a paved area with seating at the front of the home which can be used by people if they choose. This area is being developed further so people have access to a range of external facilities, specifically designed around the needs of people with dementia conditions. There is a choice of two communal lounges and two dining rooms for people living there. In addition there is a small lounge which is situated in the front of the home and is generally a quiet lounge used by visitors and relatives, although people living there have access if they choose. By looking around the home we found it to be clean and free from offensive odours. There are policies and procedures in place for staff regarding infection control. Most of the staff spoken to have received training in Infection control. The home has dedicated laundry facilities which has been designed to make sure peoples laundry is managed well. Care Homes for Older People Page 18 of 25 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. There are procedures in place for recruiting staff, ensuring the safety and protection of people living there. Training is delivered so that the staff team have the necessary skills to meet peoples needs. Evidence: We looked at how the staff team is utilised to meet the needs of people during the day and nighttime periods. We found the home is using a skills mix of staff so that there is always a senior member of staff on each shift. We saw there are sufficient numbers of staff to meet the needs of people living there. Staff we spoke to said they were happy with the way they are supported and how they work in the home. Comments included, We all work really well together as part of a team, Ive been on lots of courses and this helps me in the job I do. Most members of the care staff have achieved a recognised national care qualification with others being enrolled to complete further training. Most records we looked at showed staff have attended Dementia training at various levels over time so that the specialist needs of people living at the home can be met. In addition to external training the manager ensures there is additional training in house which she provides to look at a range of topics associated to caring for people with dementia. Staff said this has been really useful, we are kept up to date with things going on in the care for people with dementia. We looked at two staff files. They showed us staff are recruited safely using Care Homes for Older People Page 19 of 25 Evidence: procedures which take into account information about their skills and competences for the role applied for. Information about them included application records, references which have been checked, Criminal Record Bureau (CRB). Protection of Vulnerable Adults (POVA)checks to make sure they are safe to work with people who may be vulnerable. Staff we spoke to told us they feel very well supported by the manager, who has introduced induction training for all staff using an initial health and safety format, followed by a six week programme which all staff must complete and which is overseen by the manager. It covers all aspects of the staffing roles. In addition supervision and appraisal is being used on a regular basis to ensure staff are supported in their roles and their personal development is being recognised by the manager. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed for the benefit of all users of the service with systems and policies in place for the safety and protection of people living there. Evidence: We saw the manager is running the home on a day to day basis in the best interests of people living at the home and staff who work there. Comments included, the manager is very supportive, You can talk about things with the manager at any time. We talked to the management team about how they involve the staff in the running of the home. They told us and showed us records of supervision, meetings and appraisals which are held regularly to share views about the running of the home. Staff spoken to said they feel part of the decision making processes and felt their own views are valued. We found that all records and systems in the home are up to date, so that the Care Homes for Older People Page 21 of 25 Evidence: information is current. Staff were able to follow clear instructions in the records for the health and welfare of people. We saw there is a clear line of management responsibility and that staff communicated well with the manager throughout the inspection process. By talking to the manager and looking at some of the homes recent surveys for quality assurance purposes, we found the home values the views of all stakeholders of the service. The manager told us they take information from residents, staff, visitors and other professionals involved in the running of the care home so that they can make changes in the business planning of the service. Comments inlcuded, they are always asking what you think about the home. We looked at how peoples money is handled and were show records of how this is managed. It confirmed there is a good system in place to ensure money is managed safely in peoples best interests. By looking at records we saw regular tests and servicing of essential equipment including, gas, electric and fire they were safe. Care Homes for Older People Page 22 of 25 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 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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