Care Home: Greycroft Residential Care Home

What the care home does well Current and prospective residents were provided with appropriate written information. This ensured the residents were aware of the services and facilities available in the home. The admission procedure involved an assessment of people`s needs. This enabled the registered manager and prospective residents to determine whether or not their needs could be met within the home. The daily routines were flexible and designed to meet the wishes of the residents. The residents could chose to have a lie in and breakfast was served at a time to suit their preferences. The residents spoken to felt they were well cared for and the staff respected their rights to privacy and dignity. One resident wrote in a questionnaire, "I am always happy here". Activities were arranged in line with the needs and choices of the residents, which included dominoes, bingo, flower arranging and baking. Varied and wellpresented meals were served. The residents spoken to described the meals as "very good" and "lovely".Visitors were welcome in the home at any time and residents were supported to maintain good contact with their family and friends. Relatives spoken to during the inspection were satisfied with the quality of care provided, one person said, "All the staff have been wonderful, I am happy with everything". The residents were aware of the complaints procedure and knew who to talk to in the event of a concern. Residents` meetings were held on a regular basis, which gave the residents the opportunity to discuss all aspects of life in the home. The residents were provided with clean comfortable bedrooms. The residents could personalise their rooms, with their own belongings. The sitting and dining areas were decorated in a homely fashion, with a variety of armchairs, footstools, side tables, ornaments and pictures. A good percentage of staff had achieved NVQ level 2 or above. This qualification provided the staff with the necessary knowledge to carry out their role effectively. The registered manager had developed a quality assurance system, which was based on the outcomes for the people living in the home. This meant the residents were able to have some input into the future development of the service. What has improved since the last inspection? Since the last inspection, the care planning process had been developed to provide more information about the residents` preferred routines and healthcare conditions. Information about specific healthcare conditions had also been included within the care plan documentation. This meant the staff had clear guidance about the residents` needs and how they wished these needs to be met. Additional guidance had been added to the care plans about the application of prescribed creams and the storage of eye drops had been carefully monitored. This ensured the staff had information about how and where to apply creams and all medication had been stored safely. A choice of meal had been introduced at lunchtime. Residents were asked prior to each mealtime what choice they wished to make. The staff had also received basic nutrition training. This meant the staff were aware of the benefits of varied diet and good hydration. Several improvements had been made to the premises to improve the comfort and independence of the residents. A lock had been placed on the toilet door on the ground floor, the stair lift had been extended to fit round the whole stair case, several bedroom rooms and the hallway had been repainted and some bedrooms had been fitted with new furniture and carpet. A fence had also been placed round the outside bins and a handrail had been added to the main ramp up to the front door. CARE HOMES FOR OLDER PEOPLE Greycroft Residential Care Home 15 Queens Road Accrington Lancashire BB5 6AR Lead Inspector Mrs Julie Playfer Unannounced Inspection 17th September 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greycroft Residential Care Home Address 15 Queens Road Accrington Lancashire BB5 6AR Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01254 234766 Mrs Helen Elizabeth Crickmore Mr John Crickmore Mrs Ann Bernadette Williams Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 14 Date of last inspection 7th November 2007 Brief Description of the Service: Greycroft Residential Care Home is registered to provide accommodation and personal care for 14 Older People. The home is detached and is situated on a main road opposite to Accrington Victoria Hospital. There is a garden/patio area at the front of the home, which can be used by residents in fine weather. There is a small car park to the rear. Accrington Town Centre is nearby and the home is on a local bus route. The home has 2 lounges and a large conservatory. One of the lounges is used as a dining area. Accommodation is provided in 12 single bedrooms and one double bedroom. The latter has an ensuite facility. A stair lift is fitted to the main staircase to ease access to the first floor. According to information provided by the registered manager the scale of charges was £359.00 to £372.00, for both Social Services and privately funded residents. The fees included toiletries and newspapers. Additional charges were made for hairdressing. The registered person made information available to prospective residents by means of a service users guide and statement of purpose. The guide was usually given to relatives and/or prospective residents on viewing the home or at the point of assessment. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. A key unannounced inspection, which included a visit to the home, was conducted at Greycroft on 17th September 2008. At the time of the inspection there were nine people accommodated in the home. The inspection comprised of spending time with the residents, looking round the home, reading some of the residents’ care records and other documents and talking to the staff and the registered provider and registered manager. As part of the inspection process we (the commission) used “case tracking” as a means of gathering information. This process allows us to focus on a small group of people living at the home, to assess the quality of the service provided. Prior to the inspection, the registered manager completed an Annual Quality Assurance Assessment known as AQAA, which is a detailed self assessment questionnaire covering all aspects of the management of the home. This provided useful information and evidence for the inspection. Satisfaction questionnaires were sent to the home for distribution to the staff and the residents. Eight questionnaires were returned from people living in the home and two questionnaires were received from staff. The responses from the questionnaires were collated and used throughout the inspection process. What the service does well: Current and prospective residents were provided with appropriate written information. This ensured the residents were aware of the services and facilities available in the home. The admission procedure involved an assessment of people’s needs. This enabled the registered manager and prospective residents to determine whether or not their needs could be met within the home. The daily routines were flexible and designed to meet the wishes of the residents. The residents could chose to have a lie in and breakfast was served at a time to suit their preferences. The residents spoken to felt they were well cared for and the staff respected their rights to privacy and dignity. One resident wrote in a questionnaire, “I am always happy here”. Activities were arranged in line with the needs and choices of the residents, which included dominoes, bingo, flower arranging and baking. Varied and wellpresented meals were served. The residents spoken to described the meals as “very good” and “lovely”. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 6 Visitors were welcome in the home at any time and residents were supported to maintain good contact with their family and friends. Relatives spoken to during the inspection were satisfied with the quality of care provided, one person said, “All the staff have been wonderful, I am happy with everything”. The residents were aware of the complaints procedure and knew who to talk to in the event of a concern. Residents’ meetings were held on a regular basis, which gave the residents the opportunity to discuss all aspects of life in the home. The residents were provided with clean comfortable bedrooms. The residents could personalise their rooms, with their own belongings. The sitting and dining areas were decorated in a homely fashion, with a variety of armchairs, footstools, side tables, ornaments and pictures. A good percentage of staff had achieved NVQ level 2 or above. This qualification provided the staff with the necessary knowledge to carry out their role effectively. The registered manager had developed a quality assurance system, which was based on the outcomes for the people living in the home. This meant the residents were able to have some input into the future development of the service. What has improved since the last inspection? Since the last inspection, the care planning process had been developed to provide more information about the residents’ preferred routines and healthcare conditions. Information about specific healthcare conditions had also been included within the care plan documentation. This meant the staff had clear guidance about the residents’ needs and how they wished these needs to be met. Additional guidance had been added to the care plans about the application of prescribed creams and the storage of eye drops had been carefully monitored. This ensured the staff had information about how and where to apply creams and all medication had been stored safely. A choice of meal had been introduced at lunchtime. Residents were asked prior to each mealtime what choice they wished to make. The staff had also received basic nutrition training. This meant the staff were aware of the benefits of varied diet and good hydration. Several improvements had been made to the premises to improve the comfort and independence of the residents. A lock had been placed on the toilet door on the ground floor, the stair lift had been extended to fit round the whole stair case, several bedroom rooms and the hallway had been repainted and some bedrooms had been fitted with new furniture and carpet. A fence had also been Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 7 placed round the outside bins and a handrail had been added to the main ramp up to the front door. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home had their needs properly assessed and they were provided with appropriate written information to enable them to make an informed choice about where to live. EVIDENCE: Written information was available for the residents in the form of a statement of purpose and service users guide. The guide had been distributed to each resident and was available for reference in the entrance hall. An information leaflet had also been produced which offered current and prospective residents with a useful overview of the services and facilities available in the home. The leaflet included photographs of the home. All the residents who completed a questionnaire indicated they had received enough information prior to moving into the home. Copies of the last inspection report were available for reference in the entrance hall. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 10 From the personal files seen it was evident that the residents had been issued with a contract/terms and conditions of residence. The contracts had been signed by the residents and/or their representative and included information about the level and payment of fees and the rights of the residents. The contract was easy to read and was presented in a clear format. This meant the residents were aware of their terms and conditions and what they could expect from the service. The ‘case tracking’ process demonstrated that the residents had their needs assessed prior to admission by a social worker and/or manager. Copies of the preadmission assessments were seen on the residents’ files. The assessments covered a range of individual needs. The registered manager confirmed that admissions were not made to the home in the absence of a full needs assessment. This meant the registered manager was confident that the staff had the necessary skills and knowledge to meet the assessed needs of the prospective resident. The registered manager confirmed that prospective residents were encouraged to spend time in the home prior to making the decision to move in. This enabled the resident to meet other residents and staff and experience life in the home. Following admission, the contract stated that a trial period of eight weeks was offered to every resident, so that both parties could make sure the placement was successful and the resident’s individual needs could be met. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care received by residents was based on their individual assessed needs. Care practice took full account of the residents’ privacy and dignity. EVIDENCE: Three people’s files were looked at in detail as part of the case tracking process. All three files contained a care plan, which was based on the person’s assessment of needs. Social histories had been incorporated into the care plan documentation and provided details about past life experience and important events. This information was useful for staff to stimulate meaningful conversations with the person. The plans were supported by daily records of personal care, which provided information on changing needs and any recurring difficulties. These records were detailed and the residents’ needs were described in respectful and sensitive terms. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 12 Since the last inspection, the care planning process had been developed to provide more detailed information about the residents’ preferred routines and healthcare conditions. Information about specific medical conditions had also been included within the care plan documentation. Both staff who completed a questionnaire indicated that they were “always” given up to date information about the needs of the residents. One person wrote, “The manager reviews the care plans with the key workers and any changes that are made are passed onto the staff”. The residents confirmed they were involved in the care planning process and recalled discussing their care needs with a member of staff. This gave the residents the opportunity to have an active input into the delivery of the care. Written evidence seen in the residents’ files demonstrated that the care plans were reviewed each month and the care plans had been updated in line with changing needs. Healthcare needs were considered during the assessment process and there was a designated section within the care plan, which provided information for staff on how best to meet these needs. There was written evidence within the personal care notes to indicate that the residents accessed NHS services and received specialist support as necessary, for instance the District Nursing Team. Charts were maintained to monitor the residents’ weight, to ensure any significant fluctuations were noted and acted upon. A set of sit on scales had recently been purchased, which ensure all residents could be weighed safely. Since the last inspection, staff had received training on particular medical conditions, which included strokes and Parkinson’s Disease. This ensured the staff were aware of how to monitor and respond appropriately to residents with these conditions. Risk assessments in respect to moving and handling, pressure sores, falls and nutrition had been incorporated into the care plan records. Since the last inspection risk management strategies had been drawn up to support all risk assessments including the risk of pressure sores. The management strategies provided information for staff on how to reduce or manage a potential risk in a consistent and safe manner. Individual needs had been considered in respect to moving and handling techniques. As such staff had access to clear information about the type of equipment to be used and personal preferences. The residents spoken to felt the staff respected their rights to privacy and dignity and all made complimentary remarks about the staff, for instance one person said, “They’re all good, I’m looked after very well”. The residents, who completed a questionnaire, indicated that they received the care and support they needed. One person commented, “The staff are very nice people”. The staff were observed to interact with the residents in a positive manner and they referred to the residents in their preferred term of address. During Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 13 discussions, staff demonstrated an awareness of treating people with respect and considering their dignity when providing personal care. Policies and procedures were in place to cover all aspects of the management of medicines and were available for staff reference in the main policy and procedure file. The home operated a monitored dosage system of medication, which was dispensed into blister packs by a local pharmacist. Appropriate records were maintained in respect to the receipt, administration and disposal of medication and all staff designated to administer medication had received accredited training. Suitable arrangements were in place for the storage and administration of controlled drugs. Since the last inspection instructions about the application of prescribed creams had been added to the care plan and the storage of eye drops had been monitored. This ensured that staff had important information about how and where to apply creams and all medication had been stored safely. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were able to exercise choice and control over their lives and maintained good contact with their family and friends. The residents were provided with a nutritious and varied diet. EVIDENCE: The residents’ preferences in respect of social activities were recorded and considered as part of the assessment process. A broad range of activities were planned and implemented by the manager and staff. These included baking, flower arranging, sing songs, quizzes, bingo and dominoes. One resident who completed a questionnaire commented, “I like the dominoes”. Residents spoken to during the inspection had mixed views about the activities, with several people commenting that they preferred to rest and not join in. The residents were consulted at monthly meetings about what activities they wished to pursue. Information about forthcoming activities was displayed on the notice board and front door. On the day of the inspection the residents were observed to be watching television and chatting to staff. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 15 The residents were supported to continue with their chosen religion. Representatives from local churches visited the home on a regular basis and an ecumenical service was held every Monday for all those residents, who wished to participate. The routines were flexible and were primarily designed to meet the needs of the residents. The residents spoken to said they had a choice in the times they got up and went to bed. One person said “I can do as I please, staff help me when I need them to”. The staff were observed to seek the residents’ views throughout the inspection and the residents spoken to said they felt comfortable to comment on life in the home. The residents had the opportunity to develop and maintain important personal and family relationships. There were no restrictions placed on visiting times and residents were able to receive their guests in the privacy of their bedrooms, should they wish to do so. A relative spoken to during the inspection was satisfied with the quality of care. One person commented, “I am always kept well informed and the staff are very welcoming”. The residents spoken to said they liked the food provided. Since the last inspection a choice of meal had been introduced at lunch times. Residents were asked prior to each meal what choice they wished to make. Breakfast was served throughout the morning to suit the preferences of residents, who wished to have lie in. The menu was displayed on the wall in the dining area. Menu planning was discussed with the residents at the monthly meetings and all residents were able to make suggestions for forthcoming meals. The meal served on the day inspection was plentiful and well presented. Residents were given sensitive and appropriate support to eat their meals. Drinks and snacks were served throughout the day and at other times on request. Since the previous visit, the staff had received basic nutrition training, which emphasised the benefits of good hydration and the need to provide suitable aids to ensure the residents were able to eat their food with dignity. The staff spoken to had found this training useful and informative. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were able to express their views and had access to a clear complaints procedure. Policies and procedures were in place to respond effectively to any allegations or suspicions of abuse. EVIDENCE: Both informal and formal arrangements were in place to ensure the registered manager and staff listened to and acted on the views and concerns of residents. This was achieved during daily conversation, one to one discussion, satisfaction questionnaires and residents’ meetings. The residents spoken to said they felt comfortable expressing their views and were aware of whom to speak to in the event of a concern. The complaints procedure was included in the statement of purpose and service users guide. The residents had been issued with their personal copy of the complaints procedure as part of the service users guide. The procedure contained the necessary information and included the relevant telephone numbers should a resident wish to raise a concern. According to information supplied in the AQAA the registered manager had not received any complaints during the last twelve months. An appropriate recording system was in place in the event of a complaint being made. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 17 Policies and procedures for safeguarding vulnerable adults were available and provided guidance to staff should they suspect or witness any harmful practice. These issues were incorporated into the induction training and staff received specific tuition as part of their NVQ training and by means of a training DVD, with an accompanying questionnaire. The latter tested the staffs’ knowledge to ensure they had a full understanding of this important area. The staff also had access to a whistle blowing procedure. The issues associated with the protection of vulnerable adults were a recurrent theme throughout all staff training. This meant the staff were aware of the different types and where to direct any concerns. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents were provided with a clean, pleasant and well-maintained environment, which promoted their comfort and independence. EVIDENCE: Greycroft is a detached property set in its own grounds. Accommodation was provided in 12 single rooms and one double bedroom. The latter had an ensuite facility. Communal space was provided in 1 lounge, a conservatory and a dining area. Since the last inspection, the dining facilities had been moved into the smaller lounge and the conservatory was used as a sitting room. This change was designed to give the residents more light and a better view. The residents were consulted at a residents’ meeting, before any changes were made and all the residents spoken to said they preferred to sit in the conservatory. One person said, “I enjoy watching people and the traffic go by”. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 19 The toilets and bathrooms are within easy reach of the residents’ accommodation. The residents had free movement around the home and were able to choose where they wished to spend their time. Residents were observed to be sitting in different parts of the home during the inspection. It was evident from a partial tour of the premises that residents had personalised their rooms with their own belongings and decoration was a satisfactory standard throughout. The residents said they liked their bedroom, one person said, “I like my room, it suits me fine”. Since the last inspection, several improvements had been made to the premises. A lock had been placed on the toilet door on the ground floor, the stair lift had been extended to fit round the whole stair case, several bedroom rooms and the hallway had been repainted and some bedrooms had been fitted with new furniture and carpet. A fence had also been placed round the outside bins and a handrail had been added to the main ramp up to the front door. Established arrangements were in place to report repairs and routine maintenance appropriate records were maintained of the work completed. A person was readily available to carry out the general maintenance. This meant any routine problems with the building were promptly rectified. The home was clean and odour free at the time of the inspection. The residents spoken to said that a good level of hygiene was maintained at all times. All the residents who completed a questionnaire indicated that the home was “always” fresh and clean. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefited from well-trained and competent staff. EVIDENCE: A staff duty roster was drawn up in advance and provided a record of the number of hours worked by staff in the home. The roster seen indicated that at least two members of staff were on duty 8.00 am to 11.00 pm. During the night one member of staff was on waking watch and one member of staff slept in on the premises. The registered provider confirmed that all staff providing personal care were aged over 18 and all staff left in charge of the building were aged over 21. According to the information provided in the AQAA the there was a low turnover of staff and agency staff were not employed. A recruitment and selection procedure was available and a checklist was used to track documentation required for the recruitment of new staff. The files of two new members of staff were looked at in detail. It was evident all the applicants had completed an application form and had attended the home for an interview. CRB (Criminal Records Bureau) and POVA (Protection of Vulnerable Adults) checks had been obtained. Since the last inspection, the registered manager had ensured that all applicants had supplied a full working history along with a written explanation of any gaps. Whilst only one current Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 21 reference had been obtained for one person, it was noted that a copy of a reference dated 2007 was available on file. A further written reference was attained after the person commenced working in the home. Arrangements were in place for all new employees to undertake an in house induction programme and complete a “Skills for Care” induction. The latter provided underpinning knowledge for NVQ level 2. According to information supplied by the registered provider, seven out of nine members of staff had achieved NVQ level 2 or above, which equated to 77 of the overall staff team. All the staff who completed a questionnaire confirmed they received training relevant to their role and all commented that they were well supported by the management team with any training needs. Staff attended both internal and external training courses and had at least three paid days training a year. It was noted all the staff had a training and development profile and there was an overall staff training plan. This meant the manager could readily identify future training needs for individual staff and for the staff team as a whole. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management and administration practices were effective in ensuring the home was run in the best interests of the residents. EVIDENCE: The registered manager had overall responsibility for the management of the home and had completed the Registered Manager’s Award and NVQ level 4 in Care. The manager had been registered at Greycroft for three years and prior to this had several years experience working in various residential settings. Since the last inspection, the registered manager had attended various courses to update her knowledge and skills. These included moving and handling, first aid and health and safety. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 23 The management approach was consultative and there were established ways of working to consult the staff and residents on an ongoing basis. Relationships within the home were positive and staff spoke to and about the residents with respect. There was a programme in place for staff supervision and the topics discussed during supervision were recorded on a suitable format. All staff had received formal supervision six times a year and had an annual appraisal of their work performance once a year. In addition to supervision, staff were given the opportunity to attend regular staff meetings. This meant that the staff were able to share experiences and discuss future developments. The service achieved an Investors in People Award in 2004, which was reaccredited in 2007. The registered manager had developed a quality assurance system to monitor the quality of the service received by people living in the home. Satisfaction questionnaires had been distributed to residents in March 2008. The results of the questionnaires had been collated and fed back to all interested parties, to inform them of the outcome of the survey. Audit systems were in place for many aspects of the operation of the care home, for instance care planning and staff training. A development plan had been produced setting out the objectives for the forthcoming year based on the results of the quality monitoring process. This document linked with the AQAA questionnaire submitted to the Commission. All sections of the AQAA were fully completed and the information provided gave a clear picture of the current situation within the service and the planned areas for development. Arrangements were in place for handling money deposited with the home by or on behalf of a resident. A random check of monies was found to be correct. The registered provider reported that computerised records had been maintained of charges made and received in respect of fees. This meant the residents’ financial affairs were safeguarded. There was a set of health and safety procedures available, which included the safe storage of hazardous substances. Staff received health and safety training, which included moving and handling, food hygiene, first aid, fire safety and infection control. Documentation seen during the inspection and information supplied in the AQAA indicated the electrical, gas and fire systems had been serviced at regular intervals. The fire log demonstrated the staff had received instruction about the fire procedures during their induction. Risk assessments had been completed in respect to safe working practice topics. Arrangements were in place to record accidents and incidents in the home and the Commission had been notified as appropriate of any significant event in the home. Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation 17, 18, 19 Schedule 2 (as amended) Requirement All records and checks for new members of staff must be collated and maintained in line with the Care Homes Regulations 2001. This includes obtaining two current written references, prior to employment. This is to ensure the staff are properly vetted and the residents are fully protected. Timescale for action 17/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Greycroft Residential Care Home DS0000063677.V367595.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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