Greenfield Park Care Centre Care Home Service Adults 291 Myreside Street Carntyne Glasgow G32 6BX Telephone:

Transcription

1 Greenfield Park Care Centre Care Home Service Adults 291 Myreside Street Carntyne Glasgow G32 6BX Telephone: Inspected by: Linda Kemp Type of inspection: Unannounced Inspection completed on: 21 September 2011

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 10 4 Other information 21 5 Summary of grades 22 6 Inspection and grading history 22 Service provided by: Southern Cross Home Properties Limited Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Linda Kemp Telephone enquiries@scswis.com Greenfield Park Care Centre, page 2 of 24

3 Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 5 Very Good Quality of Environment Quality of Staffing N/A N/A Quality of Management and Leadership 5 Very Good What the service does well The service was providing a very good standard of care and support to residents and their carers. We saw evidence of real strengths of involving people in ways that were meaningful to them. There was a lot of evidence of feedback from all stakeholders directing service improvements and developments. There was evidence of strong, effective management and leadership practices throughout the service including robust systems to ensure very good standards of quality. What the service could do better The service should continue to progress the area of resident and carer participation using alternative formats. This had clearly been of benefit to people using the service and was ensuring a more inclusive approach. What the service has done since the last inspection The service had continued to ensure that the people who use the service were involved in ways that were meaningful to them. Greenfield Park Care Centre, page 3 of 24

4 The service had continued to ensure that all its staff maintained their level of knowledge and skills and that they received appropriate support and guidance. There were very good standards for involvement of service users and family carers and the service was able to show that they actively listened and there was evidence of improvements to the quality of care as a result of this. There was a high standard of performance in meeting the standards examined during this inspection. Conclusion The service was thought highly of by residents and carers. We witnessed several areas of good practice during the inspection. The staff team was committed to delivering a high standard of individual care to the residents. The home environment was safe, warm and homely. Who did this inspection Linda Kemp Greenfield Park Care Centre, page 4 of 24

5 1 About the service we inspected Social Care and Social Work Improvement Scotland (Care Inspectorate) regulates care services in Scotland. It awards grades for services based on the findings of inspections. These grades, including any that services were previously awarded by the Care Commission, are available on Greenfield Park Care Centre is a care home service provided by Southern Cross Healthcare. It is situated on an industrial estate in the Carntyne area of Glasgow and is near to Carntyne railway station; there are also bus routes nearby. There is car parking to the front and side of the building and there are gardens around the building as well as a courtyard area in the centre. The building has two wings with two care houses in each wing. Each care house has its own name: Roselea unit provides care with nursing for 30 older people on both a long term and short term basis and is contracted by Glasgow City Council. Oakley unit and Findlay unit provide NHS continuing care and NHS short term care for 60 older people. Westerfields unit opened in April 2010 and has 10 beds for adults with acquired brain injury. Westerfields unit has its own entrance and garden area. It also has a kitchen for the use of service users. Roselea unit has two designated beds for respite care. The care houses comprise of 30 single bedrooms with en-suite toilet and washbasin. There is a communal dining room and a small kitchen servery. There is a conservatory in each unit with access to the central courtyard. In addition there is a small lounge area off the conservatory and a small lounge opposite the dining room. Oakley unit has an activities room which is used regularly by the Activities Coordinator. Findlay unit has a "Bistro" which can be used by visitors and service users. This room is also used as a lounge and activity room. Findlay unit also use their conservatory as an art room with "art in hospital" tutors available to service users twice a week. Before 1 April 2011 this service was registered with the Care Commission. On this date the new scrutiny body, Social Care and Social Work Improvement Scotland (Care Inspectorate), took over the work of the Care Commission, including the registration of care services. This means that from 1 April this service continued its registration under the new body, Care Inspectorate. Southern Cross has a mission statement and the philosophy of care is detailed in the service user guide. Greenfield Park Care Centre, page 5 of 24

6 Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 5 - Very Good Quality of Environment - N/A Quality of Staffing - N/A Quality of Management and Leadership - Grade 5 - Very Good This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website or by calling us on or visiting one of our offices. Greenfield Park Care Centre, page 6 of 24

7 2 How we inspected this service The level of inspection we carried out In this service we carried out a high intensity inspection. We carry out these inspections where we have assessed the service may need a more intense inspection. What we did during the inspection We undertook a high intensity inspection of this service and assessed the service's performance against two of our quality themes. This unannounced inspection was undertaken during the day on 21 September 2011 by Linda Kemp, inspector. The service was given feedback on 21 September. Before our inspection, the service provided us with an annual return and a self assessment as requested by us. We used some of this information to plan our inspection activities. During our inspection we gathered information from various sources including the relevant sections of policies, procedures, records and other documents, including: Evidence from the service's most recent action plans and communications to us Personal plans of people who use the service Medication records Training records Accident and incident records Complaints records Activities programme and records Staff rotas Minutes of meetings which had been held for relatives, service users and staff. The service's own quality assurance documents. We also had discussions with various people including: the service manager, deputy manager, nurses, care assistants, activities staff, catering and housekeeping staff, and residents and their carers and visitors. We observed staff working with residents. We also looked at the home environment. Greenfield Park Care Centre, page 7 of 24

8 Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at Greenfield Park Care Centre, page 8 of 24

9 The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic. Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. The service submitted an annual return and self assessment as requested by us. We used some of this information to plan our inspection. The services' self assessment was detailed and accurate. Taking the views of people using the care service into account We met with residents in all of the care units. We were given positive comments about Greenfield Park and about the staff. Here are some comments from residents: 'The food is a lot better, they changed the menu because we didn't like it' 'I can get out when I want' 'The staff are just great' 'This place is just like a home from home, the staff make me feel good and give me all the help I need' 'I've got everything I need here' 'The staff are helping me get on my feet - I'm doing well' Taking carers' views into account We met with four visiting carers during our visit. We also looked at some cards and letters that carers had sent to the service. Here are some carers' comments: 'To get my mum in here has been a blessing' 'There is not one thing I can say negatively about the place' 'All mum's agitation has gone - she has a better quality of life here' 'Sometimes I feel there's not enough staff, but I've brought this up at the meetings' 'The care is very good, my dad is always comfortable' Greenfield Park Care Centre, page 9 of 24

10 3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Overall grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths We found this service had an excellent performance in the areas covered by this statement. We concluded this after we: - talked with the service manager, deputy managers, care staff, residents and visitors - looked at information in residents' personal plans - looked at the minutes of residents' and carers' meetings - looked at notice boards - looked at documentation about events that had taken place within the service - observed staff working with the residents. There was a well developed participation strategy used by the service. This encouraged residents, carers and relatives to get involved and gave opportunities for feedback at a variety of forums. The personal plans that we looked at had been signed by the resident or their relative and the risk assessments detailed who had been involved with the agreed plans of care. There had been regular review meetings and these were forward planned to ensure that none were missed. The minutes of the care review meetings were detailed and described discussions and outcomes. We saw evidence of outcomes being actioned and followed up. Greenfield Park Care Centre, page 10 of 24

11 We were particularly impressed with the progress of resident participation in the Westerfields Unit. Invitations, minutes and outcomes were documented in pictorial formats for ease of understanding. The Westerfields residents sent their own invitations and agenda to carers and other professionals, requesting they attend their care reviews. Some of the personal plans had been developed using visual aids to maximise residents' involvement and understanding. There was a schedule of meetings throughout the year for both service users and relatives. The service had worked with The Advocacy Project. This allowed independent facilitation of resident meetings as well as one to ones to assist in greater involvement in decisions about the service. This was very good practice. The outcomes of all participation activities were clearly displayed throughout the service in a variety of formats, and we saw significant evidence of feedback from all stakeholders directing service improvements and developments on an ongoing basis. Areas for improvement The service should continue to pursue innovative practice in respect of participation to ensure it sustains the current standard of performance. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service user's health and wellbeing needs are met. Service strengths We found this service had a very good performance in the areas covered by this statement. We concluded this after we: - talked with the service manager, deputy managers, care staff, residents and visitors - looked at information in residents' personal plans - looked at medication prescriptions and records - looked at accident and incident records - looked at menus and observed meal times - observed staff working with the residents - looked at the service's own quality systems. Greenfield Park Care Centre, page 11 of 24

12 The residents that we met with looked well and told us they were being well looked after at Greenfield Park. Carers were also very complimentary about the standard of care and support of their relatives. We saw evidence of best practice in some care areas such as nutrition, care of skin, end of life and palliative care. There was good support of residents who experienced behaviour changes as a result of their illness. We were pleased to note that there were few prescriptions for behaviour modifying medications, and that the few prescriptions there were had been reviewed regularly. There was input from a variety of other care professionals and we noted that their advice was actioned by the home staff. The quality of the personal plans we looked at was very good. Care plans and risk assessments were current and relevant and we saw evidence of regular review and updating. We saw evidence of a true person centred approach to providing care and support, particularly in the Westerfields unit. There was a strong focus on quality of day to day life and residents being supported to maintain their independence and sense of responsibility. Guardianship orders had been reviewed and were up to date to ensure that all staff knew who the guardian was and that the guardian was given opportunities for involvement in care decisions and agreeing plans of care. Adults with Incapacity Certificates were also up to date. Recognition of respect for residents' dignity was being actively promoted throughout the service. We saw this reflected in the way that staff engaged with residents and in the way they undertook their care and support duties. Some staff had trained as champions or leads for some key care areas such as infection control and nutrition: these staff were a valuable resource to the staff team. There was a very positive friendly and social atmosphere within all of the care units. We saw care being delivered to a very good standard by a motivated and skilled team of staff. Greenfield Park Care Centre, page 12 of 24

13 Areas for improvement Some of the staff told us that care and support in Westerfields unit could be further developed with the input from other care professionals such as an Occupational Therapist and Physiotherapist. This provision should be further considered by the service. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 7 Not applicable Statement 8 Living with life limiting conditions is viewed as an integral part of life in this care home. Service strengths We found this service had a very good performance in the areas covered by this statement. We concluded this after we: - talked with the service manager, deputy managers, care staff, residents and visitors - looked at information in residents' personal plans - looked at medication prescriptions and records - observed staff working with the residents - looked at the service's own quality systems. The service had adopted best practice guidelines in respect of end of life care. The Liverpool Care Pathway was being used with good effect. We saw evidence of good management of symptoms such as poor appetite and all types of pain. There were strong links with the Marie Curie nursing service and most staff had been trained to deliver palliative care. This training had also been extended to all the care home staff. The staff we talked to were well informed about this area of care practice, and told us how they supported residents and their families. The personal plans we looked at contained notes about residents' and their families' wishes should their health deteriorate, and we saw evidence of these wishes being recognised and supported by the staff team. Greenfield Park Care Centre, page 13 of 24

14 A quiet, comfortable private room was available to relatives, as were refreshments and the facility to stay in the home overnight. Areas for improvement The service should continue to develop this area of practice with its focus on supporting residents with communication support needs due to dementia. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Greenfield Park Care Centre, page 14 of 24

15 Quality Theme 2: Quality of Environment - NOT ASSESSED Greenfield Park Care Centre, page 15 of 24

16 Quality Theme 3: Quality of Staffing - NOT ASSESSED Greenfield Park Care Centre, page 16 of 24

17 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the management and leadership of the service. Service strengths We found this service had an excellent performance in the areas covered by this statement. We concluded this after we: - talked with the service manager, deputy managers, care staff, residents and visitors - looked at the minutes of residents' and carers' meetings - looked at notice boards - looked at documentation about events that had taken place within the service - observed staff working with the residents - looked at the service's own quality assurance systems. Residents and carers that we talked to spoke very highly of the management team within the service. They told us they were friendly and approachable, and that they felt comfortable to raise any issues. There were regular meetings for residents and carers and satisfaction surveys had been distributed. We saw evidence of outcomes being actioned, for example, the provision of 'pool' mobile phones and radios for residents' use and improved snacks provisions. Complaints and concerns were dealt with effectively, and the outcomes from complaints investigations were detailed in the service's improvement plan. People that we talked to told us they had been kept well informed about the issues affecting Southern Cross, and about the change of service provider. We noted that there was a lot of communication in this respect on the notice boards in the reception and in the care units. We saw evidence of prompt management responses to issues and concerns. For example, concerns about staff communication skills had resulted in customer care and values training for all the staff. During the inspection we noted that the manager maintained a high profile in the care units, and exercised good open communication with residents, visitors and staff. Greenfield Park Care Centre, page 17 of 24

18 Areas for improvement The service should ensure that it maintains its current level of communication with all relevant stakeholders during the change of provider period. The service's newsletter may be useful in this respect. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Statement 2 We involve our workforce in determining the direction and future objectives of the service. Service strengths We found this service had a very good performance in the areas covered by this statement. We concluded this after we: - talked with the service manager, deputy managers, and care staff - looked at the minutes of staff meetings - looked at the minutes of the home development committee - looked at notice boards - looked at staff supervision records - looked at the outcomes of the recent staff survey - looked at the service's own quality assurance systems. Staff that we talked with told us they had been kept well informed about the pending changes and issues regarding Southern Cross. The staff team was optimistic about the future of the service. The staff we talked to told us that they were being given clear direction and support and had opportunity to contribute their opinions and suggestions. Staff supervision was undertaken regularly and we noted this was performance and development focused. Individual personal development plans were being undertaken for all staff members. A variety of training opportunities was available for all grades of staff within the service. A staff survey had been undertaken and outcomes had been actioned. For example, the provision of new equipment to assist staff to deliver care, a firming up of the supervision schedule and a training needs survey. Greenfield Park Care Centre, page 18 of 24

19 The manager held weekly 'open door' staff surgeries which were of benefit. All of the staff that we talked to told us they were happy working at Greenfield Park, and felt they were being given the opportunity to shape the further development of the service. We saw evidence of very good management and leadership practices within the home which was having a positive impact on the quality of the service and the care and support outcomes for both staff and the people using the service. Areas for improvement The service should consider means of further involving staff in the strategic direction of the service. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide. Service strengths We found this service had a very good performance in the areas covered by this statement. We concluded this after we: - talked with the service manager, deputy managers, care staff, residents and visitors - looked at the minutes of residents' and carers' meetings - looked at samples of surveys and action plans - looked at notice boards - looked at documentation about events that had taken place within the service - observed staff working with the residents - looked at the service''s own quality assurance systems. The strengths of the services participation activities have been discussed throughout this report, and previous comments pertain to this quality theme. The home development team had been established and was representative of residents, carers and all grades of staff. Greenfield Park Care Centre, page 19 of 24

20 Satisfaction surveys had been issued to all key stakeholders, and we saw evidence of the service's response to their feedback. For example, visitors' toilets had been upgraded at the suggestion of carers, residents had better access to an improved variety of activities, the menu had been reviewed, and the times of meetings had been changed to allow more people to attend. The service's own quality assurance systems were based on the Care Inspectorate quality themes and statements, and the management team undertook regular audits to assess the quality of the service. Key stakeholders had informed the service's response to its self assessment and grading exercise. We saw evidence of systems in place to identify risks and evidence of prompt action being taken by the service where needed. Areas for improvement The service should continue to maintain its very good performance in this area by further developing its inclusive approach. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Greenfield Park Care Centre, page 20 of 24

21 4 Other information Complaints No complaints have been upheld, or partially upheld, since the last inspection. Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information N/A Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in SCSWIS re-grading the Quality Statement within the Management and Leadership Theme as unsatisfactory (1). This will result in the Quality Theme for Management and Leadership being re-graded as Unsatisfactory (1). Greenfield Park Care Centre, page 21 of 24

22 5 Summary of grades Quality of Care and Support Very Good Statement 1 Statement 3 Statement Excellent 5 - Very Good 5 - Very Good Quality of Environment - Not Assessed Quality of Staffing - Not Assessed Quality of Management and Leadership Very Good Statement 1 Statement 2 Statement Excellent 5 - Very Good 5 - Very Good 6 Inspection and grading history Date Type Gradings 2 Nov 2010 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed 28 Jul 2010 Announced Care and support 4 - Good Environment Not Assessed Staffing Not Assessed Management and Leadership 5 - Very Good 8 Mar 2010 Unannounced Care and support 4 - Good Environment Not Assessed Staffing 4 - Good Management and Leadership Not Assessed 13 May 2009 Announced Care and support 4 - Good Environment 4 - Good Greenfield Park Care Centre, page 22 of 24

23 Staffing Management and Leadership 4 - Good 4 - Good 28 Jan 2009 Unannounced Care and support 3 - Adequate Environment 3 - Adequate Staffing 4 - Good Management and Leadership 3 - Adequate 2 Jul 2008 Announced Care and support 3 - Adequate Environment 3 - Adequate Staffing 4 - Good Management and Leadership 3 - Adequate All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Greenfield Park Care Centre, page 23 of 24

24 To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on This inspection report is published by SCSWIS. You can get more copies of this report and others by downloading it from our website: or by telephoning Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: enquiries@scswis.com Web: Greenfield Park Care Centre, page 24 of 24