Greenhills Care Home Care Home Service

Transcription

1 Greenhills Care Home Care Home Service Broughton Road Biggar ML12 6HA Telephone: Type of inspection: Unannounced Inspection completed on: 10 April 2018 Service provided by: Thistle Healthcare Limited Service provider number: SP Care service number: CS

2 About the service Greenhills Care Home is owned and managed by Thistle Healthcare Limited and was registered with the Care Commission in April The home is registered to provide care and support for up to forty-five residents with physical and cognitive impairment. The home is situated within a quiet, residential area of Biggar and is accessible to public transport links, local shops and amenities. All bedrooms have full en-suite facilities and people are encouraged to bring in their own furnishings and decorate their rooms to their own preference. There are two communal lounge and dining areas, hairdressing and pantry areas for staff and relatives to use. The garden provides seated areas for residents and relatives to enjoy with lovely open views over the surrounding countryside. The home aims to "ensure residents, including those who live with dementia are supported in a person-centred environment, feel valued and respected as individuals". At the time of this inspection there were forty-four residents residing here. What people told us Prior to this inspection we issued fifteen Care Standards Questionnaires to people using the service as well as relatives/carers. At the time we carried out this inspection we received one completed questionnaire from a resident and five from relatives/carers. Three of which strongly agreed and three agreed that overall they were happy with the quality of care and support provided. We also spoke to three residents and one relative/carer during the inspection process. Some of the comments we received were as follows; "I like it here, lovely view the food is good and there's lots of choice" "I get out in the minibus, there lots of activities and love the surroundings. The food is good and can get up and go to bed when I want, can also make coffee when I want" "Lovely views, nice food, staff are all very nice" "the staff are hard workers, friendly and caring. There is a good variety of outings and entertainment for residents which they appear to enjoy. Relatives and visitors are always made welcome" "the staff are kind and friendly, supportive and always try to meet my relatives needs despite the number of residents with dementia having challenging behaviour the staff appear to mange the situations in a fair and caring manner and the atmosphere within the home is positive and homely" "access to the gardens is in need of repair, the uneven paths make it difficult to push a wheelchair" page 2 of 8

3 Self assessment The Care Inspectorate did not request the service submit a self-assessment as part of this years inspection process. From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership not assessed not assessed What the service does well Residents appeared settled and well cared for, we saw nice staff interaction who knew residents well and supported them to make choices. There was a range of activities offered and we saw residents, relatives and staff enjoying a daily morning exercise class promoting movement and interaction. The service has established a number of links with local businesses and continues to encourage and facilitate outings to the local community which residents continue to enjoy. The service continues to encourage and involve residents, their representatives and staff in discussions about the service and how the outcomes can be improved for those living in the home. This included regular reviews, meetings and a suggestion box. Care plans provided some good person centred information with up to date risk assessments. Pictorial plans provided a quick reference to individual needs followed by more detailed information which was evaluated monthly and reviewed minimally every six months to ensure people were happy with the service provided. Medication was stored safely and securely. We looked at the medication administration charts where there were a few instances of people missing their medication at night as asleep however on the whole the majority of these were completed well. These were audited by the local pharmacy and manager to ensure safe practice. Maintenance issues were recorded and there were up to date safety certificates for appliances and equipment to ensure a safe environment. Accidents and incidents were recorded and analysed and we could see that appropriate advice was sought from external professionals if concerns were identified. In some cases the manager had identified that staff required further training in the management of stress and distress and his had been actioned to ensure residents were supported by a competent staff team. We looked at recruitment files and were satisfied that staff were recruited safely. Relevant safety checks and references were in place with involvement from residents who assisted the manager in the selection process. Staff we spoke to told us they were happy and felt well supported in their role, they took part in meetings, received supervision and had access to a wide range of training opportunities. There was an annual training matrix which identified staffs training requirements and a senior development programme was about to commence in all Thistle services. This twelve week programme promotes management and leadership page 3 of 8

4 skills by encouraging self learning and reflection on a wide range of training. We look forward to seeing how this has progressed a future inspections. What the service could do better We followed up on two requirements made at previous inspections. We can see some progress had been made however further work is still required relating to the care plan documentation and additional records of support and nursing intervention. These two requirements are repeated. Although we could see activities were taking place improvements were needed in how the staff recorded these which the manager had already identified. Better recording of activities will inform people of what is planned and assist staff in assessing how effective these have been when planning events for the future. We found the home clean and tidy however some of the furniture looks old and worn and the garden area requires attention. The paving is uneven in places posing a risk of trips and falls to residents and visitors. We discussed this with the manager who was aware of this and assured us this would be reviewed as apart of the ongoing refurbishment programme. The refurbishment/development plan for the service needed updating. We saw last years plan which identified areas for improvement however this had not been fully completed to demonstrate if identified actions had been completed. We acknowledge there has been changes to the senior management structure of the company which has had an impact on all services and were assured this would be updated and reviewed accordingly. We will continue to review this at future inspections. We found gaps in some of the maintenance checks carried out routinely to ensure a safe environment. The service should make alternative arrangements in order to ensure that all the necessary safety checks continue when the maintenance person is unavailable or on leave. In addition to this the manager should audit the maintenance records to ensure they are being recorded and actioned appropriately for all areas of the home and equipment (see recommendation 1) Since the previous inspection staff have continued to work at improving the quality of information recorded within the personal plans. Further work is still required to improve these plans to include information on specific healthcare needs in particular the management of stress and distressed reactions (see requirement 1). Additional monitoring charts used for positional changes and oral hygiene still require improvement. There were gaps in these and were not being completed to demonstrate that care was actually delivered to ensure individual comfort and safety. Dietary and fluid intake charts provided a weekly record of each resident who staff were monitoring. This could be improved by recording any additional food offered as well as a weekly review and evaluation of this information which will assist staff to identify further concerns. (see requirement 2). Requirements Number of requirements: 2 1. The service must ensure that individual's personal plans are up-to-date and provide detailed information to ensure that the care required is accurately documented and delivered. Where there is a specific health care need identified that a relevant care plan is developed and regularly evaluated to ensure that the individual is page 4 of 8

5 appropriately supported by staff who are knowledgeable and competent in managing their needs, including the management of stress and distressed reactions. This is in order to comply with The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI2011/210) Regulation 5(b)(ii) Personal Plans. Timescale for implementation; to commence upon receipt of this report and be completed by: 31 December The service must develop a suitable monitoring chart for staff to record any nursing or social intervention provided to residents who are in their rooms through choice or ill health. All monitoring records in use must provide an accurate, up to date account of any support provided to individuals. All written records must be completed within a reasonable timescale following any support provided. The manager must ensure that all healthcare monitoring records are checked at least once in every twenty-four hour period and where gaps are identified that this is actioned immediately to ensure the well-being of the individual. This is in order to comply with: The Social care and Social Work Improvement Scotland (Requirements for Care services) Regulations 2011 (SSI 2011/210), Regulation 4(1) (a) - Welfare of users. Timescale for implementation; to commence upon receipt of this report and be completed by 31 December Recommendations Number of recommendations: 1 1. The manager should ensure that when the maintenance person is unavailable that there are alternative arrangements in place to ensure all the necessary safety checks and day-to-day maintenance issues are being dealt with to ensure a safe and secure environment. The manager should introduce a way of monitoring the maintenance records to ensure all actions identified have been actioned and completed. This is in order to comply with; Health and Social Care Standards 5.17 My environment is secure and safe. Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at Inspection and grading history Date Type Gradings 1 Jun 2017 Unannounced Care and support page 5 of 8

6 Date Type Gradings 19 Aug 2016 Unannounced Care and support 4 Sep 2015 Unannounced Care and support 18 Feb 2015 Unannounced Care and support 11 Nov 2014 Unannounced Care and support 19 Dec 2013 Unannounced Care and support 16 Jan 2013 Unannounced Care and support 5 - Very good 5 - Very good 30 Oct 2012 Unannounced Care and support 16 Jan 2012 Unannounced Care and support page 6 of 8

7 Date Type Gradings 19 Sep 2011 Unannounced Care and support 10 Feb 2011 Unannounced Care and support 17 Sep 2010 Announced Care and support 22 Feb 2010 Unannounced Care and support 11 Nov 2009 Announced Care and support 15 Jun 2009 Unannounced Care and support 9 Jun 2008 Care and support 2 - Weak 2 - Weak 2 - Weak page 7 of 8

8 To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. You can also read more about our work online at Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com Find us on Facebook Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 8 of 8