Inspection on 05/02/08 for Greenwood Lodge

This is the latest available inspection report for this service, carried out on 5th February 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Greenwood Lodge 11 Barry Close Chiswell Green St. Albans Hertfordshire AL2 3HN Lead Inspector Pat House Unannounced Inspection 5th February 2008 11:00 DS0000070258.V360379.R01.S.doc Version 5.2 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 DS0000070258.V360379.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 Adults 18-65. 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. DS0000070258.V360379.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenwood Lodge Address 11 Barry Close Chiswell Green St. Albans Hertfordshire AL2 3HN 01727 872181 01727 872391 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) www.grooms-shaftesbury.org.uk Grooms-Shaftesbury Annette Sear Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6) of places DS0000070258.V360379.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th February 2007 Brief Description of the Service: Greenwood Lodge is a detached chalet-style house set in a quiet cul-de-sac in a residential part of St Albans. The home has been extended and converted to provide a residential care home for six people with a learning disability. The premises comprises of six single bedrooms, four on the first floor and two on the ground floor. There is a large kitchen, a combined lounge/dining room and an adjoining conservatory. The home has easy access to St Albans City centre, which has good transport links and extensive shops and leisure facilities. The home’s Statement of Purpose, Service User’s Guide and last inspection report are available in the office. Current fees for accommodation at the home are £745 per week. DS0000070258.V360379.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 star. This means the people who use this service experience good quality outcomes. The information in this report is based on an unannounced visit to the home by one regulation inspector carrying out the work of the Commission. For the purposes of this report the Commission will be referred to as ‘we’. The inspection took place over part of one day. The manager was not on duty during the visit but the two staff members on duty provided all the information and assistance we required. There were two service users in the home during the visit and we spoke briefly with these people. We visited all areas of the home and a selection of records was examined. What the service does well: What has improved since the last inspection? The Policies and Procedures have been updated and more staff training has taken place. More general risk assessments for the home have been completed; including those for windows that have no restrictors fitted, which ensures people are kept safe from accidents. DS0000070258.V360379.R01.S.doc Version 5.2 Page 6 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. DS0000070258.V360379.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000070258.V360379.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are provided with detailed information and have their needs fully assessed so that all parties can be sure the home is appropriate and that all individual needs can be met. EVIDENCE: We were given a copy of the home’s Statement of Purpose/ Service User’s Guide and staff we spoke with said that all residents and families have copies of the document. There have been no new service users admitted to the home since the last inspection and all records examined showed that current service users had full assessments completed prior to entry. Staff said that detailed information would be sought for any new referrals to the home. DS0000070258.V360379.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported to make their own decisions about their daily lives and records detail the associated risk assessments and individual goals so that staff are aware of how best to provide care. EVIDENCE: We looked at a selection of care plans and these were well documented and contained relevant details of individual needs and how the residents concerned liked their needs to be met. Records were up to date, with reviews documented and risk assessments in place. However, we felt that a wider selection of risk assessments were needed to ensure that all areas of the residents’ daily lives had been considered e.g. going out and more detailed specific individual needs. This discussed with the deputy manager during the inspection feedback. DS0000070258.V360379.R01.S.doc Version 5.2 Page 10 Staff said that care planning was continually being reviewed to make the records more meaningful. There was evidence that service users were involved in care planning. Care plans also document how residents in the home are supported to make their own decisions about their daily lives. The residents we spoke with confirmed they chose what day facilities they attend and made decisions about bed times and meals. DS0000070258.V360379.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that staff provide appropriate support so that residents can take part in the local community and leisure activities. Varied meals are provided which residents enjoy and which promote their wellbeing. EVIDENCE: As we were aware from the previous inspection, none of the current service users in the home are in employment and two feel themselves to be ‘retired’. However, residents are involved in a variety of day services and clubs and we saw records of attendance at these centres. Residents told us they enjoyed outings to local pubs and entertainment and staff told us that neighbours are invited to the home’s summer barbeques. The home also has its own vehicle DS0000070258.V360379.R01.S.doc Version 5.2 Page 12 for providing trips out. Residents we spoke with said that visitors to the home were welcomed at all times. Domestic tasks are shared amongst the residents and we saw a rota for this on the wall. Staff said that residents take part in cooking with their support. All residents have bedroom and outside door keys although staff said that most choose not to use these. The home has two resident cats. Residents and staff usually eat meals together and the people we spoke with said they enjoyed the food and said they all had input into choosing the daily menus. Staff ensure that meals are well balanced and during the visit we saw a wide variety of fruit left out for people to take whenever they wanted. DS0000070258.V360379.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures in the home ensure that, in general, people who use the service are protected and have their needs met in a way they prefer. Additional staff training in the system for administering medication has taken place since the inspection and residents are now fully protected from drug error. EVIDENCE: The residents who spoke with us said they were happy with the support staff provided with their personal care and made their own choices about the clothes they wear. Details of health care and health professionals’ referrals were seen documented on care plans. At the previous inspection two Health professionals spoke with us and said they had good relations with staff in the home, and that care staff provided good support to the residents. We checked the system in operation for staff to administer medication to residents. All staff members have medication training and are observed when giving drugs and have competency authorised by a senior. Evidence of this is DS0000070258.V360379.R01.S.doc Version 5.2 Page 14 kept on staff records. However, an external company provides the training and we recommended at this visit that training be provided for all staff in the system specific to this home. This is to ensure that every member of staff follows the same system and that residents are protected from drug errors. Since this inspection took place the manager has provided evidence that all staff have now received in-house training in the home’ system for administering medication. We also recommended that two staff members sign any handwritten information on medication records to ensure accuracy and that totals of nonpackaged tablets have carry forward totals written on to new record sheets, to ensure audits can easily take place and the recent training has covered these areas. The manager has also confirmed that a revised system for recording the administration of a general stock of paracetamol has also been installed and that the home has purchased a record book for recording any controlled drugs which might be prescribed in the future, as required by the pharmaceutical society. DS0000070258.V360379.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that the procedures followed in the home ensure that the residents are protected from abuse and have their concerns listened to. EVIDENCE: The home has written policies for making a complaint, and for Safeguarding Adults and Whistle Blowing. We looked at the Complaints Book and the home also has an audiocassette for residents, which details the complaints procedure. Those residents we spoke with said they would not hesitate to tell staff if they had a concern. Staff induction training includes Safeguarding Adults procedures and all staff receive further in-depth training on this topic. The personal allowance and financial records for one resident was tracked and we saw details of their bank account, records, receipts and monies, which were all in order. DS0000070258.V360379.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents of the home enjoy their surroundings, which are comfortable, clean and well maintained. EVIDENCE: We visited all areas of the home and all were seen to be clean and well maintained. Residents said they were happy and comfortable in the home. The bedrooms we looked at were well decorated and personalised with people’s own possessions. The bedroom of one resident was being decorated at the time and staff said this person had chosen their own colour scheme. The garden looked attractive and residents said they enjoyed going out there in the good weather. Liquid soap and paper towels were in use throughout the building and staff said there were always supplies of disposable gloves and protective clothing DS0000070258.V360379.R01.S.doc Version 5.2 Page 17 available to support good infection control procedures. The laundry was clean and had appropriate equipment in place. DS0000070258.V360379.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are protected by robust recruitment procedures and benefit from the support they receive from competent and well-trained staff. EVIDENCE: Care staff we spoke with said that they undertake LDAF basic training and that some staff are now registered to do NVQ training. We looked at a selection of training records and these showed that a wide variety of courses were provide for staff, both basic and specialised. There is a training overview kept electronically which indicates where new courses are needed. The recruitment records for two members of staff were examined and evidence of all appropriate checks was seen including two written references. Staff contracts are issued and we saw copies on the files examined. The staff we spoke with also said they had received very good induction training when they first started work at the home. DS0000070258.V360379.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from living in a well run home where procedures ensure that health and safety are promoted and where residents’ views influence how the home is managed. EVIDENCE: Both the home’s manager and deputy have the Advanced Management in Care qualification and the residents and staff members we spoke with confirmed that the home is well run. All appropriate policies were in place and have all been recently updated. The home’s registration certificate was displayed on the wall and this reflected the recent change of ownership of the home. DS0000070258.V360379.R01.S.doc Version 5.2 Page 20 The home operates a formal Quality Assurance programme and families and stakeholders are consulted twice each year. Residents have questionnaires produced on audiotape and have their views reflected in this way and through regular informal meetings, which are minuted. The minutes of staff and residents’ meetings were available during the inspection. Service checks on equipment, lighting and heating were all up to date and the accident book was well documented. We looked at the fire records and these showed when alarms were tested and when drills took place. Records also detailed what happened during fire drills and if any actions were needed. General risk assessments are completed for all areas of the home and these now included risk assessments for bedroom windows, which do not have restrictors fitted. DS0000070258.V360379.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x DS0000070258.V360379.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action 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 DS0000070258.V360379.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 DS0000070258.V360379.R01.S.doc Version 5.2 Page 24 - 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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