Inspection on 13/06/07 for 13 Greenway Park

This inspection was carried out on 13th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

Other inspections for this house

13 Greenway Park 10/01/06

13 Greenway Park 30/06/05

13 Greenway Park 04/02/05

13 Greenway Park 30/09/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Greenway Park (13) 13 Greenway Park Chippenham Wiltshire SN15 1QG Lead Inspector Tim Goadby Unannounced Inspection 13th June 2007 09:40 Greenway Park (13) DS0000028295.V337033.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 Greenway Park (13) DS0000028295.V337033.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. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenway Park (13) Address 13 Greenway Park Chippenham Wiltshire SN15 1QG 01249 443965 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) Mr Philip Taylor Mrs Rhianydd Taylor, Mr Gregory Stephen Tennant Mr Philip Taylor Mr Gregory Stephen Tennant Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2006 Brief Description of the Service: 13 Greenway Park provides care and accommodation for eight adults with a learning disability. Service users receive support with a range of social and behavioural needs. The majority of the current group have lived in the home for over ten years. Respite care and short-term placements are not available. The service is one of a group of three care homes in Chippenham, which together are known as the Cocklebury Farmhouse Homes. This is a private organisation. The owner/managers founded the company in the late 1980s. They remain closely involved in all aspects of its daily operation. This includes regularly working in each of the services. The property is close to the centre of Chippenham. The town offers various amenities, including shops, bars, restaurants, parks, a leisure centre with swimming pool, and a cinema. Rail and road links to Bath and Bristol are available. Service users regularly access a wide range of local amenities. This is a key feature of the programme within this organisations homes. The home is a detached and well maintained property. It stands in its own grounds, opposite a public park. There is a large garden to the rear, and a car parking area at the front. The accommodation is on two floors. There are six single bedrooms. One room is shared by two service users. All current service users at Greenway Park have been within the Cocklebury Farmhouse homes since at least 1991. They are all funded by various local authorities. Fees for care and accommodation of any new service user would be based upon an individual assessment of their needs. Information about the home includes a welcome pack, Statement of Purpose and a Service User Guide which has been produced in an accessible version, with the use of photos and pictures to support the text. It includes details about the CSCI and our inspection reports. The organisation is also considering developing a website. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was completed in June 2007. The process included a review of regulatory contact since the previous inspection in January 2006. The service completed an Annual Quality Assurance Assessment document (the AQAA). Survey forms were distributed, and responses were received from all eight service users and eight members of staff. Service users were supported to complete their forms. Where relevant, findings have also been included from the May 2007 inspection of one of the organisation’s other homes. This visit, conducted by two inspectors, considered some issues which apply across all three homes, such as the organisation’s arrangements for quality assurance. An unannounced visit took place to Greenway Park. This fieldwork included sampling of records, with case tracking; a tour of the premises; sampling a meal; and discussions with service users, staff and management. What the service does well: Greenway Park is a well established service with a clear approach to promoting quality of life for its users. Everyone living at the home receives regular input to access a wide range of opportunities. The home has succeeded in this approach with people who have had difficulty in other settings. Service users have their needs and aspirations met. Individual plans and other documents reflect the assessed and changing needs and goals of each service user. The ways in which to support them, and the reasons for these, are clearly shown. If any restrictions are needed, these are fully explained. The consent of relevant parties is also shown. There is a strong focus on the provision of activities and opportunities for all service users, which gives them a full, active and interesting life. Activities are provided on a daily basis, both at home and in the wider community. A range of opportunities are offered, ensuring that all service users have a choice of things likely to appeal to them. Some sessions repeat regularly, to the benefit of those who enjoy the security and familiarity of routines. Flexibility is also available. Some activities are on a group basis, whereas others may be individual. Service users are enabled to be independent when they are safe and competent to do so. Physical exercise is a key component of many activities, helping with health promotion. All service users also have access to periodic outings and holidays, in line with their known needs and preferences. Service users can be confident they will all have equal access to opportunities likely to be of interest and benefit to them. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 6 Staffing levels support the effective delivery of a service which meets the high needs of Greenway Park’s service users. The numbers on duty at peak times provide high ratios of staff to service users, enabling the wide range of activities described above to take place. These levels also help to promote safety for service users and staff. When numbers on duty are reduced, there are effective systems in place which allow for backup to be accessed promptly if it is ever required. Service users benefit from a well run home. The organisation has a strong pool of senior staff, including the registered owner/managers themselves. They bring many qualifications and much experience. Greenway Park benefits from having a regular presence of members of this senior team. This ensures effective direction and leadership. It also means that support is readily available to all staff when needed. Service users with complex behavioural needs can be confident that they will receive effective support. The approaches that the home uses are in line with recognised good practice guidance and are individually tailored. Staff receive relevant training which enables them to uphold their own and service users’ safety. Any incidents which occur are managed appropriately and the impact on the home is kept to a minimum. The service has a good history of compliance with regulations and standards. Inspections have consistently identified very few requirements or recommendations. On this occasion, no requirements have been set, and just four recommendations for good practice. Service history also shows that the organisation takes effective measures to address any issues raised. Service users can be confident that the home strives to uphold best practice at all times, to the benefit of the people living there. All comments received from service users and staff were very positive about the service provided at Greenway Park. Service users were assisted to complete their survey forms if necessary. Their responses show satisfaction with all areas of service delivery. Service users enjoy the activities provided, get on well with the staff supporting them, and are confident to raise any issues with senior managers. Where service users were able to give additional comments, these included statements such as “It’s a good home and I like living here”. Staff feedback shows high levels of job satisfaction. They enjoy a strong rapport with service users and their colleagues. They are positive about support received from managers, available training opportunities and quality of care provided to service users. Service users can be confident they are supported by committed and motivated staff who feel valued and well led. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? 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. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 8 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 Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 9 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): Quality in this outcome area was not assessed, as the key standard was not applicable at this inspection. EVIDENCE: There have been no recent admissions. Most of the service user group have lived at Greenway Park since the home opened. One person transferred from another of the organisation’s services around three years ago. The organisation’s admission processes were inspected at another of its homes in May 2007, where quality was judged to be excellent. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 10 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): 6, 7 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users have their abilities, needs and goals reflected in their individual plans. Service users can make choices and decisions in their daily lives, and about the conduct of the home. Service users are supported to take positive risks and access new opportunities, as part of an independent lifestyle. EVIDENCE: Two service users’ files were checked during this inspection. Records are personalised, with use of photos to support some of the information. For instance, there are pictures of the activities which people undertake. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 11 Care and support records are detailed and informative. There is guidance about how all need areas are supported, and goals are set. There is regular review of needs. Reviews also take place after specific events, if required. Care plans address various topics, including personal care, medical and health issues, communication, occupation and leisure, relationships and behaviour. Each section sets out the needs and problems a service user has and the staff support and interventions to respond to these. The reasons for particular approaches are always clearly explained. Ongoing records relating to care are not necessarily made every day. The usual practice is to make an entry at least once a week, over the weekend. But other significant events are noted down as they occur. There is an appropriate level of detail. There is also clear cross-referencing, if there is linked information in more than one record. Service users participate in decisions about their own care, in line with their capabilities. Users’ families are involved too, as are other relevant professionals. Within the home, senior staff have lead responsibility for producing and updating plans. But all staff contribute to the process. The service user group at Greenway Park includes individuals from various ethnic and cultural backgrounds. Factors relating to this are specifically considered within individual care plans. If the service user wishes, they are able to reflect this heritage in ways such as how they furnish their room, or the activities they undertake. The two service users who share a bedroom have some common ethnicity. Service users can contribute to general decisions about the running of the home, as well as to their own care plans. Monthly ‘group discussions’ are held, which consider topics such as health and safety, menus, activities and key procedures. There are also more regular informal discussions, for instance during coffee breaks, at which the day’s events can be planned. There is clear information about any factors that may limit someone’s rights. Restrictions in place are linked to an individual’s assessed needs. The consent of the service user is recorded, where appropriate. There is a detailed approach to risk assessment. Documents address a wide range of significant areas. The topics assessed may be generally applicable, or specific to individuals. Information sets out the possible risks; the factors influencing these; preventive measures; and management strategies, with reasons for the approach chosen. There is a proactive approach to ensuring that all identified risks are followed up thoroughly. Risk taking is promoted, where it will benefit service users. There is also recognition of an individual’s right to exhibit certain behaviours if they do not raise issues of concern. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 12 The input of the individual is shown, where appropriate. Other relevant agencies are consulted for their views. Service users receive support with money management. Their varying individual needs are set out in their care plans. The registered persons act as appointees for some service users. Relevant records are kept. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 13 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): 12, 13, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are provided with full and active lifestyles, offering them full engagement with their local community. Service users are supported to maintain and develop relationships. Service users’ rights and responsibilities are upheld, balanced with appropriate steps to safeguard their welfare. Service users are offered healthy, nutritious and enjoyable meals, in line with individual needs and preferences. EVIDENCE: Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 14 A programme of day activities is arranged with each service user, and organised from within the home. Weekday mornings include participation in various sessions, including art, literacy, domestic skills, and cooking. Some of this work takes place in the form of projects. Service users can choose a topic of particular interest to them. Displays of some of the work produced can be found in bedrooms, and in communal areas. Some service users attend college courses, or local educational and occupational facilities for people with learning disabilities. Sessions undertaken include art and crafts, pottery, and independent living skills. A pictorial timetable of service users’ weekly activities is on display in the dining room. All service users also take part in different community activities. These involve interaction and communication with others. There are some well established group social events that take place each week. Service users’ social needs are regularly assessed, as part of the care planning arrangements. As the home has only one female service user, care is taken to ensure that this individual has access to activities and opportunities which reflect her femininity. She is supported by female staff for these sessions. Many activities take place during the daytime, when most staff are on duty. Social events will also be provided in the evenings. Rotas ensure that staff are available, to enable these to happen. Service users make frequent trips into Chippenham, and elsewhere. These may be for shopping, or in connection with other household matters. Many of the activities they attend are within walking distance of the home. The home also has its own minibus for outings, and public transport is readily accessible. Outings will usually be undertaken with two or three service users, supported by one or two staff. There are larger groups for some activities, which can also involve linking up with the organisation’s other homes. People in receipt of mobility allowance contribute a weekly sum towards transport costs. Additional charges may be made for longer journeys, according to the mileage. Service users also have the opportunity to go on an annual holiday. Accommodation in Cornwall is booked for two weeks, and groups go for a week at a time. A holiday park in the Cotswolds is also used for short breaks. This is because some users find it difficult to cope with long periods away. The chosen site is less than a couple of hours’ drive from Greenway Park. So it is easy to bring someone home early, if it is clear that is what they want. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 15 Many service users at Greenway Park do not have regular family contact. In a number of cases, their relatives live in other parts of the country, and are also quite elderly. But the home ensures that people keep in touch to an appropriate degree. This includes help with correspondence, and with taking people to visit families. Service users travel independently if able to do so. Service users may also have other friendships and relationships. They are able to maintain these as well. Service users can move freely throughout communal areas of the home. Peoples’ privacy within their own rooms is respected. Some individuals have their own satellite television channels in their room, so that they can watch their preferred programmes without detracting from the choice of others. People also use their own rooms as a space in which to pursue hobbies, such as photography, collecting model cars, or building a model railway. There is a wide range of information available about the home generally, and about individual service users. This addresses the issues of independence, choice, and restrictions very clearly. Routines of the home are set out. But there is flexibility within these for people to exercise choice. Where restrictions may be put in place, this is always linked to assessed needs of the service users concerned. Arrangements for food are well organised. There are seasonal menus, drawn up over a four week cycle. Fresh ingredients are used. The menu reflects an effort to promote a balanced diet and has recently been reviewed to enhance the focus on healthy eating. The choices of service users are also respected. Menus are regularly discussed with them. Greenway Park employs a cook on weekday mornings. She prepares the main cooked meal, which is eaten at lunchtime. Service users and staff dine together. On the day of this inspection the meal was home-made chilli chicken, with a choice of fresh fruit for dessert. When the cook is not present, care staff prepare meals. All staff receive food hygiene training. Service users may also help, but levels of participation vary. Some people are independent with certain tasks, such as making hot drinks. Service users do not need assistance with eating. None of the current group have any special dietary needs. Based on knowledge of individual preferences, alternatives to the main option are offered. There are usually three main meals per day: breakfast, lunch, and supper. Where possible, the household sit and have meals together, to promote social interaction. But service users can choose to eat separately if they wish to. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 16 Drinks are served mid-morning, and during the afternoon. Service users also have the opportunity to access drinks and snacks at other times, when they wish to. The kitchen is always accessible, although some items are stored securely for reasons of safety. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 17 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): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to address their personal and health care needs effectively. Service users are protected by the home’s policies and procedures for dealing with medicines. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 18 EVIDENCE: At Greenway Park most service users have abilities in the area of personal care. They receive any necessary prompting from staff. Some people may need supervision, due to particular needs arising from health or behaviour, and this is made clear within individual records. The home has one female service user, and this person always has support from female staff for personal care. A range of health checks are carried out for all service users at regular intervals. Information about the various needs amongst the group forms part of their individual care plans. Issues present amongst the group include epilepsy, and impairments in sight and hearing. Each service user has clear health records within their care plans. These include details of the various contacts they have with health professionals. The care of service users is overseen by visits from a consultant specialising in learning disability. Community nurses also give support as required. For instance, they can offer training for staff on specific issues relevant to the home’s service user group. Physical exercise is a key element of many of the activities offered for service users. This assists with health promotion. Nearly all service users taking medication have this administered by staff. Policies and procedures set out the home’s approach. Arrangements for storage and administration are appropriate. The pharmacy supplying medication visits every three months to check practice and give advice. Only senior staff administer medication. They receive relevant training from the pharmacist that the home uses. Training has also been given to other carers, to promote their understanding of the topic. Most of the medication prescribed for service users is dispensed via a monitored dosage system, which means that the pharmacy supplies it already divided out according to the dates and times for administration. Drugs are always checked when they are first received. Medicines are accompanied by a photo of the person they belong to, which helps to minimise any risk of errors. The home has devised its own recording charts. These records are usually maintained appropriately. They denote times of administration, who has given the drug, and use various codes to show any reasons for non-administration, such as a service user’s absence. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 19 One service user has some independence in managing their own medication. Each evening they are given the relevant items for the next day, which they then keep and take without direct observation. Some medication is prescribed to be given ‘as required’. This means that a prescribing decision has to be taken by the person administering. There are arrangements in place to support staff in doing so. Individual guidelines for service users set out how to judge when medication may be needed. Separate records are kept for any use of ‘as required’ medication, to monitor the frequency of administration. Usage is usually infrequent. One service user had been having more regular doses for a time. Senior staff felt this was linked to changes in other prescriptions, which had now been reviewed. One example was found during the inspection of an ‘as required’ dose which had been given without a record of the time this took place. This information should be recorded as there are relevant prescribing instructions such as the gap between doses, or the maximum permitted within a certain period. Review of medication may take place either by a service user’s GP, or through the consultant who gives support to the home. Some medicines available without prescription, known as ‘homely remedies’, are also kept. There is a list of the products held, and which individual may have what. This has been authorised by a GP, with approval most recently updated towards the end of 2006. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 20 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): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are safeguarded by the home’s policies and procedures for protection. Service users benefit from an effective and appropriate approach to the management of behavioural needs. EVIDENCE: Procedures relating to abuse and adult protection are in place. This includes information about the multi-agency processes within Wiltshire. Staff have received training on this topic. The organisation has operated appropriately within this framework when the need has arisen. Complaints information is also in place, including versions for service users with photos, symbols and pictures to promote their understanding. Each service user has an individual version, which is kept in their own room so they have daily access to it. The procedure is also explained thoroughly on regular occasions, often within monthly group discussions. Feedback from service users shows that they are all confident in raising any concerns. They all stated that they would be happy to speak to one of the managers if they had a problem. Service users also mentioned other people they could contact, such as relatives or their social workers. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 21 There is also a procedure relating to how staff may raise any concerns they have about practice. This is usually referred to as whistle blowing. It includes information about other agencies concerns might be disclosed to, if people feel the need to make use of them. The nature of the service user group at Greenway Park means that physical interventions may be needed on occasions. There is detailed information available about how this is practised. There are clear expectations for staff about how to manage any incidents. The approach set out for the use of physical interventions upholds all the recognised best practice principles. The various alternative strategies to be tried are also described. Staff who are expected to practise physical interventions attend a five day residential course, and refresher courses every two years. Generally only male staff receive this training. But the female deputy manager has also done so. Other female staff are not expected to participate in any holding or restraint. But there have been isolated occasions when they have been on the receiving end of assaults. They are provided with training in breakaway techniques, which should equip them to extricate themselves from such situations as speedily and safely as possible. Until new staff have attended such training they may receive additional support from colleagues. There is detailed guidance on physical interventions used in the home. Work is in progress to define which are suitable for individual service users. This can vary, depending on the characteristics of each person’s behaviour, and other features, such as their build and state of physical health. The home consults with relevant parties in deciding which of the techniques may be applied to a particular person. This guidance is being drawn up on a prioritised basis, depending upon which service users are most likely to need such interventions. Staff members described the various methods used for responding to any challenging behaviour from service users. They explained the strategies which can be used to defuse situations. They also displayed confidence in the arrangements if any difficult incidents do occur. They said that such occasions are rare, and are always managed calmly and professionally. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 22 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): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a comfortable, clean and safe environment, suitable to their needs. Cleanliness and safety could be enhanced by attention to the outbuilding used as a laundry room. EVIDENCE: Greenway Park presents as good quality accommodation. It is clean and well maintained in most areas. Décor is comfortable and homely. Upkeep and redecoration is attended to as and when required. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 23 There are three service users’ bedrooms on the ground floor, and four upstairs, including one shared room. This has an en-suite bathroom. A majority of these bedrooms were seen during the inspection, at the invitation of their occupants. All are appropriately furnished and decorated and clearly reflect the personal tastes and interests of the service users. The shared bedroom has been occupied by the same two service users since the home opened. They appear content with the arrangement. The layout of the room allows it to be divided into distinct areas, giving maximum privacy. Apart from the en-suite bathroom, there is another bathroom for general use, which is also upstairs. Downstairs, there is another separate WC. Communal space is on the ground floor. There is a large lounge at the front and a dining room at the rear, next to the kitchen. The dining room is large enough for the whole household to eat together, if wished. Laundry facilities are in an outbuilding in the back garden. This area is in need of some attention. The floor covering is no longer intact, and there are also gaps in the wall which plants have managed to grow through. The room also needs cleaning to remove dust and cobwebs, particularly from high areas. There are large areas of garden to both the front and back of the property. These are well maintained, and provide another attractive resource for service users. Some particularly enjoy helping with the gardening; for instance, by planting flowers and watching them grow. A patio area in the back garden is used for eating outdoors in good weather. A staff office and sleep-in room is on the first floor. Greenway Park employs a cleaner for weekday mornings. Care staff are responsible for cleaning at other times. Service users may participate to some degree, but this is fairly limited in this home. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 24 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): 32, 33, 34 & 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported by suitable numbers of appropriately trained staff. Induction of new staff could be enhanced by re-establishing clear links to nationally recognised standards and frameworks. Service users are protected by effective practices in staff recruitment. EVIDENCE: Staff are on duty at all times, including one person sleeping in overnight. They have access to on-call support, if required. But this is rarely necessary. The team structure includes managers, deputy and assistant managers, senior carers, and carers. The arrangements promote effective teamwork. The staff team is mostly female. But there is a male presence amongst senior staff. The home has had a stable staff team with low turnover. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 25 A minimum of two staff are present during the day and evening. More staff are allocated to work at specific times, to support the activities that service users undertake. At the busiest times there can be up to six care staff and two managers present. These numbers are slightly lower at weekends, when there is a more relaxed approach. The home also employs a cook, and a cleaner, who work weekday mornings. Care staff carry out these tasks at other times. There are three seniors and four carers specifically allocated to Greenway Park. Senior staff take on areas of additional responsibility. These include involvement with medication; service users’ money; administration and paperwork; and leading of shifts in the absence of other managers. If there are gaps in the rota, staff from elsewhere within the organisation may cover these. No use is made of agency workers. This is because unfamiliar employees can be unsettling to some of the service users. The organisation will tend to employ suitable applicants, even if this means going slightly over usual staff establishment levels for a time. People may then be deployed wherever their abilities are felt to be of most use. So staff may be based in one home for a time, but then go on to work in another. This means that some people can be available as relief cover, who already have a knowledge of the service and its users. Employees who are new to the organisation often begin at Greenway Park. If they are then felt suitable, they may move on to one of the other establishments that the group operates. There have also been examples of carers from those other homes returning to Greenway Park when successfully being promoted to a more senior level. A senior manager co-ordinates training for the organisation. This ensures that everyone attends the necessary courses, and that they have updates when required. As well as the mandatory topics covered, the training programme includes elements based on the needs of service users. Some key topics are covered in-house, such as the values of care, awareness of key documentation and expected standards of staff conduct. Staff members said that they receive regular training on various topics, and that they can follow up on areas they would like to learn more about. Training records are kept for all staff, including copies of any certificates gained. Induction of new staff is recorded. It covers a range of topics, including introduction to the home and its service users, values of care, policies and procedures, confidentiality and health and safety issues. Staff are also given relevant leaflets, such as the code of conduct for social care workers and information about Wiltshire’s procedures for safeguarding vulnerable adults. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 26 Staff members described the support received when they first started working at the home. They worked alongside another carer for a time, whilst getting to know the service users and the various routines. They also said how helpful it is that senior staff and managers are always available on every shift. Recent induction has not been in line with the national framework for staff working in learning disability services, due to failure to find a suitable training provider who would facilitate this. The need to ensure a clear link to the national induction standards for the social care workforce was discussed during the May 2007 inspection of one of the organisation’s other homes. They are already taking steps to look into this. After being in post for a while staff go on to undertake National Vocational Qualifications (NVQs). All staff who have been with the organisation for a while have achieved an NVQ award, at either Level 2 or 3. The home is well above the minimum 50 target required for people with this level of qualification. Two of the company’s own senior staff are NVQ assessors, so they can carry out observations with candidates. An external body is used to oversee and facilitate the NVQ process. A staff member who had completed NVQ Level 2 said that they had found it useful in developing their understanding of various issues relating to the running of the service. Records relating to three recent appointments showed that all required recruitment checks are carried out, at the appropriate stages. A tracking form is used to keep a check on when the various steps have been completed. Specific issues relating to the employment of individual staff are dealt with via risk assessments, if necessary. Individual supervision meetings are also used to address issues of concern, as well as to give positive feedback. The organisation is aware of the principles of equal opportunities in recruitment and selection. The registered persons were able to give examples of how these have been applied in practice. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 27 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): 37, 39 & 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home, with clear leadership and involvement from senior figures. Quality assurance measures underpin service developments, and include actions based on the views of service users. Service users’ health and safety are protected by the systems in place. EVIDENCE: Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 28 The organisation’s registered managers are Mr Greg Tennant and Mr Phil Taylor. They were originally registered under previous care homes legislation. They have operated and managed services since establishing their company in 1988. Both continue to work in their homes and have regular contact with service users and staff. They are supported by a deputy manager, Mrs Carol Pearson; and an assistant manager, Mr Simon Willis. Each of these senior managers has allocated responsibilities and also overlap roles when required. The service benefits from a strong presence of managers and senior carers at all times. There are usually two people from within these groups present during the days. On-call arrangements also ensure that a senior person can attend quickly, if the need arises. Mr Tennant, Mr Taylor and Mrs Pearson have all completed the Registered Managers Award (RMA) and a National Vocational Qualification (NVQ) Level 4. Mr Willis has also obtained the NVQ 4, and is to undertake the RMA. Records about annual development and improvement are contained in a quality assurance file. There is a policy on quality assurance, with guidance about how this is managed in the home. The assistant manager, who was met with during the visit, oversees the arrangements for quality assurance. Methods of obtaining feedback have been identified. For service users, these include individual review meetings, monthly group discussions and questionnaires in a pictorial format. Minutes of the group discussions are kept. These show that service users often make suggestions, for example about new outings, social activities and the sort of meals that they would like. Questionnaires have been used to gain the views of people outside the home. The registered persons also carry out audits and make regular checks in areas such as health and safety and medication. During the visit, a staff member said that any maintenance items are always dealt with promptly. Management meetings are held, when improvements are discussed and priorities identified for the year ahead. The outcome of an Annual Development Plan for the period 1 April 2006 – 31 March 2007 has recently been reviewed and reported on. The report gives a detailed account of work that has been carried out in various areas, such as the physical environment, the provision of activities for service users, staff training and the development of new systems and procedures. The latter includes new ‘Health Action Plans’ for service users, which have been produced in both written and pictorial formats. A new Annual Development Plan has been written for the period 1 April 2007 – 31 March 2008. The assistant manager said that one priority for the year ahead is to continue producing information in formats that are more Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 29 appropriate for service users. Consideration is also being given to creating a website for Cocklebury Farmhouse homes. Risk assessments address health and safety concerns. This is done for general topics, and for individual service user issues. The measures put in place to minimise risks are set out. When new risk assessments are drawn up these are kept at the front of the folder until all staff have read and signed them. There are suitable arrangements for fire safety, including a range of checks, practices and staff instruction. The home has a risk assessment and evacuation procedures. Staff receive training on a range of health and safety topics. This includes moving and handling, food hygiene and first aid. Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 30 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 X 2 N/A 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 4 33 4 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 4 X X 3 X Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 31 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. 1 2 Refer to Standard YA9 YA23 Good Practice Recommendations All records for administration of ‘as required’ medication should include the time that the drug was given. Guidance on the possible application of physical interventions to individual service users should be developed, to include more detail about the techniques that are appropriate with each person. Attention should be given to the décor and cleanliness of the building used as a laundry facility, so that any infection risk is minimised. The home’s induction for new staff should be clearly linked to national standards for the social care workforce and the learning disability sector. 3 YA24 4 YA35 Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Chippenham Local Office Suite C, Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: Telephone: 012 4945 4550 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 Greenway Park (13) DS0000028295.V337033.R01.S.doc Version 5.2 Page 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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