Inspection on 14/06/05 for 179, Green Lane

This inspection was carried out on 14th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

179, Green Lane 30/07/07

179, Green Lane 24/11/06

179, Green Lane 16/02/06

179, Green Lane 31/08/04

179, Green Lane 27/04/04

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Townley Road, 2-3

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Cherry Tree House

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

CARE HOME ADULTS 18-65 Green Lane, 179 179 Green Lane Morden Surrey SM4 6SG Lead Inspector Janet Pitt Unannounced 14 & 24 June 2005 11:00 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 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 Stationary 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. Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Green Lane, 179 Address 179 Green Lane Morden Surrey XM4 6SG 020 8648 1307 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Care Management Group Limited Miss Iye Fornah Care home with nursing (N) 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (MD) of places Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Female adults with Learning Disabilities 2 Psychological needs and behavioural problems Date of last inspection 31st August 2005 Brief Description of the Service: Green Lane is a care home with nursing , which provides care for up to five female service users who have mental health needs. The property is domestic in character and is situated near Rose Hill in Sutton and is accessible by road and bus. Accomodation is provided in single rooms, which have ensuite facilities. There is a large kitchen and dining room, along with a lounge. There is a high care input into the needs of service users whose behaviour can challenge the service. The home aims to equip service users with independent or semi-independent living skills. Access to family and links with the community are considered a priority. Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place unannounced over two days by one inspector. The inspection lasted a total of three and a half hours. The inspector examined care documentation, policies and procedures and staff files. A tour of the premises was undertaken. The inspector spoke with three members of staff and all five service users accommodated. What the service does well: What has improved since the last inspection? What they could do better: The home would benefit from a computer to ensure that care documentation, which is computerised, can be shared with service users once it has been agreed. The external aspect of the building requires repainting to reflect the high standard of décor within the home, and provide service users with a well maintained home in which to live. One ensuite requires new flooring, to ensure that the service user benefit from a safe and maintained bathroom. Please contact the provider for advice of actions taken in response to this Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 and 5 Service users are given clear information, which enables them to determine whether the service is able to meet their needs, and service users are included in the assessment process. EVIDENCE: Service users are able to access the Statement of Purpose, which details the care to be provided. The Statement of Purpose is currently being updated to reflect the changes in the environment. The home has recently extended the kitchen and dining room and has built one additional room to accommodate another service user. Service users have a clear indication of what is expected of them and of the home from the Statement of Purpose and contracts provided. All service users have a contract in an accessible format, which enables them to be involved in planning daily living activities. The contract and Statement of Purpose contain advice on how to make a complaint and there are photographs of relevant people in the organisation within the complaints procedure. Comprehensive pre-admission assessments are made prior to admission. The assessment process involves other health professionals such as psychiatrists, psychologist and social workers. There was evidence within the assessments of service users being involved, although this was not always consistent. The manager said that service users are encouraged to sign assessments, but are reluctant to sign each page, but the staff continue to encourage them and will develop a single form for service users to sign to reduce the amount of times a service user is required to sign. Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 Page 9 The manager said that the new service user was able to visit the home and select furnishings for their room and meet other service users and staff. Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 9 and 10 Service users are involved in the care planning process but there is a delay in getting appropriate information to them. Service users are enabled to plan their days and make decisions about what activities they wish to engage in. EVIDENCE: Service users have individualised support plans in place. Two plans examined gave clear details of care required and included appropriate risk assessments covering aspects such as taking public transport, absconding and cooking. The plans included details of contact with friends and families, which were evidenced as being maintained. Service user participate in routine reviews of their support plans and letters from the service users to people they wished to invite to reviews. were held on file. Service users can be confident that their views are heard and that they have maximum input into planning their care. The manager said that due to the lack of a computer within the home, there is a delay in service users getting information relating to their care. This potentially places service users at risk of not having care needs met if the information is not readily available. Service users have individual weekly planners, which detail activities such as household task, laundry, free time and time spent at day centres. It was Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 Page 11 apparent from the planners that service users are able to choose whether to attend any external activities. Staff are able to give assistance when using public transport or shopping, but enable service users to take appropriate risks in the community and around the home. These risk assessments are agreed with service users prior to being implemented. All records relating to service users are kept in an office, which can be locked, and service users can be certain that information held about them is handled appropriately. Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15,16,and 17 Service users preferred activities are recorded and they are supported by staff to access these activities. EVIDENCE: Each service user has a pen portrait within their file, which summarises their likes, dislikes, favourite foods and pastimes. This gives a clear indication of how they prefer to spend and plan their day. Service users are enabled to maintain meaningful relationships and are given appropriate health advice if required. One service user enjoys visiting their family and regular overnight stays are arranged to facilitate this. Another service user visits day centres to pursue drama interests. The service users who do not wish to attend day centres are enabled to structure their days and take part in meaningful activities, such as shopping or cooking. One service user requires the assistance of an advocate and the home have applied for assistance in this area. Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 Page 13 Staff interactions were observed to be positive and supportive, for example on service user wished to telephone their mother but was advised at which time it would be appropriate and this was reinforced in a calm, but firm manner. Service users throughout the inspection took time to speak with the inspector about themselves or any concerns they had. Service users are encouraged to plan and cook their own meals and therefore there is no set menu. One service user commented that ‘it would be nice if the staff cooked the meals’, but understood it was part of the development of living skills. Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 21 Service users are supported with health and personal needs, which are met. EVIDENCE: Service users can be sure that personal needs will be met and referrals to other health professionals will be made if required. Service users files evidenced involvement of other health professionals and areas where support was required with personal hygiene. One service user had an occupational therapist report, relating to provision of equipment required and a community psychiatric nurse visits the service user weekly. Staff were assisting this service user with hygiene needs on the first day of inspection. There was emphasis on both mental and physical well being of service users in the mental health assessment and health needs assessments that are made, when a service user is admitted to Green Lane. A consultant psychiatrist visits on a monthly basis to assess all service users and can be access more frequently if required, to ensure that medication is appropriate and to review service users mental health. Service users wishes on ageing, illness and death were recorded sensitively and once a relationship had been established between the staff and the service user. Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Service users can be confident that any concerns they have will be acted upon and service users are able to voice their opinions freely. There are appropriate arrangements in place to protect service users from harm. EVIDENCE: Service users are able to express their views at weekly meetings, which are minuted. The records of these meetings indicated that ideas and suggestions service users had for meals and activities were acted upon. Holiday requests were also documented and the manager said that staff were implementing these requests. None of the service users have made any complaints since the previous inspection; the home has only received one complaint relating to a skip that was used during the building works. This has now been resolved. The service users are protected from harm by the implementation of the Adult Protection policy, which has been adhered to by staff. There has been one Protection of Vulnerable Adults investigation since the previous inspection. This was proved to be unfounded, as the service user in question has a comprehensive behavioural programme, which can lead to conflict. The home co-operated with the process throughout. Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28, 29 and 30 Service users live in an environment, which is homely, but the home should ensure that the service users own areas are appropriately maintained as well as the external aspect of the building. EVIDENCE: Service users kindly showed the inspector their rooms and appeared proud of their personalisation of their rooms. Service users confirmed that they were able to choose paint colours and soft furnishings. One service user had brought their own bed; another service user explained the colour scheme they wished to have in their room when it was redecorated. One service user commented that the larger kitchen and dining room were ‘nice and good’. Service users stated that they enjoyed working in the new kitchen. The shared areas provide comfortable areas for service users to relax in. There is television and audio equipment in the lounge. Service users are able to have televisions and audio equipment in their rooms if they wish. One service user is still awaiting a new bathroom floor, which should have been renewed after the previous inspection. Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 Page 17 The external walls of the home should have been repainted as required at the previous inspection, as it has old peeling paint and does not present a well maintained building. Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 35 and 36 Service users are cared for by a team of staff who are aware of their roles and responsibilities and are appropriately supervised. EVIDENCE: Service users are supported by staff that are appropriately supervised and have a clear indication of their roles and responsibilities. Two staff files were examined and noted to include all the details required in the Regulations. Criminal Records Bureau checks are carried out and there was evidence of registration with the Nursing and Midwifery Council. Each staff file had a job description and contract. There was evidence of induction and foundation training. Mandatory training in fire, food hygiene and health and safety had been undertaken. Staff are able to access individual training appropriate to their development needs. Each file had a supervision contract and supervision sessions had been carried out at the required intervals. The manager continues to work on her NVQ Level 4 and two members of staff are undertaking Level 2. The manager stated that foundation training had recently commenced. Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,40,42 and 43 The manager and the staff at the home work together to ensure that service user needs are met. EVIDENCE: Green Lane benefits from an inclusive style of management. The manager supports staff and service users and demonstrates clear aims and objectives. Some service users who have been at Green Lane for a number of years have become more integrated in the community and exhibit less challenging behaviour and improved social skills. During the time of inspection the manager took time to discuss any concerns the service users had. Service users can be confident that their views are sought and heard, if something is not possible, this is explained to the service user giving clear reasons why. The manager stated that a team of company representatives reviews the homes policies and procedures. Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 Page 20 Service users live in a home where attention is paid to maintaining their health and safety. Fire drills are carried out both during the day and at night and documented. A risk assessment relating to buildings fire risk was undertaken in April 2005 and noted to be satisfactory. There is a clinical waste contract in place. Portable Appliance Testing was undertaken in April 2005 and noted to be satisfactory. Temperatures of the fridge and freezers are recorded daily, to ensure safe food hygiene. Green Lane, 179 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Green Lane, 179 Score 3 3 x 3 Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x 3 3 G54-G04 S19094 Green Lane V225952 140605 Stage 4.doc Version 1.40 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. 1. Standard 24 Regulation 23 (2) (b) Timescale for action The registered person must 30th ensure that the bathroom floor in September the service users bathroom is 2005 replaced. The registered person must 30th ensure that the exterior of the September home is painted. 2005 Requirement 2. 3. 24 23 (2) (b) 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. Refer to Standard 6 Good Practice Recommendations The registered person must ensure that the home has access to a computer on site, to ensure service users are given information in a timely manner. 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