Inspection on 30/07/07 for 179, Green Lane

This inspection was carried out on 30th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

179, Green Lane 24/11/06

179, Green Lane 16/02/06

179, Green Lane 14/06/05

179, Green Lane 31/08/04

179, Green Lane 27/04/04

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

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

CARE HOME ADULTS 18-65 179, Green Lane Morden Surrey SM4 6SG Lead Inspector Jean Stuart Unannounced Inspection 30th July 2007 12:00 179, Green Lane DS0000019094.V347304.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 179, Green Lane DS0000019094.V347304.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. 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 179, Green Lane Address Morden Surrey SM4 6SG 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) 020 8648 1307 www.caremanagementgroup.com Care Management Group Ltd Iye Fornah Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Female adults with Learning Disabilities Psychological needs and behavioural problems Date of last inspection 24th November 2006 Brief Description of the Service: 179 Green Lane is a care home with nursing, providing care to five females who have mental health needs. The home is situated close to public transport links and a small number of local shops. Accommodation is provided over two floors, with en-suite rooms for each resident. There is also a well-maintained garden to the rear of the property. Fees range from £1800 to £2400. 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this unannounced inspection. The visit lasted a total of six and a half hours. Time was spent talking with the five residents, the manager and three members of staff. Staff files, training records and care documentation was examined. A tour of the premises was undertaken. Five client survey forms were returned. The Annual Quality Assurance Assessment (AQAA) form was completed and returned to the CSCI before this inspection. The current range of fees is £1800 to £2400 per week. What the service does well: What has improved since the last inspection? What they could do better: The home is to consider how to support residents in taking risks in a positive manner. On inspection the rights of residents to self-administer medication was discussed. Residents should also be encouraged to cook/ contribute to the evening meal. The service must reach out to stakeholders in the community to find out if they are happy with the service. The views of professionals who contribute to the service should be sought. The home has collected positive commented from 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 6 local Authorities who purchase the service and should be used in the quality audit of the home. 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. 179, Green Lane DS0000019094.V347304.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 179, Green Lane DS0000019094.V347304.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): 1,2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Adequate information is available to residents before they move in. Skilled staff complete a needs assessments, seeking information from the resident and their family if appropriate, to confirm that this is a suitable placement. EVIDENCE: The Statement of Purpose clearly reflects the service provided i.e. for people with a learning disability. The manager spoke of the assessments taken prior to a person moving in. Prospective residents must have a full assessment from the Local Authority Care Management Team. The home’s own assessment including physical and psychological assessments ensures that the person, family, and advocates are involved in drawing up a comprehensive document. This was confirmed by the documentation seen. The assessment focuses on achieving positive outcomes for people, ensuring that the facilities can meet the ethnicity and diversity needs of the individual. 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 9 One resident reported on the survey form “I visited the house and I liked it”. All residents confirmed on survey forms that they had received enough information about the home before they moved in. No one has moved into the home since the last inspection. 179, Green Lane DS0000019094.V347304.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, and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are developed with people using the service, residents control their own lives, and direct the service. Care plans are regularly reviewed. Risk assessments for residents are individualised and are reviewed. Staff are fully committed in supporting people to lead purposeful and fulfilling lives. EVIDENCE: Person centred planning has now commenced for residents. This process is user friendly and focuses on the individual’s personal preferences. Residents are involved in the planning of care and care plans are regularly reviewed. Key worker time is available on a one to one basic to encourage the ongoing develop of care plans. Residents develop a plan for the week with their key worker. Staff have the skills to support people. 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 11 On the survey forms four residents reported that they can always make decisions about what they do each day, one resident said they are usually able to make such decisions. Residents sign documents concerning their rights and responsibilities in relation to care planning and risk assessments. In the Annual Quality Assurance Assessment (AQAA) the manager observed that residents and staff need to view risk taking as apart of the development of an independent lifestyle. Residents’ cooking and self-administrating medication was discussed as ways of widening a resident’s lifestyle. . 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 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. The home promotes the individual’s rights to live ordinary and meaningful life, both in the home and the community. Residents are supported to identify their goals, and work to achieve them. Individuals are involved in the domestic routines of the household, including cleaning and menu planning. EVIDENCE: Residents have a full and stimulating life. The service encourages varied opportunities for people using the service. Residents spoke about working in a shop, going to day care, a meal out, being on holiday and visiting their family. Religious needs of clients are noted in their plans and they are able to attend services if they chose. Residents are integrated in to community life. The varied interests of residents were reflected on care plans and in each of the individual’s daily journal. All survey forms reflected that residents can do 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 13 what they want to do. One resident said, “I always chose what I want to do and make my own decisions”. Another residents reported, “My key worker and the manager help me to do things I like”. Residents have an opportunity to develop and maintain important personal, sometimes intimate relationships if they chose. Relationship and sexual needs are addressed in care plans. Support in the form of regular health checks is given. Staff give privacy and respect for residents’ relationships. Staff promote residents rights and choices, protecting individuals, supporting residents to make informed choices. Menus are decided upon in the residents monthly meeting, residents reported that they choose the food. The record of food served shows that the menu as set by residents is not always followed, residents chose to have a different meal. Alternative food can be provided. One person reported that they like the home “because the food is good”. Special diets are reflected on the menu. Residents reported that they were “very happy for the staff to do the cooking”. 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 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. 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. Residents receive effective personal and health care support based on individual needs and preferences resulting in a better quality of life. Staff understand, and are responsive to the varied and individual requirements of the residents. The home’s medication policies and procedures protect residents from harm. EVIDENCE: Residents’ health care needs are documented in their care plans. Personal support is responsive to the preferences of the individual. All residents are registered with a local G.P. A resident spoke of visiting a local doctor. Residents’ emotional well being is also attended to and a record was seen of input by a psychiatrist. The home works closely with external professionals, and families to support the individual. As seen during this visit, staff are alert 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 15 to changes in behaviour and general well being, and understand the action to be taken. The home has an effective medication policy and procedure. Only qualified nursing staff give medication. None of the current clients were able to maintain control of their medications. Clients are protected from harm by good medication procedures. No gaps in recording of administration were noted. 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 16 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home welcomes complaints and suggestions about the service. Residents are safe and secure. Saff have a very caring manner to residents and are aware of the Adult Protection Procedures. EVIDENCE: Residents feel safe and well supported and are able to state their concerns to staff. As seen during this visit all staff know the importance of taking peoples view seriously and responding to the issues raised. Appropriate posters were available detailing the complaint procedure. A resident stated that they are informed of the complaints procedure on admission to the home. Residents said they have no concerns about the home. If there was an issue they will “speak with the key worker”. The importance of the key worker and the manager as a people who can be trusted was reflected in the survey forms. Residents also reported that they were unhappy they would speak with the family, one person mentioned their advocate. Staff stated that they are aware of Protection of Vulnerable Adults (POVA) procedures. There have been no investigations under POVA procedures during 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 17 the past year. The training programme shows that the manager is planning POVA refreshers /training for all staff. Such training must be kept up to date. To protect people the deputy manager reported all staff have been CRB (Criminal Record Bureau) checked. The staff records available confirmed this. 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 18 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): 24,25,30. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The living environment is appropriate to the needs of people who live there. Bedrooms are personalised. The home is clean and hygienic. It provides comfortable, safe accommodation some areas require improvement. EVIDENCE: The service provides accommodation in a safe and homely fashion. People have single bedrooms with an ensuite bathroom and a lounge. Furnishings and fittings are good quality and are domestic in nature. To assist residents grab rails are positioned along the stairs. All bedrooms promote high degrees of privacy and residents were seen to use keys to get into the bedrooms. There is a planned maintenance and renewal programme for the fabric and decoration of the premises. The lounge was being redecorated at the time of 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 19 this visit. The colour of the room was decided when staff asked all residents their opinion. In one bedroom recently decorated the walls the resident has marked the paintwork. This room suggests that the home is required to carry out frequent repainting to keep the room well presented. The lounge and dining area meets the N.M.S. Staff have reported that the residents would benefit from a second sitting area and suggested a conservatory. One ground floor bathroom has recently had remedial work carried out when the floor was lifted for maintenance. This room now looks neglected and is not a pleasant environment. The manager reported that it is planned to replace the bath with a shower and redecorate the room. Residents were proud of their bedroom, one resident pointed out their DVD collection, family photographs were around the individuals’ bedroom. Residents are encouraged to use bedrooms as their own and to assist with keeping it clean. The home is clean and hygienic. All residents reported in their survey forms that the house was clean, one resident said “I like to clean my own room”. 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 20 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, 24 and 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff files demonstrate that there is a good recruitment procedure. The manager appropriately supervises staff. Competent, qualified and appropriately trained staff support residents. EVIDENCE: On the day of inspection staffing levels were appropriate for the number of residents. Four residents, and three staff were present (one resident was out). Later in the day this increased to five residents and four staff. A qualified nurse plus care staff are on duty throughout the day Residents spoke highly of staff and the work they do. One residents said that the manager is “marvellous” another resident stated “all staff work very hard to make sure we can do things” such as going out for a meal or going to a disco.Four of the survey forms showed that staff always treat residents well. One person said usually they are treated well but made no comments as to what this meant. The same person said that carers always listen and act on 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 21 what they say. All residents reported that carers listen. One resident said staff “are my friends”. Management prioritise training and facilitate staff members to under take this. Staff are informed of opportunities and one person praised the organisation for ensuring staff have all the mandatory training. The AQAA returned by the manager shows that staff have or are completing NVQs, staff supported this. One member of staff reported that they have just completed a Social Care degree. Training is targeted and focused on improving the outcomes for residents The manager spoke of the procedure followed when recruiting staff. A resident took part in recent staff selection and their contribution can be seen on the paper work. References are collected for each candidate, Criminal Record Bureau checks are completed. This was evidenced in staff files. The manager demonstrates that he has a good understanding of equality and diversity throughout the recruitment and training process. The manager has worked in the home since May 2006. The process of his only recently begun and is ongoing. Staff reported that the manager is supportive of staff. On arrival at the home the manager was not present and all staff made competent contributions to the inspection process. 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 22 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 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The views of both residents who use the service and staff are listened to, valued and reflected in the development of the home. The health and safety policies are closely monitored to promote residents safety. EVIDENCE: The manager and the team were able to demonstrate a clear vision and a sense of direction. Equality and diversity issues are given priority and all individuals are encouraged to achieve their goals with staff support if required. The service has a good understanding of equal opportunity issues. Staff have regular team meetings. Records of meetings were seen. 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 23 Clients are able to voice their opinions on the running of the home. Clients are able to manage their own finances, or staff can provide assistance. Each year an audit is completed. Each person is given the opportunity to state his or her views on the service. The Care Management Group then processes this. From this review the development of the service is planned. The manager was able to show positive comments made by people purchasing the service. The role of stakeholders in the review of the service should be promoted. 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 24 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 4 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 4 33 x 34 4 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 4 x 3 x x 4 x 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 25 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 YA20 YA16 YA9 Regulation 13 (2) Requirement The home must ensure residents and staff view risk taking as apart of the development of an independent lifestyle assessment with regard self medication and cooking. Timescale for action 30/11/07 2. YA24 23 (2) (b) The home must provide the CSCI 31/10/07 with a programme of ongoing redecoration and repair for the home particularly with regard to ground floor bathroom and a first floor bedroom The registered person must ensure that training needs for all staff members are reviewed and appropriate training is implemented, to make sure that staff training is current. 31/10/07 3. YA32 18 (1) (c) (i) 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 26 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 YA6 Good Practice Recommendations It is recommended that provision of a computer in the home would enhance the lives of clients and enable staff to maintain records. The role of stakeholders in the review of the service should be promoted. 2. YA39 179, Green Lane DS0000019094.V347304.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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. 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