Inspection on 16/11/05 for Genesis Residential Care Home Ltd

This inspection was carried out on 16th November 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Genesis Residential Care Home Ltd 02/03/09

Genesis Residential Care Home Ltd 02/03/07

Genesis Residential Care Home Ltd 18/06/05

Genesis Residential Care Home Ltd 10/01/05

Genesis Residential Care Home Ltd 05/08/04

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

CARE HOME ADULTS 18-65 Genesis Residential Care Home Ltd 44 Albion Road Great Yarmouth Norfolk NR30 2JD Lead Inspector Hilda Stephenson Announced Inspection 16th November 2005 13.30 Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 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 Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 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. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Genesis Residential Care Home Ltd Address 44 Albion Road Great Yarmouth Norfolk NR30 2JD 01493 853992 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) Genesis Residential Care Home Ltd Mrs Diane Bryant Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th June 2005 Brief Description of the Service: Genesis is a care home providing accommodation for seven people with a learning disability and associated mental health problems. It is owned and managed by Mr & Mrs Bryant. The home is located between the town centre and sea front of Great Yarmouth. The accommodation comprises of two terraced houses with seven single bedrooms situated on the three floors with a lounge, dining room and kitchen on the ground floor in Number 44 and one lounge and kitchen/diner in Number 43. Access to the seven bedrooms is by the stairs. There are two small front patios and enclosed covered conservatories. A connecting doorway to both houses is accessed at the rear. There is parking in the public car park at the rear of the building. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place during the afternoon and early evening of the 16th November 2005. Part of the time was spent examining care records, staff files and records that are required for regulation. Six of the seven residents, two care staff and the proprietor were also spoken to during this visit. Comment cards were received from relatives, other professionals who visit the home and from some of the residents prior to the inspection. A partial tour of the premises found the home to be clean, tidy and tastefully decorated to ensure that residents have a comfortable home. The proprietors have united the two homes with a communal doorway leading from the patio of No 44 to the laundry room in No 43 and residents from both homes can use this. The staff organise daily activities for residents who do not go out within No 43 with residents watching a film with a carer during the afternoon. Several residents were out until late afternoon. What the service does well: The home has a small loyal staff team who have worked at the home for some time and have developed an empathy with the residents. Since the previous inspection the staff team are working between both homes to enable all the staff to get to know the residents and vice versa. It was evident throughout the inspection that staff supports residents to make their own decisions about their lifestyle and daily activities, and help residents with their chosen hobbies and work routine. The home is kept clean and tidy with several residents helping with household chores. One of the residents was assisting the staff preparing the teatime meal. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 6 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. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 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 Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 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 the following standard(s): 2,4,5 Prospective residents are invited to visit the home to meet the other residents before making their decision to move in. The manager meets with all new residents to make an assessment of their needs to ensure the home can meet these. EVIDENCE: The home has had one new resident since the previous inspection and these care records were seen. The manager visited the prospective resident at the resident’s last premises. The care records showed that initial assessment details were taken and that the resident was invited to meet the resident in Genesis the next day and stay for lunch. The assessment details were clear, although the proprietor did not organise clinical waste collection before admission and this must be carried out as soon as possible. The resident has been issued the home’s terms and conditions and due to short-term memory impairment, the resident’s family was involved with the decisions. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Residents’ care plans identify their health and personal needs and they are involved in the regular reviews. EVIDENCE: The home uses a key worker system, although the proprietor and deputy tend to write the initial care plan. The care records are contained within a care log; the daily notes and reviews are contained within the one log. This method of recording appears to work well for the home and ensures a continuous log from admission to present day care, with any special events that happen, recorded. Residents are encouraged to speak to their key worker when the reviews are carried out. One resident stated ‘My key worker asks me what I want to do and then helps me to get ready to go out, if I want to’. Six residents spoke about their care and routine during the week and this information corresponded with that in the care plans. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 12,13,15,16,17 Residents live in a communal setting with meal times conducted as a sociable event. Private individual time is also recognised. Social activities are organised by the residents with some support from the staff. EVIDENCE: The majority of the residents either go out to college, work or day care, although one resident stays in the majority of the time, and the staff organise daily activities for the resident from discussing his past life, watching films and taking part in a variety of crafts with some outings arranged, when the weather is appropriate. All of the residents were very enthusiastic about sharing their comments with the Inspector. Their individual interests are included within the care plan and staff encourages residents to continue with their social interests and hobbies, helping out when they can. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 11 The majority of the residents go out on their own, and one resident had arranged to go out to the theatre during the evening and was looking forward to this. One resident stated ‘I go out for a bike ride, but if I go on the main roads, a member of staff comes with me, I also take the proprietors dog for a walk along the seafront, I enjoy walking the dog’. The residents confirmed during the discussions that they have access to local amenities with some occasionally going swimming, going to the hairdressers, and accessing the seafront amenities and the theatre. The majority of residents go out shopping on a regular basis, with one resident working in one of the shops a few days a week. It was evident that family and friends were made to feel welcome when they visited the home through the written comments received prior to the inspection. Residents tend to their own breakfast, lunch and supper. The main meal at teatime is usually cooked by one of the residents who wishes to cook for everyone. Both houses organise their own menu, occasionally eating together. The proprietor ensures that alternatives are in place if residents do not wish for the main meal. One resident requires a specialised diet and this is cooked by one of the staff. The majority of the staff has achieved the food hygiene certificate although the proprietors must ensure that all the staff attends this course, as part of their role is preparing meals. The residents confirmed that meals and food was readily available, and that the nights they cook, they choose the menu. The proprietor keeps a record of the meals. Risk assessments were in place to ensure those residents who needed assistance in the kitchen were protected. Residents who could not cook or take part in preparing meals tended to help with the clearing up. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 18,19,20 Medication is stored and administered safely by staff. Staff supports residents with their emotional and personal needs. EVIDENCE: The home uses the Boots Monitored Dosage System with repeated medicines ordered on a monthly basis. All of the staff has undertaken the Boots Medication Awareness Course. The home has a safe system for administering medication and written guidelines in place to ensure any risks are minimised. Medication is stored safely in lockable containers. Two of the Medication Administration Records (MAR) were checked and found to be satisfactory. None of the current residents hold their own medication, although a system is in place if this was to change. One staff is on duty in each house every day and overnight. The staff tends to alternate between the two to ensure that they know all the residents well. Residents confirmed that the staff are always available when they want to sit and do an activity, or go out or just need someone to talk too. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 13 One resident stated ‘my nurse is coming into speak to me tomorrow, and I find that beneficial, as well as speaking to my staff here’. Many of the residents continue to receive extra care from visiting professionals and staff encourages the residents to speak to them in private. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 22,23 Residents’ views are listened to and acted upon. EVIDENCE: The proprietor has a robust complaints procedure in place. Any complaints are recorded with the action taken. The complaints policy is included within the initial documents given out on admission. One resident stated ‘I have no complaints to make about this home, Di and the staff are like my family’. During the inspection it was evident that the residents were comfortable within their surroundings and had developed a good rapport with the staff that was on duty. No complaints were received either from the residents, staff or relatives comments received prior to the inspection. The majority of the staff has attended the vulnerable adults workshop that highlights abuse within a care setting. Adult protection is also included within the induction and NVQ programme that staff has undertaken. The whistle blowing and missing person policies were seen and staff on duty was aware of the contents. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 24,30 Residents enjoy a home that is clean and tidy, with comfortable, homely communal space. The proprietor lacks the facilities to dispose of clinical waste in a satisfactory manner. EVIDENCE: The home now consists of two terraced houses with access between both homes through a rear doorway on the ground floor; both houses have recently been painted on the outside. The accommodation comprises of seven single bedrooms, four in Number 44 and three in Number 43. Both houses have lounges, domestic kitchens and dining areas and the rear yards have been covered to make two conservatories. This is the designated smoking area in both houses. There are adequate laundry facilities with the majority of the residents doing their own washing. The home was found to be clean and tidy. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 16 The proprietor has not made arrangements for the safe disposal of incontinent products and must contact and arrange suitable collection facilities immediately. The proprietor must ensure that all staff has an update with the guidelines in infection control, to ensure safe practices are in place. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Residents’ needs are well provided for by knowledgeable, competent staff who are trained and effective. EVIDENCE: A copy of the staff rota was provided prior to the inspection. This indicated that two staff is on duty at all times. Overnight the staff ‘sleeps in’ with the proprietors or deputy taking it in turns being on call. The proprietor has altered the rota to allow the staff to work in both houses to enable the residents to get to know all of the staff team. The home has a key worker system in place. More than half the staff team have achieved the recommended NVQ qualification and the home should be praised for achieving this. All new staff have completed the homes induction programme, although the staff turnover is small, the majority of the staff have worked at the home for some time. Many of the residents named their favourite staff, and it was evident that the staff and proprietors have developed a good rapport with the residents. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 18 Two staff files were checked, regarding recruitment and training. The proprietor follows a safe recruitment procedure with the required checks and references obtained before staff commences employment, ensuring that residents are safe. Staff receives training on a regular basis, records showed that medication, first aid, and food hygiene had been complete, although not all the staff have the food hygiene certificate. Appropriate facilities were in place to remove incontinent products from the resident’s room, although the correct waste collection has not been put in place, so staff should also update their own knowledge on appropriate infection control. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39,42 The home usually has satisfactory health and safety procedures in place, but the safe disposal of incontinent products must be implemented to reduce the risk of cross infection. EVIDENCE: The proprietor and staff meet with residents on a daily basis during teatime to discuss the daily events. A meeting with all residents to discuss plans for the annual holidays, parties and special events are arranged during the year by the proprietor and relatives are invited if they wish to attend. The proprietor has a maintenance plan in place for 2006, with carpets in No 43 to be replaced and a staff toilet to be added in the flat in No 43. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 20 The regulated checks for fire, environmental health, water, electric and risk assessments were seen to be satisfactory. The safe disposal of incontinent products must be put in place immediately, because there is a risk to staff and other residents in the home. The proprietor must ensure that staff receives updated infection control awareness and update the relevant policy, to ensure that all risk of cross infection is minimised. The proprietor Di Bryant manages the home on a daily basis, with John Bryant undertaking the maintenance. A good system is in place for the regular maintenance and upgrading of the home. Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 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 x 3 x 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x 3 x 3 2 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Genesis Residential Care Home Ltd Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 x DS0000061007.V260071.R01.S.doc Version 5.0 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. 2. 3. Standard YA4242 YA35 YA35 Regulation 16.2(k) 18.c(i) 18.c(i) Requirement The proprietor must arrange for the safe disposal of incontinence products. The proprietor must ensure that all staff has food hygiene training that prepares food. The proprietor must ensure that all staff receive up to date infection control training and renew the infection control policy. Timescale for action 30/11/05 30/01/06 30/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 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 Genesis Residential Care Home Ltd DS0000061007.V260071.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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