CARE HOME ADULTS 18-65
Genesis Residential Care Come Ltd 43/44 Albion Road Great Yarmouth Norfolk NR30 2JD Lead Inspector
Hilda Stephenson Unannounced 18 June 2005-10.00am 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. Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Genesis Residential Care Home Ltd Address 43/44 Albion Road Great Yarmouth Norfolk NR30 2JD 01493 853992 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) 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 Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 10 January 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 Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place during a Saturday morning. The majority of the time was taken up with talking to three of the six residents and two of the staff on duty. A partial tour of the property took place, a sample of records; staff files and care plans were examined. Since the previous inspection the Proprietors have purchased the care home next door so in this report both homes will be recorded as Number 43 and Number 44. There has been a doorway knocked between the two homes for easy access for the staff and residents. The home was found to be clean and tidy. All the residents had organised their own routine for the day. What the service does well: What has improved since the last inspection?
The front of both homes has been painted in a distinctive colour to merge the two homes together. The stairway and hall has been redecorated in Number 44. The kitchen tiles and worktops have been replaced in Number 44 and the hot water taps have a temperature control added onto them to reduce the risk of scalding. Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 Page 6 In Number 43 handrails have been added beside steps and doorways. An additional toilet has been placed in the rear of Number 43’s conservatory. Both homes are now using the Boots medication system and the recommended training for staff who administer medicines has been carried out. 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 Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 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 Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 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) EVIDENCE: None of these standards were checked during this visit. Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 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 standard(s) 6,7,8,9 Residents’ care plans identify their health and personal needs and they are involved in the regular reviews. EVIDENCE: Each resident has a comprehensive care plan containing personal, health and social needs to maintain or improve their lifestyle. There have been no new admissions to the home for some time. Three residents spoke about their care and routine during the week and this information corresponded with that in the care plans. One resident stated ‘Di helped me find a place at college’ . Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 Page 10 The care plans contained clear goals, actions and risks assessments to monitor daily activities and maintain active social lives. The care plans are reviewed every six months or when needs have changed, and daily notes are written to ensure all avenues of communication are continued. Evidence of input from visiting professionals such as the Community Psychiatric Nurse (CPN) was included within the reviews. The residents confirmed that they talk to the staff when they write the records about them. Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16,17 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. 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. One resident stated ‘I go out on my bike’ and this is included within the care plan and recognised as a risk. Another resident has adapted her own way of going up and down the stairs and this is highlighted in her care plan so she can maintain her independence. Residents have access to local facilities such as the swimming pool, pub and hairdressers and one resident enjoys taking the Proprietors dog for a walk along the sea front.
Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 Page 12 During the morning’s discussion it was evident that residents had been on a short break but had not decided on the second holiday destination. Staff support the residents’ choices with some going away in a group while others continue to go with family. Residents are allocated a day to choose their own menu and cook for the whole house, with help from the staff. This happens in both Number 43 and 44. Residents prepare their own breakfast, lunch and supper and have unrestricted access to snacks and drinks. The main meal is at teatime, when the residents return from their daily activities. Staff take their meals with the service users to allow them all to catch up with the days news, which is good practice. Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 Medication is stored and administered safely by staff. EVIDENCE: Number 43 has been administering medication through the Boots monitored dosage system and since the merger Number 44 has commenced the same. All of the staff that administer medication have completed the Boots medication training. The home has a medication policy in place to dictate that medicines are stored in secure areas in both houses. Two of the Medication sheets were checked and were recorded satisfactorily. Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 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 standard(s) EVIDENCE: None of these standards were checked during this visit. Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 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 standard(s) 24,27,28,29.30 Residents enjoy a home that is clean and tidy, with comfortable, homely communal space. 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. None of the bedrooms were seen during this visit. 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 Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 Page 16 The fire records were seen and had been kept up to date. The rear bedroom in Number 43 that is used for storage has a hole in the ceiling and needs repairing. The hot tap in the ground floor toilet in Number 43 also needs repairing. Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,35 Residents needs are well provided for by knowledgeable, competent staff who are trained and effective. EVIDENCE: The Proprietors cover both houses using a separate rota of staff. There are sufficient numbers of staff on duty with two care staff on duty during the morning’s inspection. Two ‘sleep in’ members of staff stay in both houses overnight with the Proprietors being on call. The Proprietors have been altering the staff rota’s to work in both houses. One of the residents stated ‘I am getting to know the staff and think they are lovely, they are very kind to me’. More than half the staff team have achieved the recommended NVQ qualification and the home should be praised for achieving this. A sample of staff records were seen indicating the following training had been complete attendance at the Boots medication training, Protection of Vulnerable Adults awareness, Food Hygiene and First Aid.
Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 Page 18 Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 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) 41,42 The home has satisfactory health and safety procedures in place for the benefit of both residents and staff. EVIDENCE: Samples of the health and safety procedures were seen during this visit. Fire records are kept up to date in both houses although it would be beneficial to hold a combined fire drill and take advice from the fire officer to connect both systems together. No outstanding requirements were seen from either the fire officer or the environmental health officer’s previous visits. Mandatory training in health and safety issues are up to date with recent first aid, food hygiene and medication training being the latest recorded in the staff records. Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 Page 20 A sample of policies and procedures was also seen and found to be satisfactory. Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 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 x x x x Standard No 22 23
ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 3 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x x 2 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 4 Standard No 31 32 33 34 35 36 Score x 4 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Genesis Residential Care Come Ltd Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x 3 3 x I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 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 24 27 42 Regulation 23.2b 23.2j 23.4c.e Requirement Timescale for action By 30.9.05 The Proprietors must repair the hole in the ceiling of the top floor bedroom in Number 43. The Proprietors must repair the By 30.7.05 hot tap in the ground floor toilet in Number 43. The Proprietors must take advice By 30.7.05 from the fire officer regarding connecting the two houses fire alarm system. 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 42 Good Practice Recommendations The Proprietors should arrange a combined fire drill between the two houses to ensure the safety of residents. Genesis Residential Care Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 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 Come Ltd I55 S61007 Genesis V233327 18605 Stage 4.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
