Inspection on 07/11/05 for Genesis Residential Home

This inspection was carried out on 7th November 2005.

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 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

Genesis Residential Home 23/05/06

Genesis Residential Home 14/03/05

Genesis Residential Home 13/10/04

Genesis Residential Home 02/02/04

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

CARE HOME ADULTS 18-65 Genesis Residential Home 2 Station Street Donington Spalding Lincolnshire PE11 4UQ Lead Inspector Roger Harrison Unannounced Inspection 7th November 2005 09:30 Genesis Residential Home DS0000002656.V264841.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 Home DS0000002656.V264841.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 Home DS0000002656.V264841.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Genesis Residential Home Address 2 Station Street Donington Spalding Lincolnshire PE11 4UQ 01775 820431 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Biswanand Oozageer Mrs Rajkumari Oozageer Mr Christopher Rampley Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (2) Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Condition of Registration One place registered for MD(E) is only valid for the period that the named service user lives in the home. This registration will then revert back to MD. 16th May 2005 Date of last inspection Brief Description of the Service: Genesis is situated on the main street in the village of Doddington, Spalding, close to shops, churches, the library and other amenities. It provides accommodation and personal care for eight residents who have a mental health condition. Two of the eight beds are for residents who are over 65 years of age, although one of these is only for the length of stay of that individual. The home is owned by Mr and Mrs Oozageer. The home is three floors high and was originally a family home. All of the rooms at the home are single and have washbasins in place. One spacious room on the ground floor has en-suite facilities. Car parking for visitors is located at the back of the home. A small garden at the front gives direct access for visitors. Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken over a four-hour period, with the inspector using a method of inspection called “case tracking”. This involved selecting three residents who currently live at the home and tracking the experience of the care and support they have received during the time they have lived at the home. This was achieved by the inspector talking to the manager, touring the home, looking at information on care plans and files, talking to residents and care staff, and observing day-to-day care practice within the home. What the service does well: What has improved since the last inspection? The home now employs a Maintenance person who has updated and improved the garden area at the rear of the home. A caravan previously located at the rear of the home and used as storage has been removed. A re-decoration and refurbishment plan has commenced, which includes developing a further room to provide en-suite facilities, and some re-decoration has already taken place, both in the residents’ rooms and in communal areas. Action has been taken to address issues raised by the fire Safety officer to ensure the safety needs of residents. Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 Page 6 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 Home DS0000002656.V264841.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 Home DS0000002656.V264841.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. Pre-admission arrangements and subsequent assessments ensure that each residents needs wishes and aspirations are supported in the way they want them to be. EVIDENCE: The home has a statement of purpose and service user guide. All residents are given a copy of each at the time of admission to the home. During the preadmission process each resident is provided with a terms and conditions contract, which states the number of the room to be occupied. Residents spoken with confirmed that they visited and stayed at the home before deciding to stay permanently. On the day of inspection residents were observed moving freely around the building and going out into the community with support from staff. Through general further observation of care practice and discussions with staff team the care home evidenced they are able to meet the needs of the current group of residents. Records looked at confirmed that residents are consulted about their needs and wishes informally and through regular reviews, and are given the support that each person needs to continue to live actively and to be as physically and mentally independent as possible. Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 Page 9 Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 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 the following standard(s): 6,7 and 9. Each resident has a care plan, which reflects their physical and social needs and how each will be met. Residents are aware of their own needs, and that they are supported to make informed choices about the way they wish to live. EVIDENCE: Each resident has a detailed care plan, which reflects all physical and social care needs. Residents have detailed risk assessment linked to their individual care plan. Care plan reviews are undertaken monthly and risk assessments reviewed every three months, or as needed. Where there are changes in need, the home undertakes further, more detailed risk assessments, which involve residents, and where appropriate their family carers. Any action taken is recorded on the daily actitvity log and transferred to residents care records as appropriate. This system enables good communication between staff and with residents so that they are fully involved in any decision-making and are able to be properly supported to take risks in the way they wish to. On the day of inspection care plans were being used actively by staff to provide support appropriate to each individual need. Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 Page 11 Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 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 the following standard(s): 12,13,15,16 and 17. Residents have access to a wide range of activities to suit their needs. Activities are supported by the staff team in the home and wider community, which helps to ensure relationships are maintained and further developed. The home provides a nutritious diet for all residents. EVIDENCE: Assessments, Care plans and reviews are used to explore needs and aspirations with residents by the Manager and care team. Each resident has an individual training and activity plan, As a result, some residents choose to attend day service programmes, which meet the need identified. A key worker system is in place to help support residents with individual programmes. Through discussion with the manager, checking of care records and a discussion with a group of residents, it was evident that a wide variety of activities are organised on a regular basis for all residents. Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 Page 13 Meals in the home are planned using a menu rota, which changes every four weeks. Residents dietary needs are established through the assessment and care plan process and any change in needs or wishes is incorporated in the menu plan. Lunchtime was observed to be unhurried, informal and relaxed, with appropriate numbers of staff on hand to assist residents positively. One resident told the inspector, “The food here is great, we have a good choice and I like what I have here”. Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 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 the following standard(s): 18,19 and 20. Residents are protected by policies and procedures within the home, which are used to ensure that social and health needs, are met in the right way and to understand wider emotional needs in order to encourage and support choice and self-determination wherever possible for each individual. EVIDENCE: Care plans provide details regarding the personal support needs of each resident and how needs are to be met. During the inspection two residents told the inspector that “The staff support me in the best way they can” and “I like being here”. The manager and key worker role is central in understanding and providing emotional support to meet residents needs, and in ensuring care is provided in the way each resident wishes it to be. Residents are encouraged to self-medicate wherever possible. However, on the day of inspection all residents required support with medication. Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 Page 15 Care plans provided information of all residents medication needs and that these are reviewed regularly. There was information on resident’s files, which confirmed good relationships between the staff team and other, community based professionals, who provide support and advice as needed as part of the review process. The care home has a detailed procedure that covers all aspects of medication administration, storage and safekeeping. A random inspection of resident’s medication records provided evidence of appropriate support being given to residents with medication at the right time and good day to day storage and record keeping was observed to be maintained by the manager and senior care team to ensure the safety of residents. Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Residents are encouraged to be open about their feelings and concerns. The manager and staff take action to address ideas put forward for developing practice and issues of concern. The home uses induction, training and team meetings to ensure that the policy in place for protecting residents is taken seriously and acted upon when required. EVIDENCE: The home has a complaints policy and procedure in place. The manager holds regular residents meetings, which are used to provide opportunities for individuals, and the resident group to “have their say”. Two residents told the inspector that they were happy to raise any concern they may have with the manager and any member of the staff team. There have been no complaints since the last inspection. On the day of inspection staff demonstrated a verbal understanding of the procedure to follow in order to protect residents from all forms of abuse. The manager uses staff team meetings to discuss the need to protect residents and has arranged for further training to support staff in the understanding of abuse and reporting procedures. The manager has not needed to invoke the Adult Protection Procedure since the last inspection. Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 Page 17 Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 The home is well maintained, clean and provides a supportive environment for residents. The Manager has a comprehensive maintenance programme in place at the home. Appropriate arrangements have been made by the manager to address issues raised regarding maintenance and fire safety. EVIDENCE: On the day of inspection residents were observed freely going about daily activities as they wished either with support or unaided. The home has a comfortable lounge area, which can be easily accessed at any time. The home has a relaxed informal atmosphere, which is created by the whole staff team. It was evident through observation of residents that they were confident and felt safe both inside and in the garden area of the home, which has been cleared of all obstacles and made safe for residents through work undertaken by a maintenance person who is employed for two and a half hours a week. Kitchen areas were seen to be clean and hygiene practices were followed properly throughout the home. All Residents have their own single rooms, which have been personalised, and adapted were appropriate to support the needs of those with higher levels of need. En suite and communal bathrooms Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 Page 19 were seen to be clean and safe with space provided for using equipment needed to maintain individual residents safety. Some further decorative update is being planned within the home, which is being actioned by the manager as part of his annual development programme/business plan. The home received a visit from the fire safety inspection officer in October 2005, during which some key recommendations were made. The manager has taken action, using clear time-scales to ensure the work is prioritised and completed as appropriate. The Manager informed the inspector that all other fire safety issues had been reviewed and met the requirements of the fire department. Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. The manager has robust recruitment procedures in place and provides appropriate levels of support to the care team, who are able to use training to meet the needs of residents within the home and wider community. EVIDENCE: On the day of inspection the home was adequately staffed, with staff who are experienced and competent to care for residents currently living at the home. The manager confirmed that a robust recruitment policy and procedure is in place to ensure that the team is balanced and provides appropriate physical, nursing and social support for all residents safely. The staff team were seen to work well together and told the inspector that they enjoyed working at the home and felt supported by the manager to do their job. Care staff told the inspector they are clear about their roles within the home and that they felt training opportunities are available for them to develop existing and new skills further. Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 Page 21 The manager and senior carer provide supervision formally for all staff with records maintained and stored securely by the manager. This system helps to ensure that staff training needs are identified and that the Manager and team are able to undertake a range of NVQ training qualifications any ideas needs or issues can be addressed as they arise. Team meetings are also provided to give the care team wider opportunities to contribute to development of practice within the home. Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. The home has a competent and committed acting manager who understands the needs of each individual resident. Resident’s benefit from the support given to staff by the manager in maintaining residents at the centre of the care giving, review and development process. Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 Page 23 EVIDENCE: The owners of the Care home are both registered nurses who provide support to the operational manager to develop his skills further. The Manager is currently undertaking the registered Managers award. The managers office is well organised, and provides a base for maintaining all records. These are kept appropriately by the manager and used in a structured way by the team to make sure care needs are met. The Manager encourages residents and staff to meet to discuss any concerns and to share ideas for developments within the home, and uses the review process to ensure resident existing and changing needs are met in the way they wish them to be. There is evidence that reviews are undertaken which fully involve residents, family carers and other professionals in a structured way. This evidence is being used to update all care plans so that it is easier to make reference to it when needed. Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 4 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 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 4 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Genesis Residential Home Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000002656.V264841.R01.S.doc Version 5.0 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Genesis Residential Home DS0000002656.V264841.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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. 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