Inspection on 27/06/06 for Green Acres

This inspection was carried out on 27th June 2006.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Green Acres 29/10/07

Green Acres 06/09/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Green Acres Green Acres 130 Nork Way Banstead Surrey SM7 1HP Lead Inspector Lisa Johnson Unannounced Inspection 27th June 2006 09:10 Green Acres DS0000062238.V301043.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 Green Acres DS0000062238.V301043.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. Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Green Acres Address Green Acres 130 Nork Way Banstead Surrey SM7 1HP 01737 351358 02083353264 Chatsworthcare@talk21.com 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) Chatsworth Care Ms Susan Anne Lowther Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2005 Brief Description of the Service: Green Acres is a six bed roomed detached house set in a residential street in Banstead, Surrey. The home provides accommodation and care for up to six people with learning disabilities. There are four bedrooms on the upper floor and two on the ground floor, all with en suite facilities. Also on the ground floor is a comfortable kitchen/diner plus two sitting rooms. The house has been newly renovated throughout with furniture, fixtures and fittings of a high standard. There is a paved area to the front of the house with parking for up to six cars. The rear garden is extensive and laid to grass with a secure fence and side gate. Access is via the kitchen or patio doors leading from the rear lounge. The scale of charges range from £1,300- £2,100. Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over eight and half hours. It was carried out by Mrs. L Johnson and Mrs. S. Lowther registered manager represented the establishment. All of the service users have complex needs and mostly have non-verbal communication therefore their direct views about their care could not be obtained. Observations of interactions and service user responses have been recorded in this report. Five service user comment cards have been received since the inspection and comments received have been reflected in this report. A full tour of the premises took place. Staff training records, staff files and policies and procedures were sampled. The inspector spoke to five members of staff. The inspectors would like to thank the staff and service users for their time, assistance and hospitality during this inspection. What the service does well: The service provides a homely atmosphere and a good standard of accommodation. Positive relationships were observed between service users and staff who had a good knowledge of individuals needs and were able to interpret and respond to non- verbal requests from service users. One individual uses makaton sign language and signed “happy”. The home is in the process of carrying out work to receive autism specific accreditation. Care plans were based on a person centred approach and were detailed and comprehensive providing a clear overview of the individuals needs. The home provides a varied range of recreational and social activities, which are tailored to meet the individual needs and preferences of service users. There was emphasis on community integration and it was evident that staff have explored opportunities for activities to provide service users with a wide range of experiences. Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 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. Green Acres DS0000062238.V301043.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 Green Acres DS0000062238.V301043.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 at least once during a 12 month period. 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. Prospective service users are provided with the information they require to make an informed choice about the suitability of the home as a place to live. The needs of service users are assessed prior to admission to the home. EVIDENCE: The home has a Statement of Purpose and a service user guide is produced in symbol picture format, which is detailed and comprehensive and clearly describes the homes aims and objectives and services it is able to offer. There is one service user vacancy. Pre admission assessments are obtained and completed prior to any individual moving into the home. Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with an individual care plan, which records their individual needs and goals. Service users are supported to make decisions about their lives with assistance. Service users are supported to take risks as part of an independent lifestyle. EVIDENCE: Each service user has a completed care plan, which has been based on a full needs assessment including personal care, communication, safety, health and social skills. Individual plans were person centred in their approach detailed and structured with clear objectives, and goal plans recorded. There was “An about me” section which recorded individual preferences about daily routines and likes and dislikes. It was evident that plans were reviewed with records recorded at the back of the individuals file. However it was recommended that the date of the next review should be recorded on the care plan. It was further recommended that daily records should reflect the progress of care plan objectives. Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 10 The communication needs for each individual was recorded in his or her care plan. Staff were observed to have a good knowledge of the non- verbal communication needs of service users and were responsive. One individual used Makaton and gestures and a member of staff responded to this positively. Pictures were displayed in the kitchen to assist service users to ask for drinks and to high light household activities, which they are supported to be involved with during the day for example filling the dishwasher and clearing the table. The home holds service user meetings where notes were maintained. Service users are supported to take part in a range of activities and new experiences. Comprehensive risk assessments were included in each individuals plan including for example the use of the kitchen, behaviour, community access and bathing. Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with a range of appropriate activities and engage in a range of leisure activities. Service uses are supported to take part in the local community. The rights and responsibilities of service users is respected. The home is able to demonstrate that service users are provided with a wellbalanced and nutritious diet. EVIDENCE: The home provides a wide range of activities for service users to attend. It was clear that activities were tailored to suit individual needs and preferences with staff showing enthusiasm and motivation in exploring new ideas for service users to gain a variety of experiences and increasing community integration. During the inspection service uses went out for lunch, one person went to the Galway centre and the afternoon service users attended sensory sessions at a leisure centre. There are opportunities to go horse riding, ten-pin bowling, aromatherapy, visits to the cinema, trampoleening, visits to the pub and the home had recently accessed a local social club. Service users have the opportunity to go the church and links have been made with a college. Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 12 One individual was seen having a game of football with a member of staff in the garden. There were opportunities to participate in cooking with one individual seen helping in the kitchen and being supported to undertake household activities. One comment received from one individual stated” I like my aromatherapy sessions, I enjoy pamper sessions and painting my nails”. There are opportunities to go out shopping and one individual enjoys pushing the trolley in the shop. Positive relationships were seen between service users and staff and it was clear that service users felt relaxed and confident in the presence of staff. Staff had a good knowledge and understanding of individuals needs and were able to respond to non-verbal forms of communication and responded to requests. Service users were able to walk freely around the house and their privacy was respected. Five comment cards returned confirm that service users are provided with keys to their rooms. One comment received stated “ I like to have my special seat in the lounge”. The home provides a four weekly menu and service users are able to choose the menus, which was confirmed by one individual who was observed to making a choice of cereal for breakfast. During the inspection service users went out for a meal, however the menu indicated that meals were well balanced and nutritious. A gluten free diet is provided for one individual. There were opportunities for service users to have drinks and snacks, which was observed during the inspection. Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 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 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. The home is able to demonstrate that service users receive personal support in the way they prefer. Service users physical and health needs are met. Service users are protected by the homes medication administration procedures. EVIDENCE: The preferences of individuals were clearly recorded in individual plans including preferred routines. During the inspection some individuals were receiving personal care which was provided in private and one person chose to have a lie in with their preference and choice respected. The health care needs and objectives of service users are documented in their care plans and the home is in the process of introducing health action plans. Service users are supported to access a range of health care professionals including a local general practitioner with referrals made if required. For example, referrals to district nurses, community learning disability team, speech therapy, audiology and dietician. Dental treatment and chiropody is accessed locally within the community Medication administration procedures were examined. Photographs were available of individuals with their records. Medication is dispensed from blister Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 14 packs and all medication administered to service users was signed for. Policies and procedures were in place. Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is able to demonstrate that the views of service users are listened to and acted upon. The staff team need to ensure that it responds to the protection of vulnerable adult policies to ensure that residents are protected from abuse. EVIDENCE: There is a complaints procedure in place which is accessible to service users in picture format. The home has received one complaint, which was appropriately followed up. One service user used a makaton sign to indicate “happy”. Staff training records indicate that staff have received training in safeguarding adults from abuse. The home has a copy of the local authority multi- agency safeguarding adult’s procedure and a whistle blowing policy. However the homes local policy did not indicate the requirement to contact the area local authority team to report any abuse if it occurred. While examining the incident and accident forms the inspector noted that an incident pertaining to a safeguarding adult issue had not been reported to the local authority team or to the Commission for Social Care Inspection following the safeguarding adult protection procedures. The registered manager upon advice acted upon this issue during the inspection. A requirement was made that the registered manager and staff should report any incidents or allegations that fall under the remit of safeguarding adults immediately to the local authority and to the Commission for Social Care Inspection to ensure that the health, welfare and safety of service users is protected. Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 16 Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 17 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, 25, 26 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a well-maintained, comfortable, homely and safe environment. The home is able to demonstrate that service users bedrooms promote their independence. The home is clean and hygienic ensuring that service users have a pleasant home to live in. EVIDENCE: The service provides a warm and homely atmosphere. The home provided a good standard of accommodation and was well maintained and pleasantly furnished. There was a large well-maintained garden to the rear of the house which service users were enjoying. Bedrooms were viewed as comfortable and reflected individuals preferences and interests with a wide range of personal possessions on display. The home was cleaned to a good standard and was hygienic. Separate laundry facilities were available and infection control procedures in place. Staff training schedules concluded that staff have received training in infection control. Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by competent and qualified staff. Service users are protected by the homes recruitment policy and practices. Services users needs are met by appropriately trained staff EVIDENCE: Fifty percent of care staff hold National Vocational qualifications (Level 2) with eight staff having completed the programme. The company has appointed a training manager and there is an overall company-training plan with a varied range of training, which is actively sought. Each staff member has their own training record in place and it was evident that staff have received mandatory training in safeguarding adults, infection control, fire, food handling, manual handling, health and safety, first aid and managing medication. Three staff personal files were sampled and contained the required information. POVA first checks are carried out and enhanced police checks are completed. New staff who have completed POVA first checks, but who are awaiting for the results of the CRB are supervised appropriately which was highlighted on the duty rota. Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 19 The home is able to demonstrate that staff receive training and development, which actively supports the needs of service users. are currently involved in training in autism with the home receiving an autism accreditation inspection in September 2006. Four staff have attended TEEACH training. A majority of staff have completed distant learning courses in equality and diversity. Staff spoken to confirmed they received induction training and have support to access training and development. Copies of training certificates were available on staff files sampled. Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 20 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, 38, 39, 41 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is able to demonstrate that service users benefit from a home, which is well run, and in the best interests of service users. The local safeguarding adults procedure will ensure that service users rights and best interests will be fully safeguarded. The health safety and welfare of service uses is mainly protected with one issue needing attention. EVIDENCE: The registered manager has experience in social care and holds the Registered Managers Award. There was an open and inclusive atmosphere in the home. The manager has completed a mentoring in the work place course and receives supervision from the responsible individual. Three staff spoken to stated that they felt supported by the management structure. The home conducts quality assurance surveys, which were formulated in pictures and symbols. Questionairres are extended to relatives and other Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 21 stakeholders. The responsible individual conducts monthly quality visits and copies are made available to the Commission for Social Care Inspection. There is a range of policies and procedures, which were sampled with a read and sign system in place. However the local safeguarding adult procedure needs to be reviewed. The manager is appointee for four service users and financial records were examined which were satisfactory with records of expenditure and receipts maintained. A number of health and safety procedures are in place. Substances hazardous to health (COSHH) were stored securely and appropriately. Accident and fire records were sampled. Examinations of records and certificates identified systems are in place for routine service and maintenance arrangements for the environment. However during a tour of the kitchen some packets of opened cereals were observed in the kitchen cupboards. A requirement was met that all opened dried foods must be kept in sealed containers to ensure the health and welfare of service users. Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 22 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 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 X X 3 2 X Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 23 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 OP23 Regulation 13(6) 37 Requirement a) Any incident that falls into the remit of safeguarding adults must be reported without delay to the local authority social care team and to the Commission for Social Care Inspection. b) The registered person must review the homes local safeguarding adult procedure to include the role of the local authority. All opened packets of food must be stored in sealed containers. Timescale for action 28/06/06 3 YA42 16(2)(j) 28/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 1. Refer to Standard YA6 YA6 Good Practice Recommendations It is recommended that the daily records reflect the individual care plan objectives. It is recommended that the dates for care reviews are recorded on the individual plan Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Green Acres DS0000062238.V301043.R01.S.doc Version 5.2 Page 25 - 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!