Inspection on 29/10/07 for Green Acres

This inspection was carried out on 29th October 2007.

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 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

Green Acres 27/06/06

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 Eamonn Kelly Unannounced Inspection 29 October 2007 11:00 th Green Acres DS0000062238.V346621.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.V346621.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.V346621.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 manager Type of registration No. of places registered (if applicable) Chatsworth Care Mrs Chris Holman Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2006 Brief Description of the Service: The Chatsworth Care web-site www.chatsworthcare.com says that the company provides “quality residential care for adults with moderate to severe learning disabilities, autism, challenging behaviours and complex needs…we specialise in caring for people with autism spectrum disorders…our aim is to enlighten and encourage people to have control over their lives as far as possible and become a valued member of their community…”. Green Acres has six bedrooms each with en-suite facilities. There are suitable communal and garden facilities. The home has exclusive use of an MPV-type vehicle. Weekly fees are from £1300 to £2100. Additional charges made to residents are shown in the information guide. Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 29th October 2007. It consisted of meeting with the manager (Mrs Chris Holman), residents and members of staff. Care practices were observed and discussed with members of staff. A variety of records was seen during the visit principally those that supported the care of residents. The commission received a completed annual quality assurance assessment (AQAA) and this was helpful in the preparation of this report. All residents (with staff assistance) returned completed questionnaires about their views of the service to the commission. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 Page 6 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.V346621.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 5. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Prospective residents and their supporters receive good initial advice and guidance to help them assess the quality, facilities and suitability of the home. EVIDENCE: Prospective residents and their representatives receive assistance and guidance to enable them to decide if the home is able to meet their support needs. This includes receipt of a written guide and brochure that contains information about services and facilities. Personal contracts include information about the rights and responsibilities of both parties. Sponsoring organisations and families are closely involved at an early stage when new residents are being considered. Four residents moved to the premises from another residential home in 2004. Since then, two further people have taken up residence. The information guide indicates that nursing care is not provided. However, in the event of serious illness residents remain at the home unless a health assessment indicates that their needs can no longer be met. Intermediate support (short-term recuperative care) is not provided. Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents are helped to make decisions and to express themselves as part of developing their confidence and quality of life. EVIDENCE: Residents are encouraged to make their own decisions and choices. Members of staff understand the importance of doing this and of understanding how to predict possible types of behaviours. Care plans and associated procedures are person centred and are agreed using a number of forms of communication with residents and observation by staff. These contain good information about resident’s support needs and how these are being met. Care plans cover all areas of each resident’s life. Members of staff have the skills and ability to support and encourage them in individual ways to be involved in the ongoing development of their plan. They use a variety of means to help individuals make a worthwhile contribution and to receive the support they need. Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 Page 9 Care plans are seen as working documents reviewed regularly and updated as necessary. They are kept up-to-date and focus on how residents develop their skills, have their changing temperaments recognised and have their future aspirations addressed. Independent advocacy contributes to these decisions in some cases. Care plan folders include risk assessments pertinent to the resident. The examples discussed address safety issues whilst aiming to maintain good qualities of life. Members of staff are aware of current policy issues and good practice developments. Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. People who use the service experience excellent quality outcomes. This judgement was made using a range of evidence including a visit to the service. Routines and activities developed with each resident give them opportunities to develop their skills and exercise preferences on a day-to-day basis. EVIDENCE: Residents are able to enjoy a positive lifestyle with a variety of options to choose from. Their interests and abilities are known and regularly reviewed. Small changes in skills or temperament are identified with degrees of significance recorded. These are taken into account when planning routines of daily living and arranging activities both on the premises and the community. Routines are flexible and residents make choices in major areas of their life. The promotion of each resident’s right to live an ordinary and meaningful life is central to the home’s aims and objectives. Members of staff understand the importance of enabling residents to achieve measurable goals, follow their interests and be integrated into community life and leisure activities. Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 Page 11 Routines, activities and plans are resident focused, regularly reviewed, and can be quickly changed to meet individuals changing needs and wishes. The availability of an MPV-type vehicle and Motability car assists with this flexibility. The ability of staff to understand what residents mean and feel, despite the lack of resident’s ability to verbally communicate, also benefits residents and enables routines to be varied. Typed activity lists for each resident and pictorial charts are used. Residents are able to choose cards to help indicate what they need. Members of staff encourage and provide imaginative and varied opportunities for residents to develop and maintain social, emotional, communication and independent living skills. Members of staff described methods that focus on involving residents and promote their rights to make informed choices with assistance. This includes links to specialist support when needed and opportunities to develop and maintain family and personal relationships. There is evidence of innovative methods being used. This includes prediction of factors that may cause upset to residents and ways of alleviating future distress. The evidence is that residents enjoy the opportunities they experience. They are helped to be independent and are involved in all areas of daily living. This includes taking some part in and responsibility for shopping, upkeep of the premises, planning meals, and meal preparation. The home provides a wide range of activities, including college attendance, for service users. It is clear that activities are tailored to suit individual abilities. Members of staff outlined how care is taken to provide good meals for residents who are involved to the greatest extent in shopping, meal preparation and household duties. During lunch, it was clear that resident’s preferences are taken into account, allergies are known and resident’s receive the levels of support they need in each case. Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents receive good personal and healthcare support. EVIDENCE: Efficient medication policy, procedure and practice guidance has been developed. A locked medicine cupboard is maintained, staff receive training in administering medicines and complete MAR sheet entries when medicines are administered. An up-to-date photograph of each resident accompanies MAR sheets together with an easy to read précis of each resident’s prescribed medication. Residents receive effective personal and healthcare support. Care plan records contain information to monitor these aspects of resident support. The notes record resident’s personal and healthcare needs and outline how these will be delivered. Members of staff ensure that personal support is flexible, consistent, and able to meet the changing needs of residents. They know and respect resident’s preferences and support needs. Male, female and age related issues are taken into account when delivering personal care. On this occasion, members of staff Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 Page 13 responded sensitively in situations involving personal care ensuring that they were conducted in privacy. Residents receive good healthcare support. This includes access to a GP, mental health nurses and all NHS healthcare facilities in the local community. Regular appointments are seen as important and systems are in place to ensure they are not missed. The home arranges for health professionals to visit residents at home when necessary and residents also attend health clinics. Members of staff referred to how they are alert to changes in mood, behaviour and general wellbeing of residents and understand how they should respond and take action. Health action plans are being developed in line with current good practice guidance. Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents are protected from all forms of abuse. EVIDENCE: Policies and procedures for safeguarding adults are available and give specific guidance to staff. These are also included in the induction process. Members of staff understand the circumstances that might need to be reported to social services or the commission. Residents are protected in many ways including through good recruitment procedures. These include CRB and pre-employment POVA checks. It is understood that all staff receive information about the various implications of POVA (protection of vulnerable adults) procedures. The manager, members of staff and staff from elsewhere in the company monitor resident’s well being. They regard resident’s safety and protection as a priority. The service has a complaints procedure that is easy to understand. Visitors and others are encouraged to make their views about the service known. No complaints were received in the past year. Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28 & 30. People who use the service experience excellent quality outcomes. This judgement was made using a range of evidence including a visit to the service. The premises are suitable for the support of residents. EVIDENCE: The premises are designed for the support of people with learning and some physical disabilities. Four residents have bedrooms on the first floor and 2 have bedrooms on the ground floors. All bedrooms have en-suite facilities including baths or shower. A communal bathroom is available in particular circumstances. There are excellent communal facilities including a sensory and music room. Excellent external facilities also serve residents, staff and visitors well. The premises were clean and tidy and are very suitable for resident care and use by residents, visitors and staff. Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents are in the care of well-trained and experienced members of staff. EVIDENCE: Residents are supported by numbers of staff considered appropriate for meeting their significant needs. There is a high level of observation, intervention where necessary and effective teamwork to assist residents develop routines and obtain essential skills. Members of staff are encouraged to undertake NVQ Levels 2 and 3 in Promoting Independence. The induction procedure covers the standards required by the relevant training agency for the care sector (Skills for Care). Members of staff undertake additional training appropriate to the needs of residents at the home. Plans for achieving a full training profile for each member of staff are discussed in formal supervision meetings between the manager and individual members of staff. Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 Page 17 Good recruitment procedures are followed. CRB and pre-employment POVA checks are taken up for all staff and volunteers. There is a good induction system and regular recorded supervision is carried out. The company’s training manager liaises closely with the manager and members of staff to provide appropriate training. Examples of staff files suggested that NVQ training is encouraged and essential training is given in, for example, first aid, safe movement of frail people, food handling and preparation, POVA, infection control, fire safety and administration of medication. The company has prepared a number of workbooks for staff development purposes. All members of staff also receive training in topics relating to direct care of residents, for example, on autism, understanding challenges faced by residents, intervention skills. Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents have the benefit of living in a home that is well managed and conducted in their best interests. EVIDENCE: Residents are encouraged to articulate their feelings and successful efforts are made to meet their changing support needs. A high priority is given to providing suitable training and personal development opportunities for staff. Staffing levels and management support combines to provide a suitable framework designed to meet the needs of residents. The manager and other members of staff outlined how they work to improve services and provide a good quality of life for residents with a strong focus on equality and diversity issues. There is a strong ethos of being open and transparent in all areas of supporting residents. They are aware of current Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 Page 19 developments and conduct the service accordingly. Their skills and knowledge are based on continuous development, gained through training and enthusiasm for the role. The manager is appropriately experienced and qualified including achievement of the Registered Manager’s Award. The home has clear health and safety policies that all members of staff are aware of. Safeguarding is given high priority and the home has a range of policies and guidance to underpin good practice. The annual quality assurance assessment (AQAA) indicates that appropriate safety certificates are in place, for example, fire safety records and annual portable appliance checks for all electrical items used by residents. Quality assurance surveys that include pictures and symbols are conducted. The company’s responsible individual conducts monthly quality visits and prepares reports based on those visits. Residents were assisted by staff to respond to the commission’s resident survey. Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 Page 20 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 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 x 27 x 28 4 29 x 30 4 STAFFING Standard No Score 31 x 32 3 33 3 34 x 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 4 14 x 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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 Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Green Acres DS0000062238.V346621.R01.S.doc Version 5.2 Page 23 - 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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