Inspection on 06/09/05 for Green Acres

This inspection was carried out on 6th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Green Acres 29/10/07

Green Acres 27/06/06

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 130 Nork Way Banstead Surrey SM7 1HP Lead Inspector Denise Debieux Unannounced 6 September 2005 @ 09:45am th 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. Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Green Acres Address 130 Nork Way Banstead Surrey SM7 1HP 01737 351358 01737 351868 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) Chatwsorth Care Ms Susan Anne Lowther CRH - Care Home 6 Category(ies) of LD - Learning Disability (6) registration, with number of places Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th April 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. Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5.5 hours and was the second inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. This inspection was carried out by Denise Débieux, Lead Inspector for the service. Miss Christine East, Deputy Manager, was present as the representative for the establishment. At present there are five service users living at the home with a sixth service user visiting four afternoons a week with a view to her moving in permanently. All of the service users have extremely complex needs and use mostly nonverbal communication, they also become unsettled and uncomfortable with people they do not know. In order to minimise any distress caused, the inspector did not feel it appropriate to carry out in depth interviews with the service users. Instead, observations of interactions and service user responses have been recorded in this report. A full tour of the premises took place. Staff training records, staff files and policies and procedures were sampled. Four of the service users, one visiting relative and four of the on-duty staff were spoken with during the inspection. 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 high standard of accommodation at Green Acres provides a comfortable, safe and homely environment for the service users at the home. The staff are skilled in communicating and working with service users with diverse and complex needs. This was apparent in all interactions observed between the staff and service users. On several occasions during this inspection the service users were seen to indicate a wish or need to staff. Each time this occurred the staff were seen to respond promptly and with clear understanding to meet the expressed need. The home is to be congratulated for their continued success in ensuring that the settling in period for the service users has been made as smooth and stress free as possible. This is demonstrated by all service users being seen to be calm, settled and happy at all times during this inspection. Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 6 A visiting relative expressed his satisfaction with the home and the quality of care and lifestyle offered to his relative. 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 H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 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 Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 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) 5 The home’s written contract has been revised and now contains all required information. EVIDENCE: Each service user has an individual contract. The home has now revised the contracts to include the fees charged, arrangements for review of service users’ needs and elements of the care management plan to be provided outside the home and has therefore met the recommendation made at the last inspection. Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 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) 9 Service users are supported and enabled to take risks as part of an independent lifestyle. EVIDENCE: Comprehensive risk assessments are included in each service users’ care plan. As the service users are settling in to their new life, additional and new activities are being introduced, such as swimming. With each new activity the staff at the home are careful to assess the potential risks and put in place measures to reduce those risks whilst encouraging the service users to explore new experiences. During this inspection the service users were seen to be making clear choices about their daily lives and to be supported by staff as necessary. Service users were seen to be choosing where they went and what they did in the home with confidence. If they wanted assistance with an activity, such as an activity or having a drink, they came to a staff member indicating that they wanted help and showing or taking the staff to what they needed. Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14 and 16 Service users are encouraged to engage in appropriate leisure activities. Their rights are respected and responsibilities recognised in their daily lives. EVIDENCE: The current service users moved to the home after it was first registered in December 2004 and the staff have been working hard in that time forging links with the local community and exploring new and fulfilling activities for the service users to try. These have included swimming, bowling and visiting local parks, farms and shops. During this summer the service users have been to a local jazz festival and funfair and the home held a family barbeque in the garden. The inspector was advised that the service users have also joined a local ‘Healthy Walking Club’ and enjoy going for walks once or twice a week with them. The staff are currently looking for suitable day centres and all service users have been registered with a local college for people with learning disabilities. Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 11 At present the service users contribute towards the cost of an annual holiday away from the home, with the home covering the cost of accompanying staff. A recommendation was made at the previous inspection that the cost of the annual holiday be included as part of the basic fee. This requires a renegotiation of fees with the funding authorities, which is ongoing. For this reason the recommendation has been brought forward to this report. The daily routines reflect the requirement to promote independence, individual choice and freedom of movement, with service users observed to be enabled to make choices of what to do and when. All interactions between the staff and service users were seen to be respectful and caring. Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 Sound policies and practices are in place for the administration and management of medications. EVIDENCE: Since the previous inspection the home have acquired a copy of the Royal Pharmaceutical Society’s guidelines for the administration and control of medicines in care homes. All staff administering medications have undergone certificated training. Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 13 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) 22 and 23 All required policies, procedures and practices are in place to ensure that service users feel their views will be listened to and that they are safeguarded, as far as reasonably possible, from harm or abuse. EVIDENCE: The home has a comprehensive complaints policy and procedure in place, with a pictorial version being supplied to all service users. All versions have been reviewed and are now consistent in the information they give. The home now has a copy of the latest Surrey Multi-agency Protection of Vulnerable Adults Procedure, which is available to all staff in the office of the home. The manager and deputy have attended a recognised training course in adult protection and this information is cascaded to all staff, with the protection of vulnerable adults now forming an early part of new staff induction. Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 14 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) 30 The home was found to be clean and hygienic and to meet service users’ individual and collective needs in a comfortable and homely way. EVIDENCE: On the day of inspection the home was seen to be warm, bright and clean with a homely atmosphere. The service users’ individual rooms have all been highly personalised with the service users’ own belongings and mementos. The provided furniture was seen to be suited to the needs of the service users and to be chosen with care and consideration towards reducing the risk of accidental injury. During this inspection service users were seen to be entering communal rooms and their own rooms with confidence and at will. It was obvious that the service users have a sense of ownership over their home whilst at the same time respecting the other service users’ personal rooms. Policies and procedures are in place for the control of infection with all staff now having received training in the control of infection. Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 15 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, 34 and 35 The home now has a staff training and recruitment programme which is designed to ensure that service users are supported by competent and qualified staff and that, as far as reasonably possible, they are protected from harm. EVIDENCE: At present two of the twelve care workers are qualified to National Vocational Qualification (NVQ) level 2, or above, in care. Four additional care workers are currently undertaking NVQ level 2, and are expected to be qualified before the end of this year. The home have revised their recruitment practices and now ensure that all required checks are carried out prior to a new member of staff commencing employment. Three staff files were sampled and found to contain the required information. All staff have now been trained in all safe working practices and the protection of vulnerable adults. In house training, specific to each individual service user, is provided to all new staff. This training has ensured that the transition from their previous home to this one has been as smooth and stress free as possible for the service users. This is demonstrated by all service users seen to be calm, settled and happy at all times during this inspection. The staff displayed their skills, knowledge and understanding in all interactions observed. Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 16 Where a new member of staff has started work with a POVAfirst check, pending receipt of a valid CRB certificate and also during the induction period of a new worker, the shift leader for each shift is responsible for supervising the new member(s) of staff. The need for a new member of staff to be appointed to a specific, experienced member of staff for supervision during these two instances was discussed at this inspection and a requirement has been made. Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 17 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) 40 and 42 All policies, procedures and practices are in place to ensure, so far as is reasonably practicable, the health safety and welfare of service users and staff. EVIDENCE: Following the previous inspection the manager has now signed and dated all policies and all staff have received training in safe work practices, i.e. fire safety, first aid, control of infection, health and safety and manual handling. All interactions observed between the deputy manager, staff and service users at this inspection evidenced an open, positive and inclusive atmosphere. Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 18 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 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x 2 x 3 x Standard No 31 32 33 34 35 36 Score x 3 x 3 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Green Acres Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x x 3 x 3 x H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 19 Are there any outstanding requirements from the last inspection? YES 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 34.3 35.3 Regulation 19(11) (a-c) 18(2)(a) 18(2)(b) (i-iii) Requirement Where the registered person permits a new worker to start work with a POVAfirst check but prior to receipt of a valid CRB certificate AND for the duration of a new workers induction training, the registered person must: - Appoint a member of staff (the staff member), who is appropriately qualified and experienced, to supervise the new worker. - So far as possible, ensure that the staff member is on duty at the same time as the new worker. - Ensure that the new worker does not escort service users away from the care home premises unless accompanied by the staff member. (Reference The Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004. Timescale for action 06.09.05 Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 20 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 14.4 Good Practice Recommendations It is recommended that the service users have, as part of the basic contract price, the option of a minimum sevenday annual holiday outside the home. Green Acres H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 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 H58 H09 S62238 Green Acres V239648 060905 Stage 4.doc Version 1.40 Page 22 - 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!