Inspection on 05/06/07 for Green Lanes Projects

This inspection was carried out on 5th June 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Green Lanes Projects 23/01/07

Green Lanes Projects 27/03/06

Green Lanes Projects 28/09/05

Green Lanes Projects 17/01/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Green Lanes Projects 40 Myddleton Road Wood Green London N22 8NR Lead Inspector Jackie Izzard Unannounced Inspection 5th June 2007 09:00 Green Lanes Projects DS0000057935.V338453.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 Lanes Projects DS0000057935.V338453.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 Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Green Lanes Projects Address 40 Myddleton Road Wood Green London N22 8NR 020 8829 0996 020 8829 0996 green.lanes@btconnect.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) Mr Pangisani Mabhena Ms Angela Mary Mabhena No registered manager Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Green Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2007 Brief Description of the Service: Green Lanes Project is a registered care home providing care for up to six men and women who have a learning disability. The home is registered to care for adults between the ages of eighteen and sixty five years. The home is a large three storey house in Haringey, North London. The home is well situated for buses and overland trains and is a short bus ride away from the underground station at Wood Green. Service users of the home have easy access to local shops, churches, cafes etc within walking distance. The house has six single bedrooms with ensuite facilities and a large lounge, kitchen diner, conservatory and garden. The house is decorated and furnished to a good standard. The aim of the home is to empower individuals to live as independently as possible according to their preferences and abilities. The home currently has five residents, one woman and four men. The fee for living at the home ranges from £850 to £2200 per week, depending on the level of care provided. Following Inspecting for Better Lives, the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Green Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on 5 June 2007 and lasted one day. The home did not know the inspector was coming. The inspection consisted of the following: • • • • • • • Tour of the home Inspection of three resident and staff files Inspection of records and policies in the home Meeting with the manager Talking to two staff members Talking in private to one person who lives at the home Reading surveys about the home written by each person who lives there. What the service does well: What has improved since the last inspection? What they could do better: The areas where the home needs to improve in order to meet the needs of the people living there are; further staff training, more careful recruitment practice, recording and reporting restraint and replacing a broken blind. Green Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 6 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 Lanes Projects DS0000057935.V338453.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 Lanes Projects DS0000057935.V338453.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in this home can be assured that their needs and aspirations will be assessed before they move in and regularly thereafter. EVIDENCE: In order to assess whether people’s individual needs and aspirations had been assessed, the inspector read the assessments for three of the five people currently living in the home. Their needs were fully assessed. Risk assessments were comprehensive and related to each individual’s needs. The inspector spoke with one resident who was able to express his needs and aspirations clearly and these matched the needs recorded in his file. The home currently has one vacancy and the manger explained that she had been to visit and assess prospective new residents and discussed these referrals with the staff team to ensure they are involved in the assessment process. Green Lanes Projects DS0000057935.V338453.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People benefit from comprehensive risk assessments and care plans which now also address their individual cultural and religious needs. EVIDENCE: Three residents’ care plans and risk assessments were inspected in detail. Risk assessments were of a good standard and very comprehensive. Care plans were good, in that they addressed the person’s needs in a number of different areas and were clear for staff to follow. Religious and cultural needs were addressed in the care plans following a requirement made at the last inspection in January 2007. Examples seen at this inspection were access to Indian and Nigerian films, African and Turkish Green Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 10 food introduced on the menu and religious needs addressed. One person told the inspector of his religious practices and said he was supported by the home in this area.. Cultural needs and preferences were recorded in care plans. Where residents have some challenging behaviour, written contracts regarding behaviour have been written and signed. People are encouraged to make decisions for themselves on a day to day basis and where this is not appropriate this is recorded. One resident had signed an agreement that staff enter his room weekly to check water temperature. People are consulted about such matters. Those people who are able, travel independently and others are escorted by staff to college and for their leisure activities. Everyone is encouraged to be as independent as they are able. Green Lanes Projects DS0000057935.V338453.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are supported to live a good quality of life following their own individual interests and maintaining their own relationships. Their rights and responsibilities are respected on a day to day basis. EVIDENCE: The inspector was able to meet and talk in private to one resident for his views on the quality of life he has living at this home. All other residents were out for the day at college when the inspection took place. The inspector left some questionnaires for residents to complete asking for people’s views on the home. All the residents kindly completed these and returned them to the inspector so their views could also be included. All five residents were enjoying a good quality of life and received support from staff to follow their interests. All five attend college on a part time basis. Staff escort them on public transport and give them the support they need. People are well supported to live their lives according to their own wishes with risk Green Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 12 assessments in place where needed for their own safety. People go out in the community whenever they wish. The home supports service users to keep in contact with family and friends and offers support with personal relationship issues. The home has links with a social club for people with learning difficulties and a dating agency for people with learning difficulties which people may use in the future. Where somebody is at risk in the community, a clear risk assessment is put in place which they are aware of. This is reviewed on a regular basis and the manager was able to give an example where the home has approached a resident’s care manager to suggest that this resident be allowed greater independence in the local community, which is very positive. Reading daily records, care plans and all other records relating to three residents showed the inspector that people were being supported to make choices about his/her daily activities and lifestyle. The food provided was inspected in detail. This involved discussing the meals with one resident, inspecting care plans regarding food preferences, menus and daily records of food eaten. Improvements have been made to the menu since the last inspection. Now as well as being varied and nutritious, the menu reflects the cultural preferences of the residents. One person said at the last inspection that he did not like the food and would prefer Turkish food. The inspector saw that the home has acted on this. Another was eating the meals but records indicated he was more used to a different ethnic diet. Some African dishes have since been introduced on the menu. Green Lanes Projects DS0000057935.V338453.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents’ physical and mental health needs are known by the home and met, using specialist services where needed. They are protected by improved safe practice in medication administration. EVIDENCE: Personal support needs and preferences are recorded in care plans and there was sufficient written evidence that people’s preferences are known and met. One person told the inspector that he was satisfied with the way staff offer and provide personal support. Three service users’ files were inspected for evidence of their health needs being addressed. There was evidence that physical and mental health needs were being met. Records were kept of appointments with a dentist, optician, GP and specialist services, ie speech and language therapist, continence advisor and psychiatrist. Mental and physical health needs were recorded appropriately. Green Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 14 Since the last inspection of the home in January 2007, improvements have been made in medication. All but one of the current staff had attended medication training and dossett boxes are no longer used which has decreased the chance of an error being made with medication. Two staff administer the medication and sign that they have done so. The home has obtained a copy of the medicines policy for residential care homes and is adhering to it. None of the current residents are able to self medicate at this time. Green Lanes Projects DS0000057935.V338453.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home can be assured that their views, their safety and protection from abuse are taken seriously by the home. EVIDENCE: The home has a complaints policy which meets the required national minimum standard. The complaints form is user-friendly. There is a written procedure for staff to follow should there be any allegation or incident of abuse. This adult protection procedure and the emergency telephone numbers for each service user’s placing authority and the local adult protection officer are easily accessible to staff. Where residents have been subject to abuse prior to coming to this home, clear written safeguards are in place to protect them. The manager showed through discussion of two individual residents and their adult protection issues that she takes adult protection seriously and has a good understanding of the risks to particular residents and addresses these risks through written risk assessments and careful practice which is agreed with the placing authorities of each individual. Green Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 16 Since the last inspection, all staff except for one newly appointed staff member have attended training in the protection of vulnerable adults. The inspector looked at the training records of two staff in detail and confirmed that both had attended this training. There was an adult protection investigation recently involving one of the residents. As a result of this investigation, the manager was asked by the inspector to go through the proper safeguarding procedure again with all staff to ensure everyone knows what to do when an allegation is made. The manager confirmed that she had discussed this procedure in a staff meeting and now staff were clear about the correct procedure to follow should there be any further disclosures of abuse made. The inspector saw in one person’s file that there had been an incident where this person had to be restrained by staff for the protection of others. The requirement to keep a record of restraint as detailed in Regulation 13 of the Care Homes Regulations 2001 was pointed out to manager and a requirement is made to keep a record of any restraint and that this should be reported to CSCI. Green Lanes Projects DS0000057935.V338453.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are provided with a homely, well maintained environment. EVIDENCE: This home blends in well with other houses on the street and is well situated for public transport and local amenities. The inspector looked at all communal rooms and five bedrooms. All rooms are well decorated and furnished with good quality furniture. The general cleanliness of the home was of a very high standard. Carpets were in the process of being replaced at the time of the inspection and the new carpets were of good quality. Green Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 18 One resident’s bedroom blind needed repair or replacing and a requirement is made to do so. The cleanliness of the communal areas was very good and the house is attractively furnished and homely. A computer is provided along with television and music facilities and there is a designated smoking area. A garden is available for residents’ use. A requirement to treat a damp wall in a bedroom had been acted on promptly and the inspector saw there is no longer a problem. Green Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 19 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 using the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from well supported and supervised staff but are at risk from a recruitment practice which is insufficiently robust at the time of this inspection. EVIDENCE: The inspector met with two staff, one of whom was newly recruited and examined training and supervision records and staff files. Staff have recently attended training in protection of adults, fire safety, medication and manual handling. One staff had completed NVQ 2 in Health and Social Care and the manager said that two others would be starting NVQ 3 in September. There was no written evidence of this available so a requirement to ensure 50 of staff are enrolled in NVQ training is restated. A training plan had been submitted to CSCI and the staff are working through this training. The inspector saw that two staff have had supervision on a monthly basis since the last inspection. This is good practice and exceeds the national minimum Green Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 20 standard. The manager told the inspector she plans to implement staff annual appraisal in the near future. Staff recruitment records were inspected. At the last inspection a requirement was made to endure staff references have been authenticated before a person commences employment. The inspector found that recruitment practice was good with the exception that one staff had been allowed to start work with only one reference instead of the required two. This is unacceptable practice and could leave residents at risk if a staff member had not been properly vetted. The requirement is restated. Green Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 21 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 using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are benefiting from a home which has made significant improvements in the last five months, demonstrating commitment to running the home in the best interests of the residents. EVIDENCE: A new manager who has experience as a registered manager started in January 2007 after a period where there were changes of manager and staff and standards had slipped in the home. The registered providers and the new manager have worked collaboratively together to make improvements in the home. Twelve of the fourteen requirements made at the last inspection have been fully met which is very positive. Green Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 22 The residents told the inspector via written comments that they were satisfied with the management of the home. The inspector saw evidence in files that key workers meetings are held on a regular basis to consult people on their satisfaction and future plans and wishes. The minutes of a house meeting held on 24 May were read. The quality assurance exercise undertaken in 2007 resulted in a development plan being written for the home as required. The inspector saw evidence of improvements in all areas since the previous inspection in January 2007 and was confident that the providers and manager were committed to continual improvement. The fire alarm system was serviced on 07/01/07. The fire extinguishers were inspected for safety in March 2007 and a gas safety inspection had been carried out. Fire drills and checks of door guards are undertaken weekly. There are written guidelines for staff regarding how to support an individual resident in responding to a fire drill which is positive. The home was inspected in November 2006 by an Environmental health officer and a recommendation made that staff attend food hygiene training. The manager said that staff have been provided with food hygiene and first aid training but certificates had not yet been received so a requirement is made to provide this written evidence to the CSCI. The registered provider is now writing monthly reports on the conduct of the home and sending a copy to the CSCI as required by Regulation 26 of the Care Homes Regulations 2001. Green Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 23 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 X 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 2 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 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x Green Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 24 yes 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 YA23 Regulation 13(8), 37(1)(e) 19(1)(c) Requirement The registered persons must ensure that any future incident of physical restraint is recorded and also reported to CSCI. The registered persons must ensure all references for new staff are authenticated before the person commences work in the home. This requirement is restated. Previous timescale of 28/02/07 not met. Timescale for action 30/06/07 2. YA34 15/07/07 3. YA35 18(1)(c) 4. YA32 18(1)(c) The registered persons must provide written evidence that staff have been trained in food hygiene and first aid. The registered persons must provide written evidence that 50 of staff have enrolled on NVQ 2 training relevant to this job. This requirement is restated. Previous timescale of 31/03/07 not met. 16/07/07 31/08/07 Green Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 25 5. YA24 23(2)(c) The registered persons must repair or replace the broken blind in one bedroom. 31/07/07 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 Lanes Projects DS0000057935.V338453.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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. 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