Inspection on 01/02/06 for Green Meadows

This inspection was carried out on 1st February 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 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 Meadows 25/07/07

Green Meadows 06/12/06

Green Meadows 20/09/05

Green Meadows 14/02/05

Green Meadows 26/08/04

Green Meadows 10/03/04

Green Meadows 10/02/04

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

CARE HOMES FOR OLDER PEOPLE Green Meadows Green Lane Denmead Hampshire PO7 6LW Lead Inspector Isolina Reilly Unannounced Inspection 1st February 2006 09:30 X10015.doc Version 1.40 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 Meadows DS0000037294.V269065.R01.S.doc Version 5.1 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 Older People. 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 Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Green Meadows Address Green Lane Denmead Hampshire PO7 6LW 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) 023 9225 5328 Hampshire County Council Mrs Rachel Jane Pearce Care Home 42 Category(ies) of Dementia - over 65 years of age (42), Old age, registration, with number not falling within any other category (42) of places Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th February 2005 Brief Description of the Service: Green Meadows is a purpose built care home providing accommodation for 42 older persons, including those with dementia. The home is owned and managed by Hampshire County Council. Accommodation is provided in four units across two floors, and benefits from a large landscaped garden and extensive views over the countryside. Each unit has a lounge dining room, small kitchen, bathroom and toilet, as well as service user bedrooms. There are additional communal areas including a spacious lounge and smaller seating areas, hairdressing salon and a day centre on site, which is available to all service users. Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This second unannounced inspection took place over one day. The inspector looked around the home, view records, procedures, spoke with service users, relatives, a visiting district nurse, staff and observed the interaction between them. The deputy and assistant manager helped the inspector during the visit. The home supplied the commission with additional pre-inspection information. This and the previous inspection report of 20th September 2005 can be read together for a full summary of how the home has done against the key National Minimum Standards. What the service does well: What has improved since the last inspection? What they could do better: The complaint and comment leaflets within the home are clear and easy to read but do not include how many days the complaint will be responded to nor the contact details of the commission. Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 6 The home is looking to finish, by March 2006 a full audit of service including seeking the views of health and adult services professional feedback on how the service is doing. 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 Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The above key standards were assessed and met at the previous inspection on the 20th September 2005. EVIDENCE: Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The above key standards were assessed and met at the previous inspection on the 20th September 2005. EVIDENCE: Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The above key standards were assessed and met at the previous inspection on the 20th September 2005. EVIDENCE: Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The home has a satisfactory complaints procedure that service users are able to use and staff have a good understanding of Adult Protection issues that protects service users from abuse. The home has an open and positive approach to listening to service user views and improving. EVIDENCE: The service users and relatives spoken with stated that the staff are very good and listen to their concerns. The relative also felt that the staff were patient, caring and willing to listen. The staff spoken with were aware of the home’s complaint procedure. The home’s complaint procedure is available in colourful easy to read leaflet that is available in large print but does not includes the address for the Commission nor a timescale for when complaints will be dealt within. This was discussed with the deputy who said she would bring this up at the next management meeting but she was aware that the home has a local procedure that does include the contact details of the commission and timescales for responding to complaints. Copies of the home’s complaint procedure are in each service user’s bedroom at the back of their care plan and from the various offices in the building. The home has received no complaints recently. The complaint log was sampled and found to be satisfactory. The deputy confirmed that detailed records of each complaint are stored separately. Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 12 All the service users spoken with stated that they always felt safe at the home and the relative spoken to also confirmed this. The visiting district nurse was complimentary, stating the home follow care instructions and informs them promptly when necessary. The staff spoken with confirmed that they have received instruction and are aware of the protection of abuse of vulnerable adults. They have attended training on recognising and reporting of concerns or suspicions. The staff records seen held copies of training certificates. There has been no allegation of abuse at this home. The home has an up to date copy of the Hampshire County Council ‘Protection of Vulnerable Adults’ policy and procedure and it’s own policy and procedures reflecting the guidelines from Hampshire County council’s own policy. Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The above key standards were assessed and met at the previous inspection on the 20th September 2005. EVIDENCE: Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 29 The home has good system for supporting staff to undertake appropriate qualifications in care. The staff at the home are well trained, supported and employed in sufficient numbers to meet the service users needs. There are good recruitment procedures that are fully implemented ensure clients are not put at risk. EVIDENCE: The service users spoken with described the staff as caring, friendly, helpful and available when they are needed. They stated that the staff were polite, had no complaints and are happy at the home. The service users and relatives spoken with said felt there was sufficient staff around, although they could be busy during peak times and that the staff know what they are doing. The rotas showed that a minimum of one manager and five carers in the mornings and evenings but sometimes there are four cares in the afternoon. At night there is a nighttime co-ordinator and three carers awake each night. These figures exclude the unit registered management and administrator. The home also employs two cooks and three kitchen assistants, four cleaners and three people in the laundry. The staff spoken with felt that the recruitment process within the home is thorough. The inspector was able to sample five different staff records and found that they held the necessary checks taken to ensure staff are fit to work at the home. Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 15 The staff spoken with stated that he induction programme run by the home was useful and very detailed. The files seen held records of the individual staff Hampshire County Council induction’ training covering the key areas with the signatures of the staff member and trainer. The deputy confirmed that the induction process meets the Skills for Care Council induction standards. The staff spoken with confirmed that the home continues to provide and support staff to achieve qualifications in care to National Vocational Qualification (NVQ) level 2. The deputy confirmed that fourteen out of the twenty-seven care staff employed by the home have or are about to achieve a qualification in care. A further four staff are waiting to enrol on the next NVQ level 2 programme due to start in June 2006. This means the home has achieved forty-eight per cent of care staff with a nationally recognised qualification in care. The home’s training records shows that the home undertakes external and internal training utilising specialist skills and qualifications within the staff group. The staff confirmed that they undertake training regularly and the inspector sampled copies of individual staff training certificates and other records of instruction undertaken by the staff. From discussion and reading of documentation it was evident the home is maintaining a proactive and supportive ethos towards staff development, knowledge and skills. Other training courses attended by staff include risk assessment and dementia. The deputy confirmed that the unit manager and assistant managers are looking to introduce awareness raising sessions on subjects related to the ageing process and other associated older persons conditions. The home has a positive supportive ethos and staff training with a programme of regular one to one supervisions, annual appraisals and various staff meetings that are minuted. The training records also show that staff receive training in relevant health and safety subjects including food hygiene, moving and handling, fire safety, first aid and medication. Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35 and 38 There is a good system for involving service users in the day-to-day running of the home and is about to undertake an auditable quality assurance system. However, there is a satisfactory system in place for the safe storage and monitoring of money should the service users request this service. The service users’ health, safety and welfare are well promoted by the home with systems that ensure everyone is protected within the home. Key standard thirty-one was assessed and met at the previous inspection on the 21st June 2005. EVIDENCE: The staff spoken with confirmed that there is a clear line of authority within the home. The deputy explained that the home is about to undertake a formal quality assurance process that feeds into the home’s development plan for the year and needs to be completed by March 2006. This is a new process that will be Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 17 undertaken annually and the inspector was able to view the new system audit tool. The service users spoken with stated that they felt their opinions were valued within the home and some participate in the service users’ meetings. The staff felt they were included in the day-to-day decision making within the home, stating that changes and or issues are discussed at regular staff meetings that are minuted. The minutes were available in the office for reference. The deputy shared with the inspector the quality survey questionnaires completed by service users, relatives and friends. These were found to be generally positive, issues identified were followed through and resolved. However, health and social care professionals have yet to been asked to complete a survey questionnaire. This was discussed with the deputy and assistant manager who agreed that they would have a management discussion on how this maybe best achieved. The inspector also advised that a brief summary of the outcomes could be made available for interested parties to read. The service users stated that their family or financial appointees rather than the home look after their money. However, the deputy manager confirmed that that they look after some of the service users’ spending money that is kept secure in the home safe and in separate wallets. The home has kept a record of the money in, out receipts and balances for the service users. The deputy counted the money of two service users, out in front of the inspector and the balances were found to be accurate. The deputy explained that none of the managers were appointees for any client. Regular risk assessments are undertaken and recorded to ensure that the safety within the home room by room were sampled and found to be satisfactory. However, it was noted that the homes building risk assessment and fire assessments is overdue. The assistant manager spoken with has recently joined the home and is taking the lead on health and safety matters including risk assessments. The inspector was able to view individual service user and staff risk assessments that are in the process of being completed and found to be satisfactory. The assistant manager stated that he will be reviewing all risk assessments within the home and up dating were necessary. The service users and relatives spoken with stated that they felt safe at the home and many confirmed that the fire alarms are regularly tested. The deputy explained the recording system for fires safety maintenance, training, evacuation and visual checks. The visual checks of all fire safety equipment has been recorded and undertaken at appropriate intervals to ensure the safety of the service users. The Hampshire Fire And Rescue Service fire officer last visited the home in May 2005. Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 18 The home has a satisfactory reference file for the Control of Substances Hazardous to Health (COSHH) information leaflets for each chemical being utilised within the home. The cleaning staff spoken with had attended training on COSHH and were aware of the safe handling of hazardous chemicals this was observed by the inspection. Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Green Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 20 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 Meadows DS0000037294.V269065.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Meadows DS0000037294.V269065.R01.S.doc Version 5.1 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!