Inspection on 21/11/06 for Greenacres

This inspection was carried out on 21st November 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

Greenacres 18/01/06

Greenacres 27/04/05

Greenacres 12/10/04

Greenacres 30/04/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Greenacres 62 Harrogate Road Ripon North Yorkshire HG4 1SZ Lead Inspector Mrs Maggie Coxon Key Unannounced Inspection 21st November 2006 09:45 Greenacres DS0000007875.V320133.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 Greenacres DS0000007875.V320133.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. Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenacres Address 62 Harrogate Road Ripon North Yorkshire HG4 1SZ 01765 606151 01765 606151 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) St Anne’s Community Services Mrs Jennifer Hanrahan Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 5 Service Users with Learning Disabilities some or all of whom may be over 65 18th January 2006 Date of last inspection Brief Description of the Service: Greenacres is a care home registered by St Annes Community services to provide personal care and accommodation to up to five adults with learning disabilities, some or all of who may be aged over 65 years. The home consists of a detached dormer bungalow located on a busy road on the outskirts of the market town of Ripon, community facilities including shops and cafes are within walking distance. Each of the five bedrooms is for single accommodation, two of which have en-suite facilities. Four of these are situated on the ground floor; the fifth is on the first floor. Whilst the home does not have a passenger or stair lift, all areas are accessible to those residents currently living there. There are well-maintained garden areas to the front and rear of the home with level access to the rear and hard standing for parking to the front. Current information about services provided at Greenacres in the form of a statement of purpose, service user guide and the most recent inspection report published by the Commission for Social Care Inspection are available by contacting the home. Information provided by the manager on 29th September 2006 indicated that the current weekly fee for the home is £686.24. Additional costs include toiletries, hairdressing, private chiropody, personal items and holidays. Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is what was used to write this report: • • • Information about the home kept by the Commission for Social Care Inspection. Information asked for before the visit, this is called a pre-inspection questionnaire. A visit to the home that they didn’t know was going to happen. This lasted for five hours and included talking to all five residents, care staff and the manager about how the home is run. All areas of the home were seen and records that the home has to keep were checked. Residents’ medication was also checked to make sure that it was being properly looked after for them. People living in the home have expressed a preference to be known as residents. What the service does well: Residents and staff get to know each other very well and staff are kind and friendly so residents can be confident that they will get good help. Residents can have lots of contact with friends and family and see them at any time. Staff also spend a lot of time talking to the residents. This means that they can have company whenever they like. Residents meet with the manager to talk about the help they need and to find out about the home before they move in. They can also visit the home to see if they like it. This means that residents can decide whether or not they move into the home. The home is well run and staffed so residents are well looked after. They have plenty of activities both inside and outside of the home and spend lots of time out and about in their local town as well as visiting places further away. Residents are helped to be as independent as possible and to make as many choices as they want to regardless of their age, gender or needs, they are all treated equally, they are also all treated respectfully by the staff. Residents see their GP, dentist, optician and chiropodist whenever they need to. This means that they can stay as healthy as possible. Residents have a good choice of food and drinks at mealtimes. This ensures that they have a varied diet of their choosing and can enjoy their meals. Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 6 Residents are asked to say what care they need and how they would like this to be given, this gives them the chance to have a say in planning services for themselves in the future. 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. Greenacres DS0000007875.V320133.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 Greenacres DS0000007875.V320133.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): 1,2 and 4. Quality in this outcome area is good. Detailed information about the service provided is available to anyone who wants it. A detailed needs assessment process ensures that all the needs of residents are identified and planned for before they move into the home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home has a detailed statement of purpose and service user guide, which are both produced in a user-friendly format and a copy of the service user guide is provided to each resident. The registered manager updates both documents regularly. An assessment had been taken of each resident before they moved in a number of years ago and no admissions have been made since then. There are currently no vacancies and therefore there are no plans to admit anyone in the near future although if this were to happen the registered manager is aware of the need for robust pre admission assessment and explained that any Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 9 such admission would be arranged via a planned introductory programme. This would include the individual making several visits to the home and a trial placement prior to this being made permanent. People currently living in the home would also be asked for their views about the suitability of the placement. Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 10 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): 6,7,8 and 9. Quality in this outcome area is good. Residents make as many decisions and everyday choices as possible and have an active say in the running of the home. They can be confident that the staff can meet their needs whilst at the same time giving them the chance to be as independent as possible. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Case tracking confirmed that residents’ personal plans are well documented and organized and are being regularly reviewed. They contain sufficient detail to inform staff how best to meet the residents’ needs in a way that promotes their independence wherever possible. Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 11 Meetings have been held for each resident in which they have had a say about how to make things better for them personally. Individuals’ wishes and agreed outcomes have been recorded and a service agreement drawn up that is to be put into action. Staff are already helping residents work towards achieving some of their goals. These documents along with daily records and things seen during the visit show that residents are able to make many choices and decisions in their daily lives and can take reasonable risks after a risk assessment has been undertaken and recorded. Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 12 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): 12,13,14, 15,16 and 17. Quality in this outcome area is good. Residents enjoy a range of activities that they have chosen themselves. They are supported to develop and maintain relationships with family and friends. Meals are nutritious and offer a varied diet. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Residents have a wide variety of activities that they participate in within their local community and were seen to attend these during the visit including going out independently. Every resident has had a holiday or short breaks this year according to personal preference. Residents are also allowed personal space when they want it. Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 13 Residents are supported to maintain relationships with relatives and friends. Residents were seen to have a choice at mealtimes. Staff explained that the residents choose the meals and menus showed that meals are varied and well balanced. Lunchtime was very relaxed and informal and residents were supported unobtrusively. Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 14 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 and 20. Quality in this outcome area is good. Residents are able to stay as healthy as they can by being helped to attend regular health appointments and by being helped to take their medication. They are also treated with respect and dignity when being helped with their personal care so they can feel comfortable and happy. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Staff were seen to provide all support, including that concerning personal care needs, in a way that promoted the residents’ privacy and dignity. Case tracking identified that each resident has a detailed health assessment and is registered with a GP. They attend regular appointments with various health care professionals, opticians, chiropodists and dentists. Residents’ health records are well kept. The registered manager explained that she is Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 15 being given training in foot care by the local hospital and will then be better able to monitor residents’ podal welfare and identify any problems early on. All of the residents have their medication administered by staff. This is well recorded and all medication is securely stored. All staff have undertaken appropriate medication training. Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 16 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 and 23. Quality in this outcome area is good. Any concerns or complaints are well dealt with and residents can be confident that they will be well protected. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A comprehensive complaints procedure is followed and is made available to residents in easy read and pictorial form. Residents also have regular meetings in which they can express any dissatisfaction. Where individuals are unable to verbalize concerns staff observe behaviours and body language to identify any dissatisfaction. There have been no complaints since the last inspection. Staff have recently undertaken adult protection refresher training and are fully aware of the procedure to follow should they witness or suspect the abuse of a resident. This procedure has recently been updated and all staff have signed to say that they have read and understood it. Residents’ monies are checked every evening by staff to make sure no mistakes have been made with them. The registered manager explained that no physical restraint is used on any of the residents. Greenacres DS0000007875.V320133.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): 24,25,27,28,29 and 30. Quality in this outcome area is good. The standard of the environment is good and provides residents with a clean, comfortable and safe home to live in. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A number of improvements have been made to the environment and each of the residents showed me their bedrooms which they have had decorated and furnished how they wanted and said they are very happy with. New flooring, a new radiator and cupboard tops and doors have been fitted in one bedroom, which has been redecorated. Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 18 Another bedroom has had a new radiator fitted, has been redecorated and has had the carpet shampooed and a third has had a new window and blind and a new radiator fitted. A new window and blind have been fitted in the 1st floor bathroom. New electric door closers have been fitted to all fire doors and a new fridge freezer has been purchased for the kitchen. Shared areas including the kitchen/dining room, the lounge and the bathrooms are well maintained, decorated, furnished and equipped. The home was clean, warm and tidy throughout so residents can feel comfortable and safe. Greenacres DS0000007875.V320133.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): 32,33,34,35 and 36. Quality in this outcome area is good. The home is run by a team of staff who are experienced, well trained and who know all the people living in the home very well so residents can be confident that they will get good help in a friendly and supportive way. This judgement has been made using available evidence including a visit to the service. EVIDENCE: As an organization St Anne’s Community services has good recruitment procedures. It undertakes appropriate personnel checks before employing someone. Sufficient staff were on duty at the time of the visit and staff rosters indicate that the home is adequately staffed at all times. Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 20 The registered manager explained that all staff have finished their NVQ training and have recently finished a certificated course in infection control. All other training is up to date. Staff confirmed that are being regularly supervised and have regular full team and key worker meetings. Greenacres DS0000007875.V320133.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): 37,38,39,41 and 42. Quality in this outcome area is good. The home is well managed so residents can feel safe and be confident that the manager and staff are always looking for ways to improve the service and thus improve residents’ quality of life. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The registered manager is fully qualified and experienced in the management of care services. She has been the registered manager of Greenacres for several years. Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 22 Staff say that she is an efficient manager who provides good leadership, guidance and support in an open and inclusive style. Staff said they have regular supervision from the registered manager and are encouraged to contribute fully to regular team meetings. Monthly quality audits are being undertaken by the service manager. Residents’ views are ascertained through regular resident meetings facilitated by staff and through individual person centred planning meetings. Relatives’, visitors’ and healthcare professionals’ views are also surveyed. Information gleaned from all sources has been fed into a team plan that assesses the current quality of services for individual residents and identifies how this can be continued and further improved. Residents, staff and the registered manager are also involved in ‘making it happen’ and ‘taking part’ meetings where their views are discussed at an organizational level. Residents’ records are kept in a locked filing cabinet. All records are well documented and are regularly reviewed and updated. Monthly health and safety checks of the building are undertaken and fire safety is well maintained including regular fire safety training for all staff. Other health and safety systems and records are well maintained including hot water temperatures that are tested weekly and fridge and freezer temperatures that are tested and recorded daily. Residents’ wheelchairs are regularly serviced. A risk assessment of the hot water system has been undertaken and records showed that the hot water is being stored at over 60°C. Greenacres DS0000007875.V320133.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 3 2 3 3 X 4 3 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 3 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X 3 3 X Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 24 No. 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. 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 Greenacres DS0000007875.V320133.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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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