Inspection on 27/11/07 for Greenacres

This inspection was carried out on 27th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 25/04/06

Greenacres 24/09/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Greenacres Mill Lane South Chailey Lewes East Sussex BN8 4PY Lead Inspector Sue Gaskell Key Unannounced Inspection 27th November 2007 11:00 Greenacres DS0000063869.V352427.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 DS0000063869.V352427.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 DS0000063869.V352427.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenacres Address Mill Lane South Chailey Lewes East Sussex BN8 4PY 01273 890863 01273 891621 john.reilly@eastsussex.gov.uk www.eastsussex.gov.uk/socialcare East Sussex County Council 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) John Reilly Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated will be seven (7). Service users must be aged between eighteen (18) and sixty-five (65) years on admission. Service users with a learning disability only to be accommodated. Date of last inspection 25th April 2006 Brief Description of the Service: Greenacres is an established service that is registered to provide care for up to seven people who have learning disabilities and challenging behaviours. The home is a large bungalow in South Chailey, a village to the north of Lewes. It is in a quiet location, and has large gardens around the bungalow. The home includes seven single bedrooms, a lounge, a dining room, a kitchenette/dining area, a large kitchen, two bathrooms and a sensory room. There are two vehicles to enable people to access services and community facilities. Staff are employed by East Sussex County Council Social Services department, and are responsible for providing the care and day-to-day running of the home. Information about the service, including the Statement of Purpose and CSCI reports is made available to prospective service users, as part of the admission process. The range of weekly fees, as of 27th November 2007, is £61.35 - £63.93. Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 27th November 2007 between 11.00 and 14.00. There were six people living at the home and there is one vacancy. I met with four residents and spoke to the registered manager and three Care Officers. I toured the building and looked at all communal areas and bedrooms. The inspection process also consisted of information collected before and during the visit to the home, and feedback from residents’ relatives and healthcare professionals after the site visit finished. Other information seen included the care plans, various risk assessments, medication records, and the duty rota. The home’s annual quality assurance assessment was completed in a satisfactory manner. There were no outstanding requirements from the previous inspection and no requirements made following this inspection. What the service does well: The home prepares clear and comprehensive care plans, which assists staff in providing consistent and appropriate care. The food is varied, nutritious and well presented. Staff are well trained and well supported. The home provides a homely environment and residents have attractive and comfortable bedrooms. Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 6 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 DS0000063869.V352427.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 DS0000063869.V352427.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 People who use the service experience good outcomes in this area. The statement of purpose, service user guide and individual statement of terms and conditions, clearly says what service will be offered. Prospective residents can be confident that their needs will be assessed and can be met This judgement has been made using available evidence including a visit to this service. Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 9 EVIDENCE: All residents have been issued with a service user guide and with an individual agreements stating their terms and conditions of residence. The service user guide is reviewed regularly to ensure that it is easily understandable and that it makes clear that the home will promote and respect everyone’s needs and choices, regardless of disability, race, religion, age, sex, or cultural background. Although no new residents have been admitted since the last inspection, the records indicate that there is a well planned and thorough referrals procedure. An assessment is carried out prior to admission which also includes input from the clients, social workers and other health care professionals. Resident’s files contain detailed and comprehensive pre-admission assessments. Prospective residents are given the opportunity to visit the home prior to admission. The home does not generally take emergency admissions. Greenacres DS0000063869.V352427.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 & 9 People who use the service experience excellent outcomes in this area. The care plans are easy to use and descriptive. Residents’ choices are respected and their decision-making is well supported. Residents are supported in taking risks in the daily and social activities that form part of an independent lifestyle. This judgement has been made using available evidence including a visit to this service. Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 11 EVIDENCE: I examined the care plans of the six residents living in the home. They are clearly indexed and easy to read. The files include residents’ personal profiles, likes and dislikes, guidelines on how to manage their needs and behaviours, and risk assessments. There are also guidelines on how the home will assist residents in achieving their short and longer term goals. A Care Officer said that residents have key workers who monitor their individual needs and activities. The records showed that the care plans are updated following the reviews or as and when their care needs change. The residents’ views are included in their reviews. One relative said that he gets a monthly update on the resident’s progress. Adequate risk assessments have been prepared for each resident’s needs or activities, and include clear and specific guidelines on how to minimise any risk. Some of the risk assessments include guidelines on the need for, and use of, any physical intervention. The records showed that staff sign to acknowledge having read any important information or guidelines. Staff confirmed that issues relating to confidentiality are addressed during the induction period. All records are stored in a lockable office and there was no public display of confidential or personal information. Greenacres DS0000063869.V352427.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, 15, 16 & 17 People who use the service experience excellent outcomes in this area. Daily life meets the residents’ lifestyle preferences and expectations. Residents have regular contact with their families and friends. Residents receive a nourishing and balanced diet. This judgement has been made using available evidence including a visit to this service. Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 13 EVIDENCE: The care plans contain a list of residents’ needs, likes and dislikes and preferences. The home has to be flexible regarding activities as each resident has different needs and interests. Leisure and social activities are generally carried out on an individual basis. Some residents attend college courses, such as animal care. Others enjoy going shopping or out for drives to garden centres or parks. Residents are also helped to participate in arts and crafts, cooking, swimming and have the use of the home’s sensory room. Residents help with food preparation and laundry but with staff supervision. There is evidence in the residents’ daily records to show that families, and other visitors are encouraged and welcomed. Staff provide support to residents when visiting families or on particular outings with families. Three of the residents’ relatives were full of praise for the home. They said how helpful staff are and that the staff keep them informed of any issues or developments. Residents have individual bank accounts which are regularly audited, with appropriate receipts and records kept. Staff signatures are required for monies taken out when residents spend money on social activities such as going out for special meals. The registered manager said that meals provided are mainly based on residents’ choices, but staff also take into account the need for a reasonably balanced diet. The home is preparing colour photographs of meals to make it easier for residents to plan, or choose from, the menus. The store cupboard contained a wide range of good quality food including fresh fruit and vegetables. Nutritional assessments are carried out when necessary and residents are weighed regularly. The food served on the day of the inspection appeared appetising and wholesome. The manager showed a good awareness of equality and diversity issues. The manager and staff said that there are no residents at present with different ethnic or cultural needs as the current residents tend to come from the local communities. Residents’ wishes over their personal needs are respected. One resident has recently expressed a wish to attend church and is supported in attending the services of her choice. Greenacres DS0000063869.V352427.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, & 20 People who use the service experience excellent outcomes in this area. Residents’ choices over their care are respected. Residents’ care plans are reviewed and their health care needs are met. Residents are protected by the home’s policies and procedures for dealing with their medication. This judgement has been made using available evidence including a visit to this service. Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 15 EVIDENCE: All of the residents were seen to be relaxed and comfortable interacting with staff. Residents care plans and daily records refer to clear guidelines on providing support and monitoring health care and social care needs. This includes personal care guidelines, blood sugar level testing, and nutritional assessments and guidelines. There is regular input from a variety of healthcare professionals. There is evidence to show that residents are also referred for specialist help if they have other health care needs such as speech and language needs. The home keeps good records of GP’s and community nurses’ visits etc, together with any subsequent advice. The manager and all members of staff showed a high level of awareness of residents’ needs and referred to a variety of issues, such as the importance of ensuring that residents’ needs are treated with sensitivity and that the care is consistent. Two professional from the community learning disability team said that there are no concerns or issues with the home and that the home keeps them informed of any particular needs or developments. The home has sound medication procedures. Staff confirmed that only trained may administer medication and that all staff are required to read the procedures stored in the medication file. There is a risk assessment procedure for assessing whether residents are able to store and/or administer their own medication but there are currently no residents for whom this would be appropriate. There are clear guidelines for assisting individual residents, eg under what circumstances to give certain “prn” medications, and what type of drinks they prefer with their medication. Medication is stored securely and appropriately. The medication records are clear and current and there is a system for the receipt and disposal of medication. Greenacres DS0000063869.V352427.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 & 23 People who use the service experience excellent outcomes in this area. Residents can be confident their complaints will be listened to and dealt with appropriately and that they will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager said that residents are given as much verbal information as possible about the home’s complaints procedure. The complaints procedure is included in the service user guide. The home has safeguarding adults procedures in place and has a copy of the East Sussex County Council procedures displayed in the office. Staff confirmed Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 17 that they have received training on recognising and reporting any form of abuse as part of either safeguarding adults or other training sessions. One recently appointed member of staff said that all newly appointed staff now undertake training under the Learning Disability Awards Framework (LDAF), which now includes specific modules regarding abuse awareness and the protection of vulnerable adults. The training records also show that staff have attended training sessions on how to intervene appropriately in difficult situations. One member of staff said that they are made aware of the local authority’s “whistle blowing procedures during the induction training period. Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 18 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, 26, 29 & 30 People who use the service experience excellent outcomes in this area. Residents live in a homely and comfortable environment. Residents are provided with all necessary equipment and adaptations to help them be as independent as possible. The home is clean and adequately maintained. This judgement has been made using available evidence including a visit to this service. Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 19 EVIDENCE: All bedrooms and living areas are furnished and decorated to a good standard, and contained the type of furniture and equipment necessary to provide a homely environment. All areas were seen to be clean and well maintained. There have been many improvements to the environment since the last inspection and this is on-going. Residents have single rooms where they can display their own effects such as pictures and ornaments, and have their own TV, DVD player etc. All of the accommodation is on one level and all rooms are wheelchair accessible. The home has some specialist equipment such as walk in showers and grab rails. There is also a well equipped sensory room. As well as the main kitchen there is a kitchen dining room where residents may, under staff supervision, prepare their own meals. There is a well-maintained garden and with garden furniture which is used by the residents. The garden is provided with a ramp to make it accessible to use all areas, eg the barbeque area and summerhouse. The home has a vehicle that is accessible for people in wheelchairs. There is a separate laundry room, which is kept locked when not in use, and residents are encouraged to help with their laundry whenever possible. There are disposable hand drying towels and pump soap dispensers in the communal bathrooms to reduce the risk of cross infection. Maintenance certificates are current and there are no outstanding health and safety requirements. Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 20 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 & 36 People who use the service experience good outcomes in this area. Staffing, in terms of both numbers and competency, is appropriate to the current needs of the residents. Residents are protected by the Home’s sound recruitment procedures. Staff are well trained and supported and morale is high This judgement has been made using available evidence including a visit to this service. Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 21 EVIDENCE: The current staff rota includes the manager or a shift leader and generally four support staff. The manager said that this is adequate to ensure that residents are safe and can participate in their chosen activities. Night staffing appears adequate and there are emergency on call systems, as well as methods of internal communication systems between nearby homes run by the same local authority. The staff on duty all showed a high level of awareness of good practice and of the individual needs of residents. They were seen to be very sensitive when assisting residents, eg reassuring them when they became anxious or if they were involved in food preparation. Although staff files were not examined on this occasion, staff confirmed that new staff do not start work until CRB and POVA checks, and written and verbal references have been obtained. The manager said that all staff receive induction training, further training and regular recorded supervision. This was confirmed by care staff. Approximately 50 of the regular staff have either completed or are working towards their NVQ’s. Staff confirmed that there has been training in safeguarding adults, , appropriate intervention techniques, moving and handling, Basic Food Hygiene, Fire Safety, medication administration and the administering of special medication for epilepsy. The staff team has been stable for some while with a low turnover of staff. The manager and a Care Officer referred to the high level of team work. The relief staff who work in the home have also worked there on a regular basis and are familiar with the residents and their needs. However relief staff do not currently attend team meetings or have the same level of training. Staff referred to the high level of morale in the home with good support for work and any personal issues that affect their work. Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 People who use the service experience excellent outcomes in this area. The home is well run in a manner that encourages the development of clients. There are regular quality assurance and safety checks to ensure that the home is run in the best interests of the clients and their safety and welfare is protected and promoted. All areas are clean, and well maintained This judgement has been made using available evidence including a visit to this service. Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 23 EVIDENCE: The manager has been in post for approximately two and a half years and is experienced in working with adults with learning disabilities. He said that there is also regular input from the Resources Officer in terms of management and staffing issues. Quality assurance is carried out through the Regulation 26 visits and also through the local authority’s internal audit system. Staff said that residents’ views and feelings are regularly questioned and monitored, either through talking to them or through observing them to see whether or not they appear happy. Staff said that quality assurance is given a high priority and any feedback from residents and/or their families or advocates is acted upon. The general management of the home and completion of records are of generally of a good standard. Staff said that morale in the home is very good and that the manager and Resources Officer are very supportive. The manager was full of praise for the staff team and referred to the high level of team work. There were no obvious safety hazards around the home and there is evidence to show that health and safety issues are taken seriously, eg staff ensure that there are no obvious hazards when residents are doing their laundry. Environmental risk assessments have been carried out including the use of transport by residents. Staff said that there is regular routine testing of equipment, eg electrical and gas supply and appliances. There are regular weekly or monthly tests for the fire alarm and emergency lighting system. All staff have had fire safety training and the regular fire drills also include residents and visitors or relief staff. Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 X 28 X 29 4 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 4 35 X 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 4 X 4 X X 4 X Greenacres DS0000063869.V352427.R01.S.doc Version 5.2 Page 25 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 DS0000063869.V352427.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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