Inspection on 07/08/08 for Greenacres

This inspection was carried out on 7th August 2008.

CSCI found this care home to be providing an Good service.

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 08/08/07

Greenacres 21/11/06

Greenacres 05/12/05

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Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Greenacres 67 Delapre Drive Banbury Oxfordshire OX16 3WS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Andy McGuckin     Date: 0 7 0 8 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Greenacres 67 Delapre Drive Banbury Oxfordshire OX16 3WS 01295269535 Telephone number: Fax number: Email address: Provider web address: haroon@caretech-uk.com Name of registered provider(s): Name of registered manager (if applicable): CareTech Community Services (No.2) Ltd The registered provider is responsible for running the service Name of registered manager (if applicable) Mrs Deborah Jill Bleach Type of registration: Number of places registered: care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category of service only:Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning disability - LD Date of last inspection Brief description of the care home Greenacres is a detached family house situated in a quiet residential area of Banbury within walking distance of local facilities. It is registered for up to four people with learning disabilities. Some parts of the home have been adapted for wheelchair access. The home is run and managed by CareTech Community Services Ltd, an organisation Care Homes for Adults (18-65 years) Page 4 of 28 4 Over 65 0 Brief description of the care home with experience in providing services for people with learning disabilities. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: A site visit was undertaken on the 07/08/2008 No questionnaires were sent out as they could not be returned in time. The inspector had informal discussion with a resident in the home on the day of the inspection. The commission observed staff caring for residents in an appropriate manner. The homes manager took an active part in the inspection process. The inspector had a brief conversation with a residents relative at the end of the inspection and gained positive feedback. The homes fees are from 1181.51 pounds per week to a maximum of 1878.00 pounds per week. Care Homes for Adults (18-65 years) Page 6 of 28 Key documentation was inspected, including current care plans for all residents. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 1,2,3,4,5. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home makes available information to enable prospective residents to make an informed decision. Evidence: The organisation has a policy that all new prospective residents are assessed by a senior member of staff and interested professionals prior to moving into the home. Prospective residents are encouraged to make several visits to the home to enable decision making on both sides. No new residents have moved into the home since the last inspection. All service users have a contract and terms and conditions and are very well able to have meaningful input into what is written in them. Previous problems with neighbours complaining have been resolved. The home has a system of Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: obtaining residents views by a weekly session called Talk Time. This is one on one time with the residents key worker at which any issues to do with the placement are discussed and any amendments to the care plan are made. This ensures that residents are fully involved and fully aware of the services which are on offer. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 6,7,8,9,10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. All residents are treated as individuals and through care planning there individual needs are being met. Evidence: Three residents files were inspected and evidenced that residents are being consulted and informed where possible about changes and challenges that are available to them. A good example of this is where a resident was unable to use his room due to injury. Other residents were asked if the downstairs dining room could be used short term. All residents agreed to this. The home has produced very clear and easily understandable documentation including a current care plan to enable staff to have a clear Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: understanding of the needs and wants of the residents. Care plans and daily changes are monitored on a regular basis. Residents are able and encouraged to take an active part in the planning and review of their care and evidence was found at inspection that this process takes place regularly. Evidence was found in the care plans that residents have access to mainstream healthcare professionals and residents are enabled to keep these appointments. Allied health care resources are available for those who want them. The home presents as a good place to be with both residents and staff satisfied with their situation. Risk assessment viewed covered personal care, medication and health needs, along with practical tasks such as, finance using electrical equipment, washing ironing, cooking and trips out. Resident’s assessments were well recorded and reviewed. Information held on residents is done so in a safe and secure manner ensuring that only those who need to know have access to this information. Staff sign a confidentiality agreement which if breeched may result in disciplinary action being taken. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 1,12,13,14,15,16,17. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. residents are encouraged to have a varied and appropriate lifestyle which includes acceptable risk. Evidence: Evidence was found at the inspection that residents enjoy a wide range of activities which are set up to meet their social, leisure and spiritual needs. The residents have very diverse attitudes and these are accepted and respected. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: Staffing levels in the home mean that residents can have activities or trips out at short notice and with flexibility. Residents have individual weekly activity plans, which act as a guide for the week but these are often changed to suit the needs and willingness of the residents. Residents are involved in the purchase and preparation of meals. Mealtimes are flexible dependent on the residents activities for the day. The main meal is usually taken in the evening and is part of the social interaction of the home. Mealtimes are relaxed and unhurried with residents assisting the clearing up and washing up routine. Residents have chosen not to attend any occupational training, one resident attends a day centre. This choice is respected and alternatives can be found within the care plan. Residents are encouraged to use public transport and the local community and are members of local community groups. Visitors are welcome to the home at all reasonable times are can stay for meals if invited. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are encouraged to maintain a healthy lifestyle. Residents health is monitored and regular health care appointments are made to key professionals. Evidence: Information regarding personal care is recorded in the individual care plans. Service users are in the main very independent and choose when they like to go to bed, have a bath, have their meals and take part in other activities. Care plans set out in detail the service users preferred routines, likes and dislikes and partnerships with families and friends. Staff ensure that personal care is flexible, consistent and responsive to the changing needs of service users. This is well documented in care plans. The staff group is balanced to ensure choice of male, female and age related preferences when delivering personal care. Residents are able to insist on their dignity and privacy being respected. Each resident has their own separate health care file. This records evidence of regular Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: health-care screening. Chiropody services are based at the local hospital out patients department and optical screening is via a local optician. These are both accessed on a needs only basis. Residents are able to choose their own GP and have access to all NHS health care facilities in the local community. Additional support is accessed through a team of health care professionals where residents can access physiotherapists, Occupational Therapists, Speech Therapists, and community dietitian and continence adviser. Visits to the home from health care professionals take place in the residents bedrooms. Staff are available provide support to individuals needing to attend outpatient and other appointments. All residents have chosen not to self medicate and have requested assistance and monitoring with their medication. There is an efficient medication policy supported by procedures and protocols. The home uses a monitored dosage system. Medication records were checked and have been completed with no omissions noted. There were no out of date medications held in the residents home. The home has a returns procedure in place. There are no controlled drugs in use at the time of the visit. Training records demonstrate that staff have undertaken accredited training in the safe handling of medicines. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 22,23. Quality in this outcome area is good This judgment has been made using available evidence including a visit to this service. Both residents are able to voice their concerns to the registered manager and feel confident that their concerns will be addressed. Evidence: The complaints procedure is produced in a service user-friendly format and is up-todate. The home has a complaints log. No complaint has been recorded since the last inspection. Evidence was found in the resident’s files, that staff are explaining the complaints procedure to the residents in a one to one sessions. Residents also have meetings attended by staff where they can voice their concerns or make recommendations. The Commission for Social Care Inspection has received no information about complaints or safeguarding adult issues. All staff have received Protection of Vulnerable Adults Training and staff members were able to describe the action that be would taken if they had any concerns about the Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: safety or well being of service users. The inspector was assured that residents finances are appropriately managed and monitored by external agents on a regular basis. Residents are assisted with the management of their personal money all transactions are clearly recorded and are subject to random monitoring. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 24,25,26,27,28,29,30. Quality in this outcome area is good This judgment has been made using available evidence including a visit to this service. The home is well maintained and provides a homely, safe atmosphere for its residents. Evidence: One resident fell breaking his arm which resulted in the Occupational Therapists advising the home that it would not be safe for him to use his bedroom upstairs. Arrangements were made for the short term for him to have the downstairs dining room converted into his bedroom. The home agrees this is not ideal and is a temporary arrangement following a recommendation from the Occupational Therapist Greenacres is a residential home providing care and support to three service users with a learning disability. The home is located in a residential area of Banbury. It is close to local shops and is on a bus route to Banbury town where a wider range of activities and amenities are available. The home consists of a two-storey building. All of the bedrooms are single. Personal Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: bedrooms are all lockable and service users choose to use this facility. There is one communal lounge and a separate lounge which as previously mentioned is currently being used as a residents bedroom. This is not the homes choice but that of the occupational therapist. This is nicely decorated, bright and homely. The kitchen is clean, spacious and well looked after. This is accessible to all service users. The home is well furnished with good quality fixtures and fittings, which are appropriate to the needs of the current residents. Lighting in communal areas is domestic in character and sufficient to facilitate reading and other activities. The home has a pleasant garden that is maintained by staff and one service user. There are no CCTV cameras in use within the home at the time of the inspection. There are accessible toilets available for service users throughout the home. Laundry facilities are sited so that soiled articles, clothing and infected linen are not carried through areas where food is stored, prepared, cooked or eaten and do not intrude on service users. The home has an infection control policy and the inspector observed this. Instructions are in place for the washing of soiled linen. There are no outstanding maintenance issues found on the day of inspection that would affect the health and welfare of the service users. The home now benefits from a new kitchen and flooring. they plan to decorate the hallway and clean the communal carpets. One residents en-suite shower needs upgrading and estimates have been sought. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 31,32,33,34,35,36. Quality in this outcome area is good This judgment has been made using available evidence including a visit to this service. Staff are employed in sufficient numbers to meet the needs of the homes residents in a flexible and consistent manner. Evidence: Staff are aware of the organisations policies and procedures and understand how they work. These policies promote the main aims of the home. The home achieves this through induction, staff training, staff meetings, and supervision sessions. There were no staff members under the age of eighteen and there are no staff under the age of twenty one left in charge of the home at any time. At the time of the inspection there are two staff members with an NVQ qualification. The inspector requested to look at the recruitment files for staff who were on duty at the time. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: All staff files looked at contains two references, copies of driving license, certificates of training and a health check. There is evidence that staff have had a criminal records bureau check before they commence work and all staff are checked against the POVA register. Staff spoken to confirmed the process of recruitment. There is an induction programmer in place to ensure that new staff members are familiarised with the organisation and their roles and responsibilities and provides the staff member with a personal development portfolio. Evidence was found at inspection, that staff are receiving at least four formal recorded supervision sessions and a yearly appraisal. Due to the small size of the home there is a lot of opportunity for staff to have a lot of additional informal supervision. Training records reflect that staff are received mandatory training and a training programme for the future is in existence. Staff spoken to informally, are very positive about the training opportunities available to them and said they felt supported to do their job. This includes fire safety, moving and handling techniques and core skills training. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 37,38,39,40,41,42,43. Quality in this outcome area is good This judgment has been made using available evidence including a visit to this service. Residents experience the home as being well managed and staffed by carers trained to deliver care in a professional manner. Evidence: The registered manager is experienced in the provision of adult care and has the appropriate qualifications to manage the home. The manager is supported in this by the parent organisation and has access to all the benefits of a large organisation. The registered manager has the appropriate management qualifications. Staff working in the home all have the opportunity to commence N.V.Q ( National Vocational Qualification ) in care. The home has a complaints procedure in place and a whistle blowing policy, which Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: enable staff and residents to voice concerns that affect the way in which the service is delivered. The home assesses the quality of its service by direct opinion gathering from the current residents. Staff attend regular meetings at which they can feedback issues which affect the delivery of care and make recommendations as to their resolution. Residents also meet and discuss issues, which affect the running of the home these issues are listened to and acted upon. Relatives and professionals visiting the home are asked their opinion on the quality of the service and any ideas they have to improve things All records required for the inspection process were found to be up to date and accurate. The home has the support of a health and safety officer who makes regular visits to the home to check on the health, safety and well being of the residents. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural backgrounds. The home is supported by its parent organisation and has access to all the benefits of a large organisation. The home would benefit greatly from the provision of a computer and a up to date printer. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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!