Inspection on 18/02/06 for Greenbanks

This inspection was carried out on 18th 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Greenbanks 31/01/07

Greenbanks 24/08/05

Greenbanks 10/12/04

Greenbanks 21/06/04

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 Greenbanks Green Hills Barham Canterbury Kent CT4 6LE Lead Inspector Nicki Dawson Unannounced Inspection 18th February 2006 09:45 Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 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 Greenbanks DS0000023427.V279546.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 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. Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Greenbanks Address Green Hills Barham Canterbury Kent CT4 6LE 01227 831731 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) Family Investment (One) Limited Mrs Roberta June George Care Home 19 Category(ies) of Learning disability (19) registration, with number of places Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The 4 residents with physical disabilities should also have a learning disability 24th August 2005 Date of last inspection Brief Description of the Service: Greenbanks provides residential care for up to 19 adults with a learning disability. The detached property is set in the rural village of Barham. Within walking distance of the home is a shop with a post office, village hall, bowls club and two churches. Buses provide links to Canterbury and Folkestone. The home is owned and managed by Family Investment Limited. The families of the residents buy shares in the company. The company also operates a day centre, which is set in the grounds of the home, but is staffed and managed separately. The home is covers three floors. All residents occupy single rooms. The two rooms on the second floor are ensuite. On the first floor there is a shower room and bathroom. On the ground floor there are two bathrooms, one of which has been adapted for disabled access. The communal space consists of a main lounge, small lounge, conservatory and dining room. The home is set within 7 ½ acres of attractive grounds. Sufficient car parking space is provided. Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection commenced at 9.45am and took just over six hours. The inspector observed staff interactions with residents and spoke to three residents and two relatives in private. The inspector also shared lunch with the residents. One of the residents showed the inspector around their home. Two support staff were spoken with and the rest of the time was spent in the office looking at records and talking with the deputy manager. What the service does well: What has improved since the last inspection? What they could do better: Residents who may want to move to Greenbanks are not given clear information about what it is like to live at Greenbanks. This information should be written in a document called a ‘service user guide’. It is disappointing that after 4 years of the National Minimum Standards, this basic information is still not available. The home needs to change the way that it stores some medicines and the records that are made when medicines are given to residents. There is no evidence to suggest that that any residents have been given the wrong medicine. However, these changes will make sure that any risks of giving residents the wrong medicine are made as small as possible. Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 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 Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Prospective residents would benefit from information written about the home in an accessible format, when choosing whether to live at the home. EVIDENCE: The home has produced a ‘statement of purpose’ that sets out the aims, objectives and philosophy of the home, together with the services and facilities provided for residents. Staff are aware of the main values of the home. The home is also required to produce a ‘service user’s guide’, which clearly sets out for residents, the services and facilities that they can expect if they move to the home. The home has produced this guide in a draft format and is undergoing consultation before giving each new and existing resident a copy. It was not possible to look at documentary evidence of how the home assesses the needs of residents before they move to the home, since there has not been any recent admission to the home. However, the home has a clear policy on the admission of new residents. This includes the potential resident or their representative completing an application form and a comprehensive assessment undertaken of their needs. Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 9 Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 8, 9 and 10 The individual needs and choices of residents are promoted. EVIDENCE: Resident’s health, personal and social care needs are clearly recorded in their individual plans of care. The plans are detailed and well organised. Staff said that they were easy to understand and refer to them on a regular basis. The majority of residents said that they were aware that staff write about them. Any changes identified in a residents care are clearly highlighted. Residents are encouraged to promote their independence. Potential risks in daily living have been identified and a strategy written as to how each potential hazard should be managed. Residents said that they have regular, recorded meetings where they come together to discuss their home life. Staff demonstrated that they understood the importance of keeping residents confidences; and that they also knew when information given to them in confidence needed to be shared with others. Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13 and 14, The home supports residents to live fulfilling lives. EVIDENCE: Residents are allocated one day at home a week in order to undertake their share of the household tasks. During the inspection, residents were observed, laying the table and making drinks. Family Investment has developed a range of day opportunities for the residents. In the grounds of the home there is a workshop where residents said that they participate in arts and crafts. Nearby, residents work in the pottery, vineyard and teashop. One resident proudly showed the work that they were undertaking to complete their NVQ in catering and discussed the science day that they had enjoyed attending. Residents said that they enjoyed their activity programmes. On the day of the inspection a number of residents had travelled independently to go shopping and others had gone with staff support. An additional support worker has been employed at the weekend to undertake art and crafts, cooking and quizzes Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 12 with the residents. This has added to the quality of life of residents who are not able to travel independently in the community. Residents participate in a wide variety of leisure activities such as the Special Olympics, yoga; keep fit, bowling and trips to the pub. Some residents attend the local church. There is an events board on the wall in the conservatory, which details coming special events and resident holidays. One staff member said that they “get a lot of pleasure out of residents doing and enjoying things” At the previous inspection it was observed that the menu offered residents a balanced diet. During the inspection staff asked residents their choices for lunchtime. The inspector joined the residents and staff for lunch. The meal was relaxed, with jovial conversation. Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 20 Residents physical and emotional healthcare needs are met. Medication practices do not ensure a safe system for the administration of medication. EVIDENCE: Residents’ healthcare needs are clearly recorded in their individual plans of care. One staff member is responsible for ensuring that residents attend regular appointments with the dentist, chiropodist, optician and GP. Clear records are kept of all these appointments. Selected aspects of the ordering, storage and administration of medications were inspected. All staff have been trained in the administration of medication and the home has begun to assess the competency of all staff in this area. Staff demonstrated that they not only knew what to do if a medication error occurred, but also that the culture of the home promoted them to report any errors. A number of requirements were made in relation to the recording of medications administered in the home. These are detailed below. Firstly, there is no record made of the amount of medicines received by the home. Secondly, one resident’s medication had been temporally stored in an unsecured room. When this was pointed out to the deputy manger, she took steps to remedy the matter. Thirdly, three medications were unnamed, including an opened body cream, which the deputy manger immediately disposed of. Fourthly, the list of homely remedies that the GP has agreed can be administered to Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 14 residents does not cover all homely remedies stored in the home. Lastly, there was no signature and counter signature to ensure safety when changes had been made to the administration of medication record sheet. The deputy manager agreed to meet these requirements since she wanted to ensure that safe systems of medication administration are carried out in the home. . Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Residents live in a homely, clean and comfortable environment that suits their needs and lifestyle. EVIDENCE: Greenbanks is a large, detached house surrounded by gardens. It is in walking distance of the village of Barham and public transport. One of the residents gave a tour of parts of their home. On the ground floor there are three communal areas, consisting of a conservatory, a day room that has recently been redecorated and a lounge. There is also a separate dining area and laundry. Resident’s rooms are accommodated on all three floors. The rooms viewed were decorated according to individual needs and tastes. The home was clean and well aired on the day of the inspection. Staff have undertaken training in the control of infection and demonstrated that they knew of safe practices to minimise the spread of infection. Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 33 A competent and effective staff team supports residents. EVIDENCE: Staff were observed interacting with residents in a positive manner. One staff member established good eye contact and used touch to communicate with a resident who does not always respond well to verbal communication. One resident described staff as, “ pleasant, caring and joking”. Another, when asked what staff did, responded that, “they don’t do much work”. This demonstrated that staff support residents in a discrete manner, promoting their independence and self-confidence. It is one of the biggest compliments that could be given to a staff team. The staff team consist of the registered manager, two deputy managers (who work some shifts in the office) a number of full time and part-time support workers, a cook, and a part-time maintenance person. There is a minimum of two staff on duty at all times and this can rise to three or four staff. At the last inspection it was noted that at the weekend there is no cook and therefore staff take on this responsibility, which takes them away from their care duties. Since this time an additional member of staff has been recruited to work weekends and this has improved the quality of life for residents. During the night there is either one sleep-in staff and one waking night, or two waking night staff. Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 18 Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42 The quality of care provided by the service is regularly reviewed. The health, safety and welfare of residents are promoted and protected. EVIDENCE: The home uses various methods to gain the views of residents, staff and stakeholders about the quality of care provided at Greenbanks. The home receives monthly visits from the registered provider. Staff meetings and supervisions are held. The home’s policy states that there are shareholders meetings and an annual general meeting. Residents said that their views were sought and listened to during regular meetings. In addition residents had completed a quality service questionnaire. An inspection of records revealed that the maintenance of electrical installation and of fire-fighting equipment had been undertaken. Policies and procedures are in place to minimise the health and safety risks to residents and staff. Staff demonstrated that they knew how and when to record any accidents in the home. First aid boxes are well stocked. Records indicate that staff receive training in relation to fire, first aid, food hygiene, infection control and moving Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 20 and handling. Three staff have been trained to be moving and handling assessors for the staff team. Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 21 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 2 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 X 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 3 3 3 LIFESTYLES Standard No Score 11 3 12 4 13 3 14 4 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 2 X X X 3 X X 3 X Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 22 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. 1 Standard YA20 Regulation 13 (2) Requirement The registered person should ensure that: A record is made of the amount of all medications entering the home; All medications are clearly labelled with the name of the resident to whom it is prescribed and the dosage; Only homely remedies that have been agreed by the GP should be administered to residents; Any changes made to the MAR sheet should be signed and countersigned and this should include: - medications that are discontinued; entries made by hand; and changes made to the dosage of medication Timescale for action 25/02/06 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 Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 23 Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Greenbanks DS0000023427.V279546.R01.S.doc Version 5.1 Page 25 - 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. 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