Inspection on 24/08/05 for Greenbanks

This inspection was carried out on 24th August 2005.

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

Greenbanks 31/01/07

Greenbanks 18/02/06

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 Announced 24/08/2005 at 9:30hrs 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 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 Stationary 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 H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Greenbanks Address Green Hills, Barham, Canterbury, Kent. CT4 6QB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01227 831731 Family Investments (One) Limited Mrs Roberta June George Care Home 19 Category(ies) of Learning Disability (19) registration, with number of places Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th December 2004 Brief Description of the Service: Greenbanks provides residential care for 19 adults with a learning disability. The detached property is situated 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, and the families of residents may 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 from Greenbanks. The home is sited on three floors. All residents have single rooms. The two rooms on the second floor are ensuite. On the first floor there is a shower room and bathroom, plus two toilets. 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, a day room, conservatory and dining room. The home is set within 7 1/2 acres of attractive grounds. Sufficient car parking space is provided. Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection commenced at 9.30am and concluded at 7.05pm. The majority of this time was spent talking with residents and staff. Three support staff, the cook and the maintenance person were interviewed. Time was spent in the office looking at records and speaking with the registered manager. The inspector also had the opportunity to talk to a relative who was visiting the home. One of the residents showed the inspector around their home and the inspector shared a meal with seven of the residents. What the service does well: What has improved since the last inspection? The registered manager has undertaken a review of the home’s policies and procedures and updated those concerning medicines, death of a service user, complaints, adult protection and the induction of staff. Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 Page 6 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. Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 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 standard(s) EVIDENCE: Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 Page 9 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 standard(s) 6, 7, 8 and 9 Staff understand the individual care needs of residents. Residents are enabled to make choices and are involved, as far as possible, in all aspects of life within the home EVIDENCE: Resident’s individual plans contain information about their personal history, contact details, health, mobility, eating, medication, literacy and numeracy and activities. The plans are detailed, well organised and easy to read. Staff said that they refer to these plans and are knowledgeable about their content. Residents spoken to were aware that they have an individual plan and the nature of the content. They also said that they were aware that staff write about them, and either know, or did not want to know the content of this information. Staff said that any changes identified by them are incorporated into these individual plans. 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. Staff, through discussion, gave examples of situations where they had offered residents choices. Choices can be limited due to the level of staffing in the home. If there is two staff on duty, then only the residents who can travel Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 Page 10 independently are able to access the community. The staff rota indicated that this is more likely to occur at weekends. Residents said that they have regular, recorded meetings where they come together to discuss their home life. One staff said that at these meetings residents put forward their views “without a doubt”. Residents are encouraged to take responsibility for their own monies. A risk assessment has recently been undertaken to ensure that residents who hold their own monies are able to do so safely. Clear records are kept of all financial transactions involving residents. Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 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 standard(s) 11, 12, 13, 14, 15, 16 and 17 The home values encouraging residents to do as much as they can for themselves to promote their self-esteem. The company, which owns the home, offers residents a wide range of work and leisure activities. The degree to which residents’ access community activities is dependent on staffing levels for those residents who cannot travel independently. EVIDENCE: Residents are allocated a day at home a week in order to undertake their share of the household tasks. During the inspection, residents were observed cooking, laying the table, cleaning their rooms and ironing. 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 tea shop. Some residents are able to travel independently by foot and public transport. One resident explained that they were catching the bus to Canterbury to watch a cricket match. Other residents require staff support and use the home’s own Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 Page 12 vehicle. They are reliant on the staffing levels in the home in order to access 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. Residents were particularly excited about the family day when they invite their family members to their home. Staff said that residents often have friends around for dinner. Residents explained that they keep in contact with friends and relatives by phone and are able to use the residents phone in private, with support from staff as needed. Many residents have a key to their bedroom and are responsible for its safekeeping. A cook is employed Monday to Friday and she is helped by the residents to prepare lunch and dinner. The storage of food was well organised and a variety of fresh vegetables were available, some of which are grown in the greenhouse. The menu was viewed and indicated that residents are offered a balanced diet. During the inspection the cook asked residents their choices for lunchtime. The inspector joined the residents and staff for lunch. The meal was relaxed, with jovial conversation. A relative said that the food was always excellent, and residents praised the cook for the food after the meal. Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 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 standard(s) 18, 20 and 21 The home has a sound system for the administration of medications. Staff are sensitive to the personal and emotional needs of residents. EVIDENCE: A relative said that staff attended to residents personal care needs discretely and that there was “no room for improvement” in this area. Selected aspects of the recording, administration, disposal and storage of medication was inspected and seen as in accordance with the homes policies and procedures. Staff demonstrated that they knew what to do if medication was refused or given in error. Residents who are able are encouraged to self medicate and are checked at regular intervals to ensure that they continue to have the capacity to do so. The home has a comprehensive policy on what to do in the event of the death of a resident. Funeral wishes are included in residents care plans. Staff demonstrated that they are sensitive to the needs of residents and one staff said that they are going to enhance these skills by attending a counselling course. Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 Page 14 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 standard(s) 22 and 23 Residents feel that their views are listened to and acted on. Staff’s ability to protect adults from abuse and neglect would be strengthened by undertaking a formal training programme. EVIDENCE: Residents said that they were able to approach any staff if they had a concern and that staff listened to them. Staff gave examples of when residents were upset and the action that they had taken. The manager, to meet the National Minimum Standards, has updated the home’s complaints procedure. To make the policy more meaningful to residents, she proposes to write it in a format more easily understood by the residents. This is an example of good practice undertaken in the home. The manager said that she discusses issues of adult protection with the staff and staff demonstrated that they would inform someone else if abuse were suspected. There is no formal training programme in adult protection and the manager agreed to address this with the whole staff team. The homes adult protection and physical intervention policy have been updated to meet the National Minimum Standards. Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 Page 15 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 standard(s) 24, 25, 26, 27, 28 and Greenbanks provides a homely and comfortable environment for the residents who live there. EVIDENCE: Greenbanks is a large, detached house surrounded by gardens and provides accommodation over three floors. It is in walking distance of the village and public transport. One of the residents was delighted to give a tour of his home. On the ground floor there are three communal areas, a conservatory, day room (which was in the process of being decorated by relatives) 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. Where rooms do not contain all of the items of furniture listed in the National Minimum Standards, residents have been consulted and their wishes recorded. There are four toilets and two baths, one containing a mermaid swivel seat, on the ground floor; four toilets and a shower and bath on the first floor; and two rooms that are en-suite on the second floor. The second floor accommodation feels separated from the rest of the home, giving the two residents who are accommodated their a feel of extra independence. Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 Page 16 The plans to convert two more rooms into en-suite have unfortunately been put on hold due to financial constraints. Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36 Staff are motivated and good at communicating with residents and each other. Staffing levels need to be reviewed in line with the care needs of the residents. Staff induction needs to be changed to meet the standard. The residents are protected by the home’s recruitment and selection procedure. EVIDENCE: An examination of personnel files showed that before an employee commences work at the home, a thorough recruitment and selection procedure is undertaken, including the necessary pre-employment checks. Staff are given a copy of their job description and were clearly able to describe the responsibilities of their role within the home. Staff demonstrated that they are motivated, with one describing their job as “wonderful”. The is a low level of absence due to sickness and the manager said that on these occasions staff often cover each others shifts. Staff said “residents are first” and that they are the “main priority”; “you have to listen…and they know that you are listening”. Indeed, during the inspection, staff listened carefully and responded to the residents. Regular staff meetings are held and staff confirmed that any issues raised were actioned. Staff described themselves as “a working team” and said that there was “very good communication” between themselves. Staff said that they received regular supervision, however, staff files viewed showed that staff supervision had not been recorded for very long periods. The Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 Page 18 manager agreed to record all supervision sessions in future. Staff receive an annual appraisal. New staff receive in-house induction training. The National Minimum Standards require that in addition staff be inducted to Sector Skills Council Specification. Staff said that they were encouraged to undertake training. The training matrix, detailing staff training for the whole team, indicates that some statutory training is now out of date. The manager confirmed that over 50 of the staff team have achieved NVQ level 2. The staff team consist of the registered manager, two deputy managers (who work some shifts in the office) nine full time and one part-time support worker, two full time and two part-time night support staff, 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 weekend there is no cook, therefore staff take on this responsibility, which takes them away from their care duties. When there is only two staff on duty, residents who need support are unable to leave the home and this limits their choices and opportunities. It is recommended that staffing levels be reviewed, particularly at the weekends, in respect of the level of care needs of the residents. During the night there are either one sleep-in staff and one waking night, or two waking night staff. The manager explained that this variation is to ensure there is sufficient night staff to cover all shifts during periods of annual leave and sickness and to help with the laundry of clothes. Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38 and 40 The residents and staff benefit from the clear management approach of the home. EVIDENCE: The registered manager has managed the home for many years and has completed her NVQ Care level 4 and Registered Managers Award. Residents and staff both said that the registered manager is approachable, encouraging and supportive. “I wouldn’t think twice about going to Robbie (registered manager) with a problem…she seems very fair with staff, residents and families”. Staff said that policies and procedures were accessible and that they endeavoured to read them whilst on shift. The registered manager, as part of the process of reviewing policies and procedures, is going to ask residents which policies they would like to be written in a format that they can more easily understand. This practice is commendable. Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Greenbanks Score 3 x 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x x x H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 Page 21 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 23 Regulation 13 Requirement The registered manager must commence staff training in adult proction, which includes an understanding of the Kent and Medway Adult Protection Policy The registered manager must ensure that staff receive structured induction training to Sector Skills Council Specificaiton The registered manager must ensure that staff whose moving and handling training is out of date, recieve additional training Timescale for action 24/2/06 2. 35 18 immediate 3. 35 13 24/2/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 7 Good Practice Recommendations The registered person should review staffing levels in relation to the needs of residents to ensure that residents needs are met at all times and that they have the opportunity to regularly access the community; and inform the Commission of the outcome of the review. The registered manager should keep a copy of notes taken during the interview process H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 Page 22 2. 34 Greenbanks 3. 4. 36 35 The registered manager should keep a record of all supervisions with staff The registered manager should ensure that training is linked to the Learning Disability Award Framework Greenbanks H56-H05 S23427 Greenbanks V236115 240805 stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 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. 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