Inspection on 09/08/06 for Greenfield Care Home

This inspection was carried out on 9th August 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Greenfield Care Home 09/08/07

Greenfield Care Home 24/10/05

Greenfield Care Home 18/07/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Greenfield Care Home 385/387 London Road Mitcham Surrey CR4 4BF Lead Inspector Jean Stuart Unannounced Inspection 9th August 2006 10:30 Greenfield Care Home DS0000061460.V307476.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 Greenfield Care Home DS0000061460.V307476.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. Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenfield Care Home Address 385/387 London Road Mitcham Surrey CR4 4BF 020 8687 3131 020 7431 8618 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) Greenfield Care Homes Ms Madrine Rugano-Wilson Care Home 9 Category(ies) of Learning disability (9), Physical disability (9) registration, with number of places Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th October 2005 Brief Description of the Service: London Road Lodge is a registered care home for nine residents with a learning disability. The home is on two floors of a detached property and is situated within a residential area of Mitcham. Parking is to the front of the home. Public transport bus services and the tramline are within a short distance of the home. The home currently has six residents. The fee range is £1100 to £1236. Greenfield Care Home DS0000061460.V307476.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 during late morning and afternoon, on 9 August 06. A brief tour of the premises took place and care documentation was inspected. Six service users and two members of staff were spoken to individually. The inspection took seven hours, the manager was present. This inspection demonstrated that the manager is improving the services offered at Greenfield residential home. What the service does well: 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. Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 Page 6 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 Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 Page 7 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): 1,2,3,4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents make a positive choice about the home. Needs are assessed. EVIDENCE: One resident with verbal skills asked me to see their bedroom. This individual said before moving in they “visited” and “I am happy here”. Another person with no speech enthusiastically led the way to their room. The prospective resident will have several visits before moving in. These are documented on the residents file. The representative of the prospective resident (generally a parent) will visit the home with the resident. The local authority with contributions from the resident, their family and professionals, has produced a user-friendly pictorial document. “The passport” documents individual’s social, emotional and physical needs. Using this assessment and discussions with the resident and their family, the home develops an individual service plan. This plan helps staff to individualise care. The provider is aware that the Statement of Purpose and the service users guide require improvement. These should be user friendly for service users. To make the best possible choice with regard to the home, the care provided Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 Page 8 by the home must be clearly stated in the home’s documentation. The provider is currently working on these improvements. Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 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 the following standard(s): 6,7,9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Staff knows residents needs, each service user has a care plan. They are recognised as individuals. EVIDENCE: A resident reported that they enjoyed “doing things” such as going to “the club”. The care plans for residents with limited or no speech indicate how they show enjoyment and displeasure. Pointers are given in the care plan, one individual “likes to be with people” another person “does not like noisy or busy places”. One resident likes to be active and is now walking with a member of staff to and from the day centre. Residents’ support needs and preferences are outlined in their care plan. This promotes the values of choice and independence documenting how people make their own choices concerning their lifestyle. Care plans for three residents showed that over time residents needs have changed. Indeed while at the home the way they express their emotions has Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 Page 10 become more moderate. Care plans are reviewed on a regular basis, and reflect changing needs. a good record of their daily life is maintained. Appropriate care is delivered. Risk assessments documenting the risk to the resident and action to reduce risk, are carried out for all aspects of a residents life. All moving and handling strategies are presented to the home on the admission of the service user. When transferring from a chair the needs of one resident had been discussed with a physiotherapist. The home must written confirmation from the physiotherapist outlining the correct procedure. Staff have moving and handling training to ensure they can meet residents’ needs. The risk management strategy must cover all aspects of a residents care and promote the individual’s wellbeing. Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 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): 12,13,1415,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are encouraged to make use of the community and to have appropriate personal relationships EVIDENCE: One resident reported that they “go to three day centres” and “meet different people”. Residents attend day care four days a week. Residents do not attend the day centre on a Thursday and spend the day at home. On a Thursday the daily report reflects regular visits by family members, an activity organiser, and a masseur. One resident chooses to go swimming with their brother. Another resident who went swimming with the day centre has stopped swimming, as it is no longer enjoyable. The daily report shows that one person goes out to a club, another individual likes to eat out. Going to church is important to one individual and others in the home. This is a regular feature of their week. Two churches are used (Catholic and Methodist), no one in the home has diverse cultural needs. All people are individuals. Outside of Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 Page 12 the working day routines are flexible and can be changed to meet individual needs. Outside of the working day routines are flexible and can be changed to meet individual needs. Staff were seen talking to and interacting with residents using the preferred form of address as highlighted in the care plan. Residents were able to go to their bedroom or into the garden as they wished A menu forms indicates the food served, but how it is served varies. To meet individual needs, potatoes were served as mashed or chipped potatoes, fish in very small pieces or whole. Staff were available to assist residents as required. The manager reported that no one has a cultural or religious requirement. Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 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): 18,19,20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents’ health needs are attended to, staff have accredited medication training. EVIDENCE: The staff team give residents the opportunity and support to remain independent. Support given is responsive,flexaiable and reliable. Staff were observed maintaining the privacy and dignity of service users, and personal care needs are appropriately met. Personal support is as far as possible provided by a person of the same gender. To prevent inequality due to physical needs technical aids and equipment is available to maximise residents’ independence. Service users health care needs are noted in “the passport” and care plan. The daily report demonstrates when they have received medical treatment. Service users receive medication from the staff of the home. The manager reported that discussions are ongoing with “Boots” about using blister packs for medication. Two staff reported that they had completed medication training. Files showed accredited medication training for staff had taken place, the Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 Page 14 manager confirmed this. Good medication practice protects the well being of residents. Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 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): 22,23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Adequate systems are in place to ensure residents’ rights are respected. Residents feel safe and confident in the service provided. EVIDENCE: Staff takes residents’ views seriously. A resident who had no verbal skills clearly demonstrated that they did not want to eat the meal and was offered an alternative. Another resident showed impatience when waiting for the meal service users, reassurance was given that the meal was about to be served. Some residents do not find it easy to verbalise their views, they show agreement or disagreement through body language. Staff reported that one resident clearly says when they do not want to do something. Another resident indicated that the conversation was acceptable, as their body language was relaxed. Since opening the home has received one complaint. A record was seen of the issues raised, actions taken, and outcome. The complaint procedure has been set out in makaton for residents. The family of one service user has written to praise the home for the good services given. This is a measure of the level of satisfaction felt by the residents, and their families. Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 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): 24,25,26,27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Greenfield provides a safe, and comfortable home for residents. EVIDENCE: One resident went to their bedroom and the bathroom to make the inspector aware that this was their room. Individual bedrooms provide comfortable homely accommodation for residents. Rooms were observed to be clean and free from offensive odour. There are two communal areas offering service users a choice of where to sit. The rooms are homely in appearance. There is a seating area outside in the garden. Facilities in the garden have improved, the walkway for disabled access is now around half the garden with a turning circle at the end. There are plans to flatten out the grassed area. The home offers access to local amenities, local transport and support services to suit service users personal and lifestyle needs. The home has six residents in total. Residents who use a wheelchair have single bedrooms to a suitable size for wheel chair users, with ensuite bathrooms. Bedrooms are personalised Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 Page 17 by the service users with the help of family and staff, making the rooms individual to the service user. Specialist equipment is provided in line with individual needs. . Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 Page 18 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): 32,34,35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents can have confidence in the staff that care for them are well trained. EVIDENCE: A service user reported that they “looked after”. Regular staff members ensure the needs of the individuals are known and are met. Residents relaxed when with staff. Staff are approachable and comfortable with residents. All staff have completed National Vocational Qualifications to improve the care they deliver. The one exception to this is a new member of staff who already has a start date for the course. One member of staff has completed their NVQ three . Three staff files were seen and showed that staff had completed NVQ training, food hygiene, first aid and other courses. Training and development is in line with the homes service, and the manager has enquired about training concerning epilepsy. Files sampled had the required documentation and included reference checks and forms returned from the Criminal Records Bureau (CRB). Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 Page 19 Staff must have regular supervision six times a year. This is not happening. and must commence. Ongoing supervision ensures that carers have the necessary skills to complete their work. . Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 Page 20 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): 37,39,42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The manager is resident focused. Her management skills are growing. EVIDENCE: The manager and the provider work continuously to improve services. The improvements can be seen but must cover all areas of service delivery. Residents receive care that is regularly reviewed. The manager has commenced with NVQ level four, the required qualification to run the home. She plans to complete this within the next six months. Records are well organised and routinely completed. The management process must ensure care documents are signed and dated. In June the manger sent out a letter to relatives asking their opinion of the service ,she is yet to receive any responses. The audit of the home must be further developed. Recorded supervision sessions are required. Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 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 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 2 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 x x 3 x Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 Page 22 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. 2. Standard YA1 YA9 Regulation 4(1) Schedule 1 13(5) Requirement The registered person must ensure that the statement of purpose meets the regulations. The registered person must ensure action concerning any identified risk is based on good information. The register person must ensure staff training meets the needs of residents. A course is required in epilepsy. The registered person must ensure regular supervision takes place and a supervision programme is drawn up. Timescale for action 31/10/06 30/09/06 3. YA35 18(1)(c) 30/11/06 4. YA36 18(2) 30/09/06 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 YA5 Good Practice Recommendations The registered person must ensure the service users’ guide is produced in a format suitable for people who live at the home. Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Greenfield Care Home DS0000061460.V307476.R01.S.doc Version 5.2 Page 24 - 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!