Inspection on 22/12/05 for Greenfields

This inspection was carried out on 22nd December 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Greenfields 31/05/07

Greenfields 03/08/06

Greenfields 27/04/05

Greenfields 12/01/05

Greenfields 27/07/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Greenfields Derby Road Barnstaple Devon EX32 7EZ Lead Inspector Jo Walsh Unannounced Inspection 22nd December 2005 09:15 Greenfields DS0000039188.V262908.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 Greenfields DS0000039188.V262908.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. Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Greenfields Address Derby Road Barnstaple Devon EX32 7EZ 01271 343709 01271 329121 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) Devon County Council Paul William Jellicoe Care Home 11 Category(ies) of Learning disability (11), Physical disability (11), registration, with number Sensory impairment (11) of places Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Caters for young people and adults between the ages of 16 and 25 years Current service users over the age of 25 or under the age of 16 will be allowed to continue to use the service To admit one named person aged under 16 as detailed in the notice dated 5th August 2004 and one named person aged over 25 as detailed in the notice dated 10th September 2004 The maximum number of persons accommodated at the home, including the named young persons, will remain at 11. On the termination of the placement of either of the named young persons, the registered person will notify the Commission in writing and the particulars and conditions of this registration will revert to those held on the 26th July 2004 or as appropriate 27th April 2005 4. 5. Date of last inspection Brief Description of the Service: Greenfields provides planned respite care and accommodation for up to 11 young adults and some children with severe learning disabilities and physical or sensory impairment, aged 10 to 25 years (male and female), whose families live within North Devon and Torridge District Councils boundaries. Services are sometimes provided to young people and adults from outside these catchments areas. Some service users who reach the age of 25 years continue to use the service for a further 10 years. Usually the maximum number of children, young people and adults staying at the home at any one time is nine. However, in certain circumstances, up to 11 children, young people and adults are accommodated. Emergency admission for unplanned respite is provided, for those service users already using the facility for planned respite care. The home has nine bedrooms. Only children aged less than 16 years share bedrooms. The home also provides day care for young adults, Mondays to Fridays, 9 am to 4 pm with various activities on offer. Greenfields is owned and managed by Devon County Council Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection meaning the home were not given prior notice the inspection was to take place. The inspection took place during a weekday in December and lasted for 4.5 hours. The main focus of this inspection was to observe how staff interacted with service users and to talk to those who are able to communicate verbally about the care and support they receive. Some key documents were viewed as part of the inspection process as well as previous reports and the pre inspection questionnaire that had been completed by the home. Staff were also asked for their views about the home as well as one carer. The home were asked to request service users and their carers to complete feed back cards. These were reviewed as part of the inspection process. What the service does well: What has improved since the last inspection? Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 Page 6 Service Users care plans now have more detail and those viewed were comprehensive, which enables staff to understand the care and support needs of individuals. 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. Greenfields DS0000039188.V262908.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 Greenfields DS0000039188.V262908.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): 2 Comprehensive assessments are now completed to ensure staff are enabled to meet individuals needs. EVIDENCE: A sample of three care plans were viewed during this inspection, including the newest service user admitted. The home ensures that the care management assessment and care plan are obtained and then complete an assessment of the individuals needs. Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 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 Individual plans clearly identify personal health care needs as well as what the individual likes to do and their dislikes. This information assists staff to help plan for providing care and social activities suitable and appropriate to needs and wishes. EVIDENCE: A sample of three plans were viewed and document that individuals needs are assessed and this is incorporated into the care plan detail. The plans should be reviewed on a six monthly basis, currently this is annually. The home uses a pro forma of daily recording for each individual, and this is used to record all activities undertaken as well as observations about the individuals moods and emotional well being. Personal and environmental risk assessments were present and seen to be reviewed regularly. Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 Page 10 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): 12,14,17 The home offers a good range of activities and staffing levels suitable to enable all service users to take part meaningfully in activities and accessing the local community. Meals provided are well balanced and provided a wide variety and choice for service users. EVIDENCE: The home has a wide and varied range of facilities for life skills activities and stimulation. These facilities are used for residents on a daily basis. Choice is limited due to the resident’s limited communication but staff talked of varying the activities daily. Records in care plans did not reflect variety of activity or if the activity had been resident’s choice. Residents are daily enabled to attend the local school or college or to participate in peer activities. Staff were observed communicating with residents in their preferred way and giving choice and responsibility where able. Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 Page 11 Menu plans were looked at and one of the service users stated that they really enjoyed all the meal choices and that there was plenty of it. The mid day meal was observed being served and service users assisted in a relaxed and respectful manner. Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 Page 12 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): 20 Robust procedures are in place for the safe handling and administering of medications. EVIDENCE: Although standard 18 was not fully assessed, comments from one carer stated that personal support was not always delivered in a way that they preferred. This comment was discussed with the manager and it has been agreed that regular meetings with the carer would be useful to ensure that identified care plan goals are met consistently. The medication system and records were viewed with the senior carer and found to be well documented, medications appropriately and securely stored. Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 Page 13 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): 23 The home has good systems in place to protect service users from abuse, neglect and self-harm. EVIDENCE: Staff have training in abuse, have good policies and procedures in place, and since the last inspection have had some training in dealing with behaviour that challenges. There are robust procedures in place for handling service users monies, which was viewed and checked during this inspection. Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 Page 14 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): 24,30 The home is suitable for its stated purpose, is well maintained and provides a homely safe environment for service users. EVIDENCE: As part of the inspection process a tour of the building was completed with a carer and one of the service users. DCC have a maintenance programme and all areas were found to be wellmaintained and previous requirements met, i.e. the macerator had been repaired and more suitable arrangements had been made for the collection of clinical waste. The home was clean and free form odour and there are policies and procedures in place to ensure prevention of infection or cross contamination. Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 Page 15 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): 32,34,36 An effective, competent and experienced staff team supports residents. The recruitment procedures are now more robust and protect the Service Users. Staff are effectively trained and supported to complete their role and ensure good care is given to service users. EVIDENCE: Staff spoken to confirmed they had regular training in all key areas and some staff are completing LDAF training and most are doing NVQ training. Records are kept to evidence that staff have regular supervision and staff spoken to state they were supported and supervised. Two staff files were viewed to ensure that appropriate checks are now being competed and files contain all relevant documentation as stated in the schedules of the regulations. One area of good practice that was observed during the inspection is that staff have a task list for each shift so it is made clear what tasks and responsibilities they have for that particular shift. Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 Page 16 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): 39,42 The home does not currently evidence that full consultation and engagement takes place with service users and/or their carers. Good procedures and policies are in place to ensure the safety and welfare of service users. EVIDENCE: Although standard 39 was not fully inspected, one carer stated that they did not feel consulted at times and would welcome being part of a quality assurance programme within the home. Staff spoken to state that the policies and procedures are clear and training is given in all key areas to ensure they are able to work in a safe manner. Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 Page 17 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 X 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X X X 2 X X 3 X Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 Page 18 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 YA6 YA39 Regulation 15 24 Requirement Timescale for action 30/03/06 The home must ensure that care plans are reviewed at least 6 monthly. The home must ensure it reviews 30/07/06 the quality of care seeking the views of the service users and their representatives. 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. 2. 3. Refer to Standard YA2 YA19 YA41 Good Practice Recommendations The maintaining of full clear records of assessment of needs from which the care plan can be formulated on admission. The provision of training to enable staff to recognise and meet the psychological and emotional needs of residents To keep full, clear and timely records of all incidents and the way in which they have been handled Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Greenfields DS0000039188.V262908.R01.S.doc Version 5.1 Page 20 - 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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